Obstet Gynecol Sci.  2024 Jul;67(4):414-420. 10.5468/ogs.24031.

Evaluation of oxidative stress and inflammation in patients with polycystic ovary syndrome

• Sen B
• Gonultas S
• Albayrak C
• Temur S
• Acar I
• Ozkan BN
• Islek HS
• Yilmaz MB
• Kale E
• Guler EM

• KMID: 2557858
• DOI: http://doi.org/10.5468/ogs.24031

Abstract

Objective
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine and metabolic disorder characterized by hyperandrogenism, hyperinsulinemia, and insulin resistance. The prevalence of PCOS is increasing worldwide. Although the etiology of this disease is currently unknown, it is thought to be closely related to inflammation and oxidative stress. Our study aimed to compare patients have PCOS to healthy volunteers and assess the changes in oxidative stress and inflammatory parameters in these patients.
Methods
Thirty patients between the ages of 18-45 diagnosed with PCOS and 30 healthy volunteers with the same demographic characteristics were included in this study. Clinical parameters were measured using immunoassays. Oxidative stress biomarkers, total oxidant (TOS), total antioxidant (TAS), total thiol (TT), and native thiol (NT) levels were measured using photometric methods according to Erel’s method. The dynamic disulfide level (DIS) and oxidative stress index (OSI) were calculated using mathematical equations. Among the inflammatory parameters, values for interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) were measured photometrically using commercially purchased kits.
Results
Moreover, TT and NT levels were lower in patients with PCOS compared to those in the healthy group statistically significantly (P<0.001). In addition, TAS, TOS, OSI, DIS, IL-1β, IL-6, and TNF-α levels were identified to be significantly higher in the patients with PCOS than those in the healthy group (P<0.001).
Conclusion
Evaluation of oxidative stress and clinical parameters used in the follow-up may be beneficial for the disease.

Keyword

Inflammation; Oxidative stress; Polycystic ovary syndrome; Reactive oxygen species; Disulfide

Reference

References

1. Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016; 106:6–15.

2. Uçkan K, Demir H, Turan K, Sarıkaya E, Demir C. Role of oxidative stress in obese and nonobese PCOS patients. Int J Clin Pract. 2022; 2022:4579831.

3. Sulaiman MA, Al-Farsi YM, Al-Khaduri MM, Saleh J, Waly MI. Polycystic ovarian syndrome is linked to increased oxidative stress in Omani women. Int J Womens Health. 2018; 10:763–71.

4. Diamanti-Kandarakis E. Insulin resistance in PCOS. Endocrine. 2006; 30:13–7.

5. Sharma ST, Nestler JE. Prevention of diabetes and cardiovascular disease in women with PCOS: treatment with insulin sensitizers. Best Pract Res Clin Endocrinol Metab. 2006; 20:245–60.

6. Zuo T, Zhu M, Xu W. Roles of oxidative stress in polycystic ovary syndrome and cancers. Oxid Med Cell Longev. 2016; 2016:8589318.

7. Murri M, Luque-Ramírez M, Insenser M, Ojeda-Ojeda M, Escobar-Morreale HF. Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): a systematic review and meta-analysis. Hum Reprod Update. 2013; 19:268–88.

8. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004; 19:41–7.

9. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005; 38:1103–11.

10. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014; 47:326–32.

11. Pizzino G, Irrera N, Cucinotta M, Pallio G, Mannino F, Arcoraci V, et al. Oxidative stress: harms and benefits for human health. Oxid Med Cell Longev. 2017; 2017:8416763.

12. Mirończuk-Chodakowska I, Witkowska AM, Zujko ME. Endogenous non-enzymatic antioxidants in the human body. Adv Med Sci. 2018; 63:68–78.

13. Lubrano V, Balzan S. Enzymatic antioxidant system in vascular inflammation and coronary artery disease. World J Exp Med. 2015; 5:218–24.

14. Sakthivel R. Counseling therapy with hatha yoga on adherence level, nutritional status, and quality of life among HIV-infected adolescents. J Holist Nurs Midwifery. 2023; 33:130–9.

15. Mittler R. ROS are good. Trends Plant Sci. 2017; 22:11–9.

16. Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem. 2004; 37:112–9.

17. Yilmaz M, Bukan N, Ayvaz G, Karakoç A, Törüner F, Cakir N, et al. The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome. Hum Reprod. 2005; 20:3333–40.

18. Verit FF, Erel O. Oxidative stress in nonobese women with polycystic ovary syndrome: correlations with endocrine and screening parameters. Gynecol Obstet Invest. 2008; 65:233–9.

