Abstract:Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS.The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health.PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy-related risk profile should ideall… Show more
“…Moreover, the solubility of alkaloids like piperine in ethanol may contribute to the association with alcohol intake. It is worth noting that a previous study by M. Bahri Khomami et al also reported a positive association between liquor intake and an increased risk of PCOS [39]. Considering these ndings, it is possible that PCOS patients may consume more alcohol, leading to a higher intake of piperine.…”
Objective
Polycystic ovarian syndrome (PCOS) is a common reproductive disorder that affects a considerable number of women worldwide. However, previous studies investigating the connection between metabolites and PCOS have produced conflicting results. The aim of this study was to explore the potential relationship between PCOS and metabolites using genetic polymorphisms.
Methods
We utilized a comprehensive two-sample Mendelian randomization (MR) analysis to examine the causal link between 1352 metabolites and PCOS. We employed complementary MR methods, such as the inverse-variance weighted (IVW) method, and conducted sensitivity analyses to evaluate the reliability of the outcomes. Reverse MR analysis was performed to evaluate the possibility of reverse causation.
Results
Five metabolites were identified to be significantly associated with PCOS risk: Methionine sulfoxide levels (IVW: OR [95%]: 1.549[1.274 to 1.883], p = 1.154E-5), Theophylline levels (IVW: OR [95%]: 0.725[0.589 to 0.890], p = 0.002), 4-hydroxycoumarin levels (IVW: OR [95%]: 0.786[0.658 to 0.940], p = 0.008), Tyramine O-sulfate levels (IVW: OR [95%]: 0.699[0.568 to 0.862], p = 0.0008), and Sulfate of piperine metabolite C16H19NO3 (3) levels (IVW: OR [95%]: 1.296[1.064 to 1.579], p = 0.009). We found PCOS was suggestively associated with decreased Tyramine O-sulfate levels using IVW method (OR [95%]: 0.953[0.917 to 0.991], p = 0.015) in the reverse MR analysis. The results of the sensitivity analyses were consistent with the main findings.
Conclusion
Our MR analysis provides strong evidence supporting a causal association between metabolites and the susceptibility of PCOS.
“…Moreover, the solubility of alkaloids like piperine in ethanol may contribute to the association with alcohol intake. It is worth noting that a previous study by M. Bahri Khomami et al also reported a positive association between liquor intake and an increased risk of PCOS [39]. Considering these ndings, it is possible that PCOS patients may consume more alcohol, leading to a higher intake of piperine.…”
Objective
Polycystic ovarian syndrome (PCOS) is a common reproductive disorder that affects a considerable number of women worldwide. However, previous studies investigating the connection between metabolites and PCOS have produced conflicting results. The aim of this study was to explore the potential relationship between PCOS and metabolites using genetic polymorphisms.
Methods
We utilized a comprehensive two-sample Mendelian randomization (MR) analysis to examine the causal link between 1352 metabolites and PCOS. We employed complementary MR methods, such as the inverse-variance weighted (IVW) method, and conducted sensitivity analyses to evaluate the reliability of the outcomes. Reverse MR analysis was performed to evaluate the possibility of reverse causation.
Results
Five metabolites were identified to be significantly associated with PCOS risk: Methionine sulfoxide levels (IVW: OR [95%]: 1.549[1.274 to 1.883], p = 1.154E-5), Theophylline levels (IVW: OR [95%]: 0.725[0.589 to 0.890], p = 0.002), 4-hydroxycoumarin levels (IVW: OR [95%]: 0.786[0.658 to 0.940], p = 0.008), Tyramine O-sulfate levels (IVW: OR [95%]: 0.699[0.568 to 0.862], p = 0.0008), and Sulfate of piperine metabolite C16H19NO3 (3) levels (IVW: OR [95%]: 1.296[1.064 to 1.579], p = 0.009). We found PCOS was suggestively associated with decreased Tyramine O-sulfate levels using IVW method (OR [95%]: 0.953[0.917 to 0.991], p = 0.015) in the reverse MR analysis. The results of the sensitivity analyses were consistent with the main findings.
Conclusion
Our MR analysis provides strong evidence supporting a causal association between metabolites and the susceptibility of PCOS.
