Analysis of serum homocysteine concentration in patients less than 35 years of age with polycystic ovary syndrome and hyperandrogenism
, 2, 3, 1, 1, 4
Abstract
Objectives: An increase in homocysteine (Hcy) concentration is closely related to polycystic ovary syndrome (PCOS). This study aimed to further explore serum homocysteine concentration and its influencing factors in clinically young (≤ 35 years) patients with PCOS and hyperandrogenism.
Material and methods: An electrochemical immunoassay was used to investigate the changes in serum homocysteine and related indexes in clinically young patients with PCOS and hyperandrogenism, and the results were statistically analyzed.
Results: Serum homocysteine concentration in clinically young patients with PCOS and hyperandrogenism (n = 208) was found to be significantly higher than in the control group (n = 663) (15.21 } 9.99 vs 12.56 } 7.20 μmol/L, p < 0.0001), and the total testosterone concentration (1.65 } 0.68 ng/mL) was higher in the PCOS group than in the control group (1.52 } 0.58 ng/mL), p = 0.007. The receiver operating characteristic curve showed that the area under the curve of homocysteine in predicting PCOS was 0.606, and the 95% confidence interval (CI) was 0.563–0.650 (p < 0.001). The homocysteine concentrations of the two groups were graded, and it was found that the percentage of patients with homocysteine levels > 15 μmol/L was 26.92% in the PCOS group and 19.15% in the control group; the difference between the two groups was statistically significant (p = 0.0143). The serum homocysteine levels of the two groups were higher in obese patients than in non-obese patients (normal weight vs overweight), and the difference in the control group was statistically significant.
Conclusions: Serum homocysteine concentration in clinically young patients with PCOS and hyperandrogenism is elevated, so hyperhomocysteinemia can be used as one of the potential indicators of PCOS. In the process of the diagnosis and treatment of patients with PCOS, serum homocysteine concentration and body weight should both be considered.
Keywords: polycystic ovary syndromehyperandrogenemiahomocysteinehyperhomocysteinemia
References
- Sung YA, Oh JY, Chung H, et al. Hyperandrogenemia is implicated in both the metabolic and reproductive morbidities of polycystic ovary syndrome. Fertil Steril. 2014; 101(3): 840–845.
- Ibáñez L, Oberfield SE, Witchel S, et al. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Horm Res Paediatr. 2017; 88(6): 371–395.
- Herkiloglu D, Gokce S. Correlation of monocyte/HDL ratio (MHR) with inflammatory parameters in obese patients diagnosed with polycystic ovary syndrome. Ginekol Pol. 2021; 92(8): 537–543.
- Franik G, Plinta R, Madej P, et al. Circulating vaspin levels and nutritional status and insulin resistance in polycystic ovary syndrome. Ginekol Pol. 2020; 91(5): 251–255.
- Hemati T, Moghadami-Tabrizi N, Davari-Tanha F, et al. High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome. Iran J Reprod Med. 2011; 9(3): 223–228.
- Meng Y, Chen X, Peng Z, et al. Association between High Serum Homocysteine Levels and Biochemical Characteristics in Women with Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis. PLoS One. 2016; 11(6): e0157389.
- Cerqueira JM, Costa LO, Nogueira Ad, et al. [Homocysteinemia in polycystic ovary syndrome women]. Rev Bras Ginecol Obstet. 2010; 32(3): 126–132.
- Vrbíková J, Bicíková M, Tallová J, et al. Homocysteine and steroids levels in metformin treated women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes. 2002; 110(2): 74–76.
- Tehrani FR, Rashidi H, Khomami MB, et al. The prevalence of metabolic disorders in various phenotypes of polycystic ovary syndrome: a community based study in Southwest of Iran. Reprod Biol Endocrinol. 2014; 12: 89.
- Zeng X, Xie YJ, Liu YT, et al. Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity. Clin Chim Acta. 2020; 502: 214–221.
- Escobar-Morreale HF. The Role of Androgen Excess in Metabolic Dysfunction in Women : Androgen Excess and Female Metabolic Dysfunction. Adv Exp Med Biol. 2017; 1043: 597–608.
- HASHIMOTO T, SHINOHARA Y, HASEGAWA H. Homocysteine Metabolism. YAKUGAKU ZASSHI. 2007; 127(10): 1579–1592.
- Malinow MR, Bostom AG, Krauss RM. Homocyst(e)ine, diet, and cardiovascular diseases: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation. 1999; 99(1): 178–182.
- Belcastro V, Striano P. Antiepileptic drugs, hyperhomocysteinemia and B-vitamins supplementation in patients with epilepsy. Epilepsy Res. 2012; 102(1-2): 1–7.
- Maleedhu P, M V, S S B S, et al. Status of Homocysteine in Polycystic Ovary Syndrome (PCOS). J Clin Diagn Res. 2014; 8(2): 31–33.
- Elci E, Kaya C, Cim N, et al. Evaluation of cardiac risk marker levels in obese and non-obese patients with polycystic ovaries. Gynecol Endocrinol. 2017; 33(1): 43–47.
- Lin XF, Wu RR, Du J, et al. Exploring the significance of sex hormone-binding globulin examination in the treament of women with polycystic ovarian syndrome (PCOS). Clin Exp Obstet Gynecol. 2015; 42(3): 315–320.
- Srećković B, Soldatovic I, Colak E, et al. Homocysteine is the confounding factor of metabolic syndrome-confirmed by siMS score. Drug Metab Pers Ther. 2018; 33(2): 99–103.
- Mehrabani HH, Salehpour S, Amiri Z, et al. Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: a randomized controlled intervention study. J Am Coll Nutr. 2012; 31(2): 117–125.
- Barry JA, Qu F, Hardiman PJ. An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS). Med Hypotheses. 2018; 110: 42–45.
- Orio F, Palomba S, Di Biase S, et al. Homocysteine levels and C677T polymorphism of methylenetetrahydrofolate reductase in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003; 88(2): 673–679.
- Wang YL, Guo YF, Xu KX, et al. Analysis of phytochemical constituents of zuogui wan in rat serum and its effects on early embryonic development of mice. World Journal of Traditional Chinese Medicine. 2020; 6(3): 324.
- Sakamuri A, Pitla S, Putcha UK, et al. Transient Decrease in Circulatory Testosterone and Homocysteine Precedes the Development of Metabolic Syndrome Features in Fructose-Fed Sprague Dawley Rats. J Nutr Metab. 2016; 2016: 7510840.
