Activation of systemic inflammation and oxidative stress in adolescent girls with polycystic ovary syndrome in combination with metabolic disorders and excessive body weightстатьяИсследовательская статья
Статья опубликована в высокорейтинговом журнале
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Дата последнего поиска статьи во внешних источниках: 7 октября 2020 г.
Аннотация:Relevance: Mitochondrial dysfunction and systemic inflammation are believed to play
pivotal role in the pathogenesis of polycystic ovary syndrome (PCOS) and related complications
of metabolic disorders in adult patients. Though such researches are limited or almost absent in
adolescents. The aim of the study is to evaluate the impact of mitochondrial dysfunction and systemic
inflammation on PCOS pathogenesis during adolescence with regard to body mass index and insulin
resistance. Design: a case-control study. Methods: The study included 95 adolescent girls (15 to
17 years old inclusive) diagnosed with PCOS based on the Rotterdam criteria. The control group
consisted of 30 healthy girls of the same age with a regular menstrual cycle. All participants were
subjected to a full clinical and instrumental examination, as well as an assessment of the levels of
leptin, C-reactive protein (CRP), and malondialdehyde (MDA) as oxidative stress marker. Serum
levels of IL-6, IL-10, IL-18, TNF-α, and plasma concentrations of macrophage migration inhibitory
factor (MIF), sFas, and sFasL were determined. Patients with PCOS were divided into groups
according to the presence of metabolic disorders (MD) (impaired glucose tolerance and/or over insulin
resistance) and normal weight or excessive weight (NW or OW). Results: Patients with PCOS of
NW in the absence of metabolic disorders (MD−/NW) had a lower concentration of MDA and a higher level of IL-10 compared to healthy girls (p < 0.05). The group (MD−/NW) was characterized
with lower levels of CRP, leptin, MDA, and higher levels of sFasL, when compared to OW patients
with PCOS in the absence of metabolic disorders (MD−/OW) (p < 0.05). Overweight adolescent
girls with PCOS and metabolic disorders (MD+/OW) showed higher CRP, leptin, and a two-fold
increase in IL-6 and IL-18 concentrations compared to the control group of healthy girls (p < 0.05
for all parameters). The group (MD+/OW) was also characterized with higher levels of CRP, leptin,
MDA, IL-18, MIF (p < 0.05), when compared to overweight patients with PCOS in the absence of
metabolic disorders (MD−/NW). In comparison with the MD−/OW group, the obese insulin resistant
girls with PCOS (MD+/OW) had a highera level of IL-18 (p < 0.05). Moreover, the MD+/OW girls
demonstrated a significant increase in CRP, MDA and IL-18 levels when compared to the MD+/NW
group (p < 0.05). OW girls with PCOS without MD (MD−/OW) had lower concentrations of sFasL
compared to healthy girls (p < 0.05), and higher levels of MDA compared to MD+/NW (p < 0.05).
Adolescent girls of NW with PCOS and with MD (MD+/NW) had lower levels of MDA compared to
the control group of healthy girls (p < 0.05). These data are confirmed by a correlation analysis and
two-factor ANOVA test. Conclusions: Lean girls with PCOS demonstrate the protective mechanism
of decrease in oxidative stress mediated by the activation of antioxidant defense, reduction of lipid
peroxidation and systemic inflammation. Excessive weight and metabolic disorders in adolescents
with PCOS are the most significant factors in reducing the capacity of antioxidant systems, activation of oxidative stress, mitochondrial dysfunction, and systemic inflammation.