نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار گروه تغذیه، مرکز تحقیقات سلامت بارداری، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

2 دانشیار گروه زنان و زایمان، مرکز تحقیقات سلامت بارداری، بیمارستان امام علی (ع)، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

3 کارشناسی ارشد گروه تغذیه، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

4 پزشکی عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

5 دانشیار گروه تغذیه، مرکز تحقیقات ارتقای سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

6 استادیار گروه ایمونولوژی، مرکز تحقیقات ایمونولوژی بالینی، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

چکیده

زمینه و هدف  سندرم تخمدان پلی‌کیستیک (PCOS)، یکی از شایع‌ترین اختلالات هورمونی در زنان سنین ناباروری است. زنان مبتلا به این بیماری، در معرض خطر زودرس بیماری‌های قلبی- عروقی قرار دارند. لذا مطالعه حاضر با هدف بررسی وضعیت استرس اکسیداتیو، فاکتورهای التهابی و سایر عوامل خطر بیماری‌های قلبی- عروقی در بیماران مبتلا به PCOS انجام شد.
مواد و روش‌ها در این مطالعه مورد شاهدی،50 زن مبتلا به PCOS و 50 زن سالم مراجعه‌کننده به کلینیک ناباروری زاهدان که از نظر سن و BMI  همسان شده بودند، به روش نمونه‌گیری در دسترس انتخاب شدند. در کلیه افراد، شاخص‌های تن‌سنجی، بیوشیمیایی، کمپلمان‌های 3 C،  4C، ظرفیت تام آنتی‌اکسیدانی (TAC) و سطح مالون‌دی‌آلدئید (MDA) اندازه‌گیری شد. اطلاعات به‌دست‌آمده با استفاده از روش‌های آماری آزمون تی مستقل و تحلیل واریانس، در سطح معناداری 0/05>p  تجزیه‌وتحلیل شد.
یافته‌ها نتایج نشان داد میانگین دور کمر (048/ 0=p)، فشار خون سیستولیک (0/01<p) و دیاستولیک (048/ 0=p)،LDL  کلسترول (0/05=p) و MDA (p>0/0001) سرم در زنان PCOS به‌طور معناداری بیشتر و میانگین سطح HDL کلسترول (0/03=p) و  TAC (p=0/05) به‌طور معنی‌داری، کمتر از گروه کنترل بود. میانگین سطح سرمی 3 C و 4 C در گروه PCOS بیشتر از گروه کنترل بود اما این اختلاف، فقط برای3 C معنادار بود (0/03=p).
نتیجه‌گیری یافته‌ها نشان داد که اختلالات لیپید، مارکرهای استرس اکسیداتیو و فاکتورهای التهابی در زنان PCOS با چاقی شکمی، بیشتر بود. بنابراین غربالگری این فاکتورها و مدیریت وزن، به‌ویژه در زنان چاق مبتلا به سندرم تخمدان پلی‌کیستیک، در استراتژی درمانی پیشنهاد می‌شود.
 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Study of Oxidative stress, inflammatory factors and Some Cardiovascular risk factors in Polycystic Ovary Syndrome (Case control study)

نویسندگان [English]

  • Farzaneh Montazerifar 1
  • Marzieh Ghasemi 2
  • Rasul Taghvaee far 3
  • Mahdieh Keykhahnejad 4
  • Mansour Karajibani 5
  • Ebrahim Alijani 6

1 Associate professor , Dept. of Nutrition, Pregnancy Health Research Center , School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

2 Associate professor , Dept .of Obstetrics and Gynecology, Pregnancy Health Research Center, Emam Ali Hospital, Zahedan University of Medical Sciences, Zahedan, Iran

3 MSc, Dept. of Nutrition, Student Research Committee, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

4 Medical student, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Associate professor, 5Associate professor , Dept. of Nutrition, Health Promotion Research Center , School of Medicine, Zahedan University of

5 Assistant professor , Dept. of Immunology, Clinical Immunology Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

6 Assistant professor , Dept. of Immunology, Clinical Immunology Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

چکیده [English]

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders in women of infertility. Women with PCOS are at high risk for early cardiovascular disease. The aim of this study was to evaluate the oxidative stress, inflammatory factors and other cardiovascular risk factors in patients with PCOS.
Materials and methods: In this case-control study, 50 women with PCOS and 50 healthy women referred to Zahedan Infertility Clinic who were matched for age and BMI were selected by convenient  sampling method. Anthropometric parameters, biochemical tests, C3 and C4 complements, TAC and MDA levels were measured in all subjects. Data were analyzed using independent t-test and analysis of variance at the significant level P Results: Results showed that mean waist circumference (P = 0.048), systolic blood pressure (P <0.01) and diastolic (P = 0.048), serum LDLC levels (P = 0.05) and MDA (P <0.0001) were significantly higher in women with PCOS and serum HDL-C levels (P = 0.03) and TAC (P = 0.05) were significantly lower than   control group. Mean serum levels of C3 and C4 were higher in the PCOS group than in the control group, but this difference was only significant for C3 (P = 0.03) .
Conclusion: The findings showed that levels of dyslipidemia, oxidative stress and inflammatory factors were higher in PCOS women with abdominal obesity. Thus, screening of these factors and weight management, especially in obese women with polycystic ovary syndrome, is recommended in treatment strategy. 

کلیدواژه‌ها [English]

  • Polycystic Ovary Syndrome
  • Oxidative stress
  • complement protein C3 and C4
  • Dyslipidaemia
  • Obesity
[1]. Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev 2015;36:487-525.
[2]. Heshmati N, Shahgheibi SH, Nikkhoo B, Amini S, Abdi M. Association of Pro-oxidant–Antioxidant Balance with Clinical and Laboratory Parameters and Its Relation to Different Drug Regimens in Polycystic Ovary Syndrome Women with Normal BMI. Indian J Clin Biochem. 2017, 32(3):315–22.
[3]. Rosenfield RL, Ehrmann DA. The pathogenesis of polycystic ovary syndrome (PCOS): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev 2016;37:467-520.
[4]. McEwen B, Hartmann G. Insulin resistance 'and polycystic ovary syndrome (PCOS)': Part 1. The impact of insulin resistance. J Aust Tradit-Med So. 2018; 24:214.
[5]. Kuscu NK, Var A. Oxidative stress but not endothelial dysfunction exists in non-obese, young group of patients with polycystic ovary syndrome. Acta Obstet Gynecol Scand. 2009;88 (5):612–7.
[6]. Lee JY, Baw CK, Gupta S, Aziz N, Agarwal A. Role of oxidative stress in polycystic ovary syndrome. Curr Womens Health Rev 2010; 6: 96-107.
[7]. Snyder ML, Shields KJ, Korytkowski MT, Sutton-Tyrrell K, Talbott EO. Complement protein C3 and coronary artery calcium in middle-aged women with polycystic ovary syndrome and controls. Gynecol Endocrinol. 2014; 30(7): 511–15.
[8]. Fernandez-Real JM, Broch M, Vendrell J, Ricart W. Insulin resistance, inflammation, and serum fatty acid composition. Diabetes Care. 2003;26(5):1362–8.
[9]. Gonzalez F, Rