Bone markers in polycystic ovary syndrome: A multicentre study

Lingaiah, Shilpa; Morin‐Papunen, Laure; Piltonen, Terhi; Puurunen, Johanna; Sundström‐Poromaa, Inger; Stener-Victorin, Elisabet; Bloigu, Risto; Risteli, Juha; Tapanainen, Juha S.

doi:10.1111/cen.13456

Cited by 18 publications

(17 citation statements)

References 35 publications

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“…The important prohormone 25OHD influences BMD by regulating calcium metabolism, but 25OHD per se may not have any significant influence on BTMs (37). Even though 25OHD levels showed an increasing trend in non-obese and obese subjects in both treatment groups, significant increases were observed only in the non-obese subjects treated with metformin and obese subjects treated with placebo.…”

Section: Tablementioning

confidence: 88%

Metformin decreases bone turnover markers in polycystic ovary syndrome: a post hoc study

Lingaiah

Morin‐Papunen

Risteli

et al. 2019

Fertility and Sterility

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Objective: To study the effects of metformin treatment on bone turnover in women with polycystic ovary syndrome (PCOS), as measured by serum concentrations of bone turnover markers. Design: Post hoc study of a previously conducted prospective multicenter, placebo-controlled, randomized study. Setting: University clinic. Patient(s): The study cohort consisted of 74 non-obese women (body mass index < 27 kg/m 2) and 44 obese women (body mass index R 27 kg/m 2) diagnosed with PCOS, with a mean age of 27.6 AE 4.0 (SD) years. Intervention(s): Randomization to receive metformin or placebo for 3 months. Main Outcome Measure(s): Serum levels of bone formation marker procollagen type I amino-terminal propeptide (PINP) and bone resorption marker carboxy-terminal cross-linking telopeptide of type I collagen (CTX) at baseline and after metformin/placebo treatment. Result(s): Serum levels of PINP and CTX were similar between the metformin and placebo groups at baseline in the whole study population. Obese women, when compared with non-obese, had lower baseline levels of PINP and CTX. Levels of PINP and CTX were significantly reduced in the whole study population, as well as in both non-obese and obese women after 3 months of metformin treatment, whereas no significant changes were observed in the placebo group. Conclusion(s): Metformin treatment, when compared with placebo, was associated with reduced bone turnover, as suggested by reductions in markers of bone formation and resorption, leading to slower bone remodeling in premenopausal women with PCOS. Clinical Trial Registration Number: NCT00994812.

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Section: Tablementioning

confidence: 88%

Metformin decreases bone turnover markers in polycystic ovary syndrome: a post hoc study

Lingaiah

Morin‐Papunen

Risteli

et al. 2019

Fertility and Sterility

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“…Hyperandrogenism and hyperinsulinemia, well-recognized characteristics of PCOS, may influence bone mineral density and biochemical markers of bone turnover. Bone formation markers were found to be decreased in younger PCOS patients compared with healthy controls [66]. It has also been reported that metformin and sulfonylureas may have a neutral or positive effect on bone health [67,68].…”

Section: Discussionmentioning

confidence: 99%

Lean Women on Metformin and Oral Contraceptives for Polycystic Ovary Syndrome Demonstrate a Dehydrated Osteosarcopenic Phenotype: A Pilot Study

et al. 2019

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Scarce data exist on the body composition of lean women with polycystic ovary syndrome (PCOS) on treatment with metformin and oral contraceptives (OCs). Thirty-four lean (body mass index 18.5–24.9 kg/m2) women (17 with PCOS on metformin and OCs treatment for six months and 17 controls) aged 18–40 years were assessed for body composition parameters (fat, muscle, glycogen, protein masses, bone masses, and body water compartments) and phase angles. PCOS patients demonstrated lower muscle, glycogen and protein masses (U = 60, p = 0.003), along with a lower bone mineral content and mass (U = 78, p = 0.021; U = 74, p = 0.014) than their healthy counterparts, while total and abdominal fat masses were similar between the two groups. PCOS patients also exhibited increased extracellular body water (U = 10, p < 0.001) and decreased intracellular water, compatible with low-grade inflammation and cellular dehydration. Key differences in body composition between women with PCOS and controls demonstrated an osteosarcopenic body composition phenotype in PCOS patients. A confirmation of these findings in larger studies may render osteosarcopenia management a targeted adjunct therapy in women with PCOS.

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“…Moreover, different OC levels in subjects with PCOS are supposed to be responsible for the heterogeneity of this syndrome [163]. Contrastingly, a multicentric study, that evaluated 298 women with PCOS and 194 healthy controls, reported that OC levels were decreased in PCOS patients compared with controls [164]. Taking into account the precursor of osteocalcin, the undercarboxylated form, a study reported its regulatory role in energy metabolism by promoting insulin release and increase of adiponectin production [165].…”

Section: Other Implications Due To Oxidative Stressmentioning

confidence: 99%

Oxidative Stress and Low-Grade Inflammation in Polycystic Ovary Syndrome: Controversies and New Insights

Mancini

Bruno

Vergani

et al. 2021

IJMS

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The pathophysiology of Polycystic Ovary Syndrome (PCOS) is quite complex and different mechanisms could contribute to hyperandrogenism and anovulation, which are the main features of the syndrome. Obesity and insulin-resistance are claimed as the principal factors contributing to the clinical presentation; in normal weight PCOS either, increased visceral adipose tissue has been described. However, their role is still debated, as debated are the biochemical markers linked to obesity per se. Oxidative stress (OS) and low-grade inflammation (LGI) have recently been a matter of researcher attention; they can influence each other in a reciprocal vicious cycle. In this review, we summarize the main mechanism of radical generation and the link with LGI. Furthermore, we discuss papers in favor or against the role of obesity as the first pathogenetic factor, and show how OS itself, on the contrary, can induce obesity and insulin resistance; in particular, the role of GH-IGF-1 axis is highlighted. Finally, the possible consequences on vitamin D synthesis and activation on the immune system are briefly discussed. This review intends to underline the key role of oxidative stress and low-grade inflammation in the physiopathology of PCOS, they can cause or worsen obesity, insulin-resistance, vitamin D deficiency, and immune dyscrasia, suggesting an inverse interaction to what is usually considered.

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Bone markers in polycystic ovary syndrome: A multicentre study

Abstract: Bone formation markers were decreased in younger women with PCOS when compared with healthy women, which may affect bone mass in these women.

Cited by 18 publications

References 35 publications

Metformin decreases bone turnover markers in polycystic ovary syndrome: a post hoc study

Metformin decreases bone turnover markers in polycystic ovary syndrome: a post hoc study

Lean Women on Metformin and Oral Contraceptives for Polycystic Ovary Syndrome Demonstrate a Dehydrated Osteosarcopenic Phenotype: A Pilot Study

Oxidative Stress and Low-Grade Inflammation in Polycystic Ovary Syndrome: Controversies and New Insights

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