Increased Body Iron Stores of Obese Women With Polycystic Ovary Syndrome Are a Consequence of Insulin Resistance and Hyperinsulinism and Are Not a Result of Reduced Menstrual Losses

Luque‐Ramírez, Manuel; Álvarez‐Blasco, Francisco; Botella-Carretero, José I.; Sanchón, Raúl; Millán, José L. San; Escobar-Morreale, Héctor F.

doi:10.2337/dc07-0642

Cited by 79 publications

(61 citation statements)

References 32 publications

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“…Polycystic ovary syndrome is not only a gynecological condition affecting reproductive age women, but also a syndrome comprehensive with a variety of metabolic disorders associated commonly with PCOS [21]. The present result was demonstrate that G1and G2 patients have significant elevation of BMI, and no significant difference in G3and G4 patients as compared with normal healthy group Table (1).…”

Section: Discussionsupporting

confidence: 63%

“…Transferrin saturation percent (%TS) was significantly elevated patients of G1, G2, G3, and G4 as compared with control. The fact that high intake of dietary iron and obesity may facilitate the intestinal absorption caused deposition of iron tissue [21,36]. Transferrin concentration and serum total iron binding capacity were significantly decreased in G1 patients of PCOS and increased in groups G2, G3 and G4 in compared with normal healthy groups, this explained due erythropoietin which has been effected by hyperandrogenemia, that is widely known as a critical component of PCOS.…”

Section: Discussionmentioning

confidence: 67%

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Effect of Polycystic Ovary Syndrome and Hormones Disorder on Enzymes Gammaglutamyl Transferase, Oxaloacetic Transaminase, and Proteins

Saleem

2017

JNUS

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Polycystic ovary syndrome (PCOS) is complex metabolic disorder of endocrine gland in women of reproductive age. The present work illustrate the effect of (PCOS) and hormone disturbance on serum enzymes activities, iron status parameters and hormone profile in patient women suffering from, PCOS, acute kidney disease (AKD) with PCOS, acute kidney disease and iron deficiency anemia (IDA). A total of 160 women, include 135 patients and 25 of control apparently healthy group, patients were subdivided into four groups,(G1) consisted of 50 patients of PCOS, (G2) of 30 patients of PCOS with AKD, (G3) of 30 patient of AKD and (G4) involve 25 patients of IDA. The specimens were collected from different hospital in Baghdad city. The patients and control were investigated for enzymes, gammglutamyltrasferase (GGT), glutamic oxaloacetic transaminase (GOT) or aspartate transaminase (AST) & glutamicpyruvic transaminase (GPT) or alanine transaminase (ALT) lactate dehydrogenase (LDH), total serum proteins (TSP), albumin, globulin, total cholesterol (TC), triglyceride (TG), urea, creatinine and uric acid. Also iron status parameters (serum iron, transferrin saturation percent (TS%), transferrin concentration, and total iron binding capacity (TIBC) and ferritin concentration) were estimated. As well as hormone profile (testosterone (TT), Follicle stimulating hormone (FSH), lutinizing hormone (LH), prolactin (PL), estradiol (E), and progesterone (PRG)) were estimated Results revels highly significant increases for AST or GOT, ALT or GPT, and GGT activities P˂0.001, and a change in LDH of G1 and G2 patients were highly increased P˂0.001 as compared with normal. Remarkable rising was detected in TSP of (G1) patient while there is significant decrease in proteins level of (G2) patients in comparison with normal. Patients of (G3) show significant difference in GGT, LDH and protein.There is significant change in LDH and albumin in (G4), and no change in AST, ALT, GGT, and proteins as compared with normal. Triglyceride (TG), total cholesterol (TC), creatinine show very highly significant change for patients of (G1, G2, G3&G4). Patients women with PCOS show no remarkable change in uric acid and urea and a change in creatinine concentration. Serum iron parameters were changed significantly in patients of (G1, G2, G3, and G4) in comparison with healthy control groups. Hormones levels were significantly different in PCOS patients as compared with normal individual. In conclusion there were remarkable changes in the activities of AST, ALT, GGT, and LDH. This is the first time for the estimation of a change in LDH activity in women with (PCOS) this could be due to genetic and envirmental factor and gene mutation. Hormone levels and iron status parameter changed remarkably may be due to metabolic disturbance and abnormality in the function of hypothalamic neurotransmitter.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 67%

Effect of Polycystic Ovary Syndrome and Hormones Disorder on Enzymes Gammaglutamyl Transferase, Oxaloacetic Transaminase, and Proteins