“…The inclusion criteria were as follows: (1) studies that measured IGFBP-1 and insulin levels in PCOS and non-PCOS women; (2) studies that compared IGFBP-1 and insulin levels among different weight women with or without PCOS; or (3) studies written in English. Diagnostic criteria for PCOS are shown in Table 1.…”
BackgroundInsulin-like growth factor binding protein-1 (IGFBP-1) is considered a decline in polycystic ovary syndrome (PCOS), but it remains controversial that whether such reduction is attributed to obesity.AimsThis systematic review aims to explore whether IGFBP-1 is reduced in PCOS, and whether such reduction is associated with obesity.ResultsOur pooled study included 12 studies with a total of 450 participants. IGFBP-1 levels in PCOS were significantly lower than that in non-PCOS (SMD (95%CI)=-0.49(-0.89, -0.09), P=0.02). No significant difference in IGFBP-1 levels between patients with or without PCOS classified by BMI. Whilst, stratification by PCOS status revealed a significant decrease in IGFBP-1 in overweight (SMD (95%CI)=-0.92(-1.46, -0.37), P=0.001). When comparing fasting insulin in the same way, PCOS patients had significantly elevated fasting insulin level but not statistically declined IGFBP-1 after classified by BMI.ConclusionThis meta-analysis provides evidence that the decrease of IGFBP-1 in PCOS was more strongly influenced by comorbid obesity than by PCOS itself. Additionally, contrast to previous findings that insulin significantly suppresses IGFBP-1, our results suggested that the suppression of PCOS-related hyperinsulinemia on IGFBP-1 seemed diminished. Overall, our work may provide a novel perspective on the mechanism between insulin and IGFBP-1 underlying PCOS development.
“…Another study by Sha et al [ 41 ], in a meta-analysis of pregnancy-related outcomes and complications in women with polycystic ovary syndrome undergoing IVF found that women with PCOS had higher risks of miscarriage (OR 1.41); however, the authors concluded by stating that they were unable to perform a further analysis to evaluate the influence of phenotypic variants of PCOS on the prevalence of pregnancy and neonatal complications. Finally, an expert opinion piece published in 2022 on the association between PCOS and miscarriage stated that women with PCOS are at increased risk for ectopic pregnancy, hydatidiform molar pregnancy, and miscarriage, mainly following fertility treatments, but that given that fertility treatments are known risk factors for the outcomes, it is hard to disentangle the association of PCOS per se with these adverse outcomes [ 42 ].…”
Section: Spontaneous Miscarriagementioning
confidence: 99%
“…This controversy about the role of possible confounding factors in the risk between GDM and PCOS unfortunately therefore remains, with a recent expert opinion [ 42 ] concluding that the higher risk of GDM was independent of, yet exacerbated by, obesity in PCOS related to insulin resistance, in contrast to three relatively recent publications including two meta-analyses and a Danish prospective study which all [ 56 , 57 , 58 ] concluded that PCOS may not be an individual risk factor for GDM as pregnancies in PCOS are characterized by factors known to increase the risk of GDM, especially high BMI and fertility treatment.…”
Polycystic ovary syndrome (PCOS) is a prevalent condition that not only has the potential to impede conception but also represents the most common endocrine dysfunction in fertile women. It is considered a heterogeneous and multifaceted disorder, with multiple reproductive and metabolic phenotypes which differently affect the early- and long-term syndrome’s risks. Undoubtedly, the impact of PCOS on infertility has attracted most of the attention of healthcare providers and investigators. However, there is growing evidence that even after conception is achieved, PCOS predisposes the parturient to several adverse pregnancy outcomes including a high risk of pregnancy-induced hypertension, spontaneous abortion, gestational diabetes, preeclampsia, and preterm birth, which increase the risks of stillbirth and neonatal death. Fetal growth abnormalities may also be more common, but the relationship is less well defined. This narrative review aims to summarize current knowledge regarding these conditions as they interplay with PCOS and concludes that although there appears to be an increase in these complications during the pregnancy of women with PCOS, there is a need for further research to clarify the possible confounding impact of obesity. Implications for clinical practice and future research are outlined.
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