19. Jiang Y, Shi H, Liu Y, Zhao S, Zhao H. Applications of melatonin in female reproduction in the context of oxidative stress.   Oxid Med Cell Longev. 2021; 2021:6668365.

20. Karabulut H, Gulay MS. Free radicals. MAKU J Health Sci Inst. 2016; 4:50–9.

21. Scandalios JG. The rise of ROS. Trends Biochem Sci. 2002; 27:483–6.

22. Kılıç E, Erek Toprak A, Kesgin Ayhan S, Baş A, Duruyen S. Oxidative stress in the attack and remission periods of schizophrenic patients. Gaziosmanpaşa Uni Med J. 2015; 7:286–98.

23. Zhang R, Liu H, Bai H, Zhang Y, Liu Q, Guan L, et al. Oxidative stress status in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2017; 86:88–96.

24. Georgescu SR, Mitran CI, Mitran MI, Matei C, Popa GL, Erel O, et al. Thiol-disulfide homeostasis in skin diseases. J Clin Med. 2022; 11:1507.

25. Kalem AK, Kayaaslan B, Neselioglu S, Eser F, Hasanoglu I, Aypak A, et al. A useful and sensitive marker in the prediction of COVID-19 and disease severity: Thiol. Free Radic Biol Med. 2021; 166:11–7.

26. Aydın GA, Turan Ozsoy HG, Ankarali H, Ozgen G, Neselioglu S. The association of dynamic thiol-disulfide homeostasis and inflammatory markers in patients with polycystic ovary syndrome. Taiwan J Obstet Gynecol. 2020; 59:79–84.

27. Yildirim M, Turkyilmaz E, Neselioglu S, Alisik M, Avsar AF. Dynamic thiol-disulphide status in polycystic ovary syndrome and its association with the pathogenesis of the disease. Gynecol Obstet Invest. 2017; 82:54–9.

28. Biyik I, Erten O, Isiklar OO, Ince O, Soysal C, Berikten D, et al. Comparison of serum human Klotho levels and thiol/disulfide homeostasis in women with polycystic ovary syndrome and in healthy women. Taiwan J Obstet Gynecol. 2021; 60:487–91.

29. Thébault S. Potential mechanisms behind the antioxidant actions of prolactin in the retina. Exp Eye Res. 2017; 160:56–61.

30. Vural P, Değirmencioğlu S, Saral NY, Akgül C. Tumor necrosis factor alpha (-308), interleukin-6 (-174) and interleukin-10 (-1082) gene polymorphisms in polycystic ovary syndrome. Tumor necrosis factor alpha (-308), interleukin-6 (-174) and interleukin-10 (-1082) gene polymorphisms in polycystic ovary syndrome. 2010; 150:61–5.

31. Dhindsa G, Bhatia R, Dhindsa M, Bhatia V. Insulin resistance, insulin sensitization and inflammation in polycystic ovarian syndrome. J Postgrad Med. 2004; 50:140–4.

32. Bensi G, Raugei G, Palla E, Carinci V, Tornese Buonamassa D, Melli M. Human interleukin-1 beta gene. Gene. 1987; 52:95–101.

33. Bostancı SM, Bayram M, Sevinc FC, Pasaoglu H, Elbeg S. The relationship between biochemical parameters, interleukin-6 and ovarian morphology in polycystic ovary syndrome. J Clin Trials Exp Investig. 2012; 3:307–12.

34. Maruotti N, d’Onofrio F, Cantatore FP. Metabolic syndrome and chronic arthritis: effects of anti-TNF-α therapy. Clin Exp Med. 2015; 15:433–8.

35. Gonzalez F, Thusu K, Abdel-Rahman E, Prabhala A, Tomani M, Dandona P. Elevated serum levels of tumor necrosis factor alpha in normal-weight women with polycystic ovary syndrome. Metabolism. 1999; 48:437–41.

36. Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril. 2011; 95:1048–58.e1-2.

37. Olszanecka-Glinianowicz M, Banaś M, Zahorska-Markiewicz B, Janowska J, Kocełak P, Madej P, et al. Is the polycystic ovary syndrome associated with chronic inflammation per se? Eur J Obstet Gynecol Reprod Biol. 2007; 133:197–202.

38. Zafari Zangeneh F, Naghizadeh MM, Masoumi M. Polycystic ovary syndrome and circulating inflammatory markers. Int J Reprod Biomed. 2017; 15:375–82.