Saleem

2017

JNUS

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“…However, although Diane 35 Diario is still considered a safe drug for the treatment of PCOS (34) and it has been suggested that the risk of thrombotic events in women taking oral contraceptives containing ethinyl-estradiol plus cyproterone acetate (the components of Diane 35 Diario) does not appear to be higher than that observed with other third generation oral contraceptive pills, this issue is still a matter of debate (35). Therefore, although the overall effect of oral contraceptives on the classic and nonclassic cardiovascular risk markers associated with PCOS is beneficial in our experience (3,(15)(16)(17)(18), it must be noted that others have reported an undesirable impact of contraceptive pills on the cardiovascular risk profile of these women (36)(37)(38). Diario, whereas white circles represent the data from the PCOS women on metformin.…”

Section: Discussionmentioning

confidence: 70%

“…Despite the beneficial impact of metformin on some aspects of the cardiovascular risk profile of PCOS women (15,16), metformin might reduce vitamin B 12 absorption thereby increasing homocysteine levels (39). Considering that homocysteine increases the rate of synthesis of tissue factor, which in turn activates the extrinsic coagulation pathway (27), the finding of an increase in plasma homocysteine concentrations during treatment with metformin suggests that this mechanism may contribute to the parallel changes in prothrombin time and activity observed in our patients.…”

Section: Discussionmentioning

confidence: 70%

“…During the past year, we have reported the results of an ample randomized controlled clinical trial (clinicaltrials.gov; NLM Identifier NCT00428311) addressing the effects of an antiandrogenic oral contraceptive pill compared with the insulin sensitizer metformin on a series of classic and non-classic cardiovascular risk factors (3,(15)(16)(17)(18). In the present extended report of the aforementioned clinical trial, we show that both oral contraceptives and metformin might exert a detrimental effect on the blood coagulation tests of our young PCOS patients, whereas these drugs have no apparent major impact on their endothelial function.…”

Section: Introductionmentioning

confidence: 99%

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Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking

Luque‐Ramírez

Mendieta-Azcona²,

Sánchez³

et al. 2009

European Journal of Endocrinology

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Objective: To study the blood clotting tests and endothelial function of polycystic ovary syndrome (PCOS) patients and non-hyperandrogenic women, and their changes during PCOS treatment, as a function of the presence of obesity and smoking. Design: Case-control study followed by a randomized clinical trial. Methods: Blood clotting and endothelial function were analyzed in 40 PCOS patients and 20 nonhyperandrogenic women. Thirty-four PCOS women were randomized to an oral contraceptive containing 35 mg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane 35 Diario) or metformin (850 mg twice daily), monitoring the changes on these parameters during 24 weeks of treatment. The influence of obesity and smoking was also analyzed. Results: Blood clotting and endothelial function tests were similar among PCOS patients and controls with the exception of a higher platelet count in the former. Obesity increased circulating fibrinogen levels, prothrombin activity and platelet counts, and reduced prothrombin and activated partial thromboplastin times. Smoking increased fibrinogen levels, platelet counts, and prothrombin activity, and reduced prothrombin time, in relation to the larger waist circumference of smokers. Irrespective of the treatment received, PCOS patients showed a decrease in prothrombin time and an increase in prothrombin activity, with a parallel increase in homocysteine levels in metformin users. The activated partial thromboplastin time decreased markedly in the patients treated with Diane 35 Diario. Finally, flow-mediated dilation improved in non-smokers irrespective of the drug received, but worsened in smokers. Conclusions: Oral contraceptives and metformin may exert deleterious effects on blood clotting tests of PCOS women, yet the effects of metformin appear to be milder. Because smoking potentiates some of these effects and deteriorates endothelial function, smoking cessation should be promoted in PCOS patients.

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Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome

Fraison

Kostova

Moran

et al. 2020

Cochrane Database of Systematic Reviews

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Increased Body Iron Stores of Obese Women With Polycystic Ovary Syndrome Are a Consequence of Insulin Resistance and Hyperinsulinism and Are Not a Result of Reduced Menstrual Losses

Cited by 79 publications

References 32 publications

Effect of Polycystic Ovary Syndrome and Hormones Disorder on Enzymes Gammaglutamyl Transferase, Oxaloacetic Transaminase, and Proteins

Effect of Polycystic Ovary Syndrome and Hormones Disorder on Enzymes Gammaglutamyl Transferase, Oxaloacetic Transaminase, and Proteins

Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking

Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome

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