PATHOGENETIC ASPECTS OF METABOLIC SYNDROME IN WOMEN OF REPRODUCTIVE AGE (A LITERATURE REVIEW)
https://doi.org/10.25207/1608-6228-2019-26-2-162-172
Abstract
Aim. The aim of this work was to analyze recently published data on the risk factors and pathogenetic aspects of metabolic syndrome (MS) in women of reproductive age.
Materials and methods. This review covers data presented in foreign and Russian literature, which has been published in electronic bibliographic databases Pubmed and the Cochrane Library over the past 10 years. Specifi cally, we carried out an analysis of works containing information on risk factors, pathogenetic aspects and diagnostic criteria of MS in women of reproductive age, as well as on methods currently used for the treatment of this condition.
Results. We characterize modern theories that explain mechanisms triggering the development of MS complicated with diabetes 2 type and polycystic ovary syndrome (PCOS). Data on proteomic markers refl ecting the complex pathogenesis of PCOS is generalized, along with their role in the diagnosis and treatment of this disease. The possibility of using these markers for predicting pregnancy outcomes is shown. The importance of regulating metabolic processes for the preparation of women for pregnancy and fertility recovery is emphasized.
Conclusion. Hyperandrogenism, insulin resistance, obesity, diabetes 2 type, dyslipidemia, PCOS are shown to be the most signifi cant factors determining pathological changes in fertile age women with metabolic syndrome. The correction of these factors should be included in the course of pregravid preparation for the prevention of adverse pregnancy outcomes.
About the Authors
Nina D. Kastueva
Institute of Biomedical Investigations — Branch of the Vladikavkaz Scientifi c Centre of the Russian
Academy of Sciences
Russian Federation
Russian Federation
Researcher, Department of Mother and Child Care,
Pushkinskaya str., 47, Vladikavkaz, 362025
Tatyana D. Tsidaeva
North Ossetian State Medical Academy, Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Dr. Sci. (Med.), Prof., Head of the Department of Obstetrics and Gynecology No. 2,
Pushkinskaya str., 40, Vladikavkaz, 362019
Zalina F. Belikova
North Ossetian State Medical Academy, Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Cand. Sci. (Med.), Assoc. Prof., Department of Dermatovenereology,
Pushkinskaya str., 40, Vladikavkaz, 362019
Liana V. Maysuradze
Institute of Biomedical Investigations — Branch of the Vladikavkaz Scientifi c Centre of the Russian
Academy of Sciences;
North Ossetian State Medical Academy, Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Dr. Sci. (Med.), Prof., Senior Researcher, Department of Mother and Child Care, Pushkinskaya str., 47, Vladikavkaz, 362025;
Prof., Department of Obstetrics and Gynecology No. 1, Pushkinskaya str., 40, Vladikavkaz, 362019
References
1. Serov V. N., Shestakova I. G., Mgeryan A. N. Metabolicheskii sindrom (neiroobmenno-endokrinnyi sindrom). In.: V. N. Serov, G. T. Sukhikh, V. N. Prilepskaya, V. E. Radzinskii, editors. Rukovodstvo po ambulatorno-poliklinicheskoi pomoshchi v akusherstve I ginekologii. 3rd edition, recycled, augmented. Moscow: GEOTAR-Media; 2018. 951–956 (In Russ.).
2. Bozdag G., Mumusoglu S., Zengin D., Karabulut E., Yildiz B. O. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum. Reprod. 2016; 31(12): 2841– 2855. DOI: 10.1093/humrep/dew218
3. Polycystic ovary syndrome in reproductive-aged women (modern approaches to diagnosis and treatment). Clinical recommendations (treatment protocol) of the Ministry of Healthcare of the Russian Federation. Moscow; 2015 (In Russ.).
4. Chernukha G. E., Blinova I. V., Kuprashvili М. I. Endocrine and metabolic characteristics of patients with different phenotypes of polycystic ovary syndrome. Obstetrics and Gynecology. 2011; 2: 70–76 (In Russ., English abstract).
5. Podzolkova N. M., Koloda Yu. A. Polycystic ovary syndrome: Proteomic aspects. Obstetrics and gynecology. 2017; 4: 53–60 (In Russ., English abstract).
6. Flehmig G., Scholz M., Kloting N., et al. Identifi cation of adipokine clusters related to parameters of fat mass, insulin sensitivity and infl ammation. PloS One. 2014; 9(6): e99785. DOI: 10.1371/journal.pone.0099785
7. Choi D. H., Lee W. S., Won M., et al. The apolipoprotein A-I level is down regulated in the granulosa cells of patients with polycystic ovary syndrome and affects steroidogenesis. J. Proteome Res. 2010; 9(9): 4329– 4336. DOI: 10.1021/pr100008e
8. Naidukova A. A., Ananyev E. V., Chernukha G. G. Effect of metformin on the reproductive function of women with various phenotypes of PCOS. Obstetrics and gynecology. 2017; 10: 55–61 (In Russ., English abstract). DOI: 10.18565/aig.2017.10.55-61
9. Escobar-Morreale H.F, Luque-Ramirez M., Gonzalez F. Circulating infl ammatory markers in polycystic ovary syndrome: a systematic review and meta-analysis. Fertil. Steril. 2011; 95(3): 1048–1058. el-e2. DOI: 10.1016/j.fertnstert.2010.11.036
10. Insenser M., Escobar-Morreale H. F. Proteomics and polycystic ovary syndrome. Expert. Rev. Proteomics. 2013; 10(5): 435–447. DOI: 10.1586/14789450.2013.837665
11. Galazis N., Pang Y. L., Galazi M., et al. Proteomic biomarkers of endometrial cancer risk in women with polycystic ovary syndrome: a systematic review and biomarker database integration. Gynecol. Endocrinol. 2013; 29(7): 638–644. DOI: 10.3109/09513590.2013.777416
12. Dag Z. O., Dilbaz B. Impact of obesity on infertility in women. J. Turk. Ger. Gynecol. Assoc. 2015; 16(2): 111–117. DOI: 10.5152/jtgga.2015.15232
13. Alfadda A. A. Circulating adipokines in healthy versus unhealthy overweight and obese subjects. Int. J. Endocrinol. 2014; Article ID 170434: 7 p. DOI: 10.1155/2014/170434
14. Vedzizheva E. R., Kuznetsova I. V., Uspenskaya Yu. B. et al. On the the pathogenesis of reproductive disorders in women with obesity. Obstetrics and gynecology. 2017; 6: 18–24 (In Russ., English abstract). DOI: 10.18565/aig.2017.6.18-24
15. Selyatitskaya V. G., Pinkhasov B. B., Karapetyan A. R., Kuzminova O. N. Adipokines and a risk for metabolic disturbances in different types of female obesity. Therapeutic Archive. 2015; 87(10): 80–84 (In Russ., English abstract). DOI: 10.17116/terarkh2015871080-84
16. Matsuzawa Y. Establishment of a concept of visceral fat syndrome and discovery of adiponectin. Proc. Jpn. Acad. Ser. B. Phys. Biol. Sci. 2010; 86(2): 131–141. DOI: 10.2183/pjab.86.131
17. Pinkhasov B. B., Selyatitskaya V. G., Karapetyan A. R., Astrakhantseva E. L. Metabolic syndrome in men and women with upper or lower types of body fat distribution. Health. 2012; 4(12 А): 1381–1389. DOI: 10.4236/health.2012.412A200
18. Heidemann C., Sun Q., van Dam R. M., Meigs J. B., Zhang C. C., Tworoger S. S., et al. Total and highmolecular-weight adiponectin and resistin in relation to the risk for type 2 diabetes in women. Ann. Intern. Med. 2008; 149(5): 307–316.
19. Bozdag G., Mumusoglu S., Zengin D., Karabulut E., Yildiz B. O. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum. Reprod. 2016: 31(12): 2841– 2855. DOI: 10.1093/humrep/dew218
20. Bastien M., Poirier P., Lemieux I., Després J. P. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog. Cardiovasc. Dis. 2014; 56(4): 369–381. DOI: 10.1016/j.pcad.2013.10.016
21. Moran L. J., Hutchison S. K., Norman R. J., Teede H. J. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst. Rev. 2011; (7): CD007506.
22. Tong Q., Xu Y. Central leptin regulation of obesity and fertility. Curr. Obes. Rep. 2012; 1(4): 236–244. DOI: 10.1007/s13679-012-0025-8
23. Dalton M., Cameron A. J., Zimmet P. Z., et al. Waist circ umference, waist-hip ratio and body mass index and their correlation with cardio-vascular disease risk factors in Australian adults. J. Intern. Med. 2003; 254(6): 555–563.
24. Sheng T., Yang K. Adiponectin and its association with insulin resistance and type 2 diabetes. J. Genet. Genomics. 2008; 35(6): 321–326. DOI: 10.1016/S1673- 8527(08)60047-8
25. Meyer U. A. Personalized medicine: a personal view. Clin. Pharmacol. Ther. 2012; 91(3): 373–375. DOI: 10.1038/clpt.2011.238
26. Olefsky J.M, Glass C. K. Macrophages, infl ammation, and insulin resistance. Annu. Rev. Pisiol. 2010; 72: 219–246. DOI: 10.1146/annurev-physiol-021909-13584627
27. Genau A., Devereux R. B., Roman M. J. Pattern left ventricular hypertrophy and geometric remodeling in essential hypertension. J. Amer. Coll. Cardiol. 1992; 19E: 1550–1558.
28. Maliqueo M., Echiburu B, Crisosto N. Sex steroids modulate uterine-placental vasculature: implications for obstetrics and neonatal outcomes. Front. Physiol. 2016; 7; 152.
29. Amato M. C., Giordano C., Galia M., et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010; 33(4): 920–922. DOI: 10.2337/dc09-1825
30. Insenser M., Martinez-Garcia M. A., Montes R., et al. Proteomic analysis of plasma in the polycystic ovary syndrome identifi es novel markers involved in iron metabolism, acute-phase response, and infl ammation. J. Clin. Endocrinol. Metab. 2010; 95(8): 3863– 3870. DOI: 10.1210/jc.2010-0220
31. Isakova J. T., Lunegova O. S., Talaibekova E. T., et al. Association of adiponectin gene G276T polymorphism with the development of metabolic syndrome in ethnic Kyrgyz patients. Terapevticheskiy arkhiv. 2015; 87(10): 85–89. DOI: 10.17116/terarkh2015871085-90 (In Russ., English abstract).
32. Lee B., Shao J. Adiponectin and energy homeostasis. Rev. Endocr. Metab. Disord. 2014; 15(2): 149–156. DOI: 10.1007/s11154-013-9283-3
33. Orio F., Palomba S. Reproductive endocrinology: New guidelines for the diagnosis and treatment of PCOS. Nat. Rev. Endocrinol. 2014; 10(3): 130–132. DOI: 10.1038/nrendo.2013.248
34. El Idrissi A., Sidime F., L’Amoreaux W. Neuro-endocrine basis for altered plasma glucose homeostasis in Fragile X mouse. J. Biomed. Sci. 2010; 17 (Suppl 1): S8. DOI: 10.1186/1423-0127-17-S1-S8
35. Kosygina A. V., Vasyukova O. V. New evidence for the pathogenesis of obesity: adipokines are adipose tissue hormone. Problemy endokrinologii. 2009; 55(1): 44–50 (In Russ., English abstract).
36. Angelidis G., Dafopoulos K., Messini C. I., et al. Ghrelin: new insights into female reproductive system-associated disorders and pregnancy. Reprod. Sci. 2012; 19(9): 903–910. DOI: 10.1177/1933719112443880
37. Ambekar A. S., Kelkar D. S., Pinto S. M. Proteomics of follicular fl uid from women with polycystic ovary syndrome suggests molecular defects in follicular development. J. Clin. Endocrinol. Metab. 2015; 100(2): 744–753. DOI: 10.1210/jc.2014-2086
38. Biryukova A. M., Nazarenko T. A., Sukhikh G. T. Genetic aspects of metabolic changes in women with polycystic ovary syndrome (a review). Reproduction Problems. 2011; 17(4): 7–9 (In Russ., English abstract).
39. Tan B. K., Chen J., Farhatullah S., et al. Insulin and metformin regulate circulating and adipose tissue chemerin. Diabetes. 2009; 58(9): 1971–1977. DOI: 10.2337/db08-1528
40. Budak E., Fernandez Sanchez M., Bellver J., et al. Interactions of the hormones leptin, ghrelin, adiponectin, resistin, and PYY3-36 with the reproductive system. Fertil. Steril. 2006; 85(6): 1563–1581. DOI: 10.1016/j.fertnstert.2005.09.065
41. Despres J.-P., Arsenault B. J., Cote M., et al. Abdominal obesity: the cholesterol of the 21st century? Can. J. Cardiol. 2008; Suppl D: 7D-12D.
42. Barthelmess E. K., Naz R. K. Polycystic ovary syndrome: current status and future perspective. Front. Biosci. (Elite Ed). 2015; 6: 104–119.
43. Gambino Y. P., Maymó J. L., Pérez Pérez A., et al. Elsevier Trophoblast Research Award Lecture: Molecular mechanisms underlying estrogen functions in trophoblastic cells — focus on leptin expression. Placenta. 2012; 33 Suppl: S63-S70. DOI: 10.1016/j.placenta.2011.12.001
44. Blüher M. The distinction of metabolically ‘healthy’ from ‘unhealthy’ obese individuals. Curr. Opinion. Lipidol. 2010; 21(1): 38–43. DOI: 10.1097/MOL.0b013e3283346ccc
45. Alberti K. G., Eckel R. H., Grundy S. M., et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120(16): 1640–1645. DOI: 10.1161/CIRCULATIONAHA.109.192644
46. Weyer C., Funahashi T., Tanaka S., et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J. Clin. Endocrinol. Metab. 2001; 86(5): 1930–1935. DOI: 10.1210/jcem.86.5.7463
47. Fruhbeck G. Overview of adipose tissue and its role in obesity and metabolic disorders. Metods. Mol. Biol. 2008; 456: 1–22. DOI: 10.1007/978-1-59745-245-8_1
48. Nigro E., Scudiero O., Monaco M. L., et al. New insight into adiponectin role in obesity and obesity-related diseases. Bio Med. Res. Int. 2014; Article ID 658913: 14 p. DOI: arti10.1155/2014/658913
49. Yang W. S., Yang Y. C., Chen C. L., et al. Adiponectin SNP276 is associated with obesity, the metabolic syndrome, and diabetes in the elderly. Am. J. Clin. Nutr. 2007; 86(2): 509–513. DOI: 10.1093/ajcn/86.2.509
Review
For citations:
Kastueva N.D., Tsidaeva T.D., Belikova Z.F., Maysuradze L.V. PATHOGENETIC ASPECTS OF METABOLIC SYNDROME IN WOMEN OF REPRODUCTIVE AGE (A LITERATURE REVIEW). Kuban Scientific Medical Bulletin. 2019;26(2):162-172. (In Russ.) https://doi.org/10.25207/1608-6228-2019-26-2-162-172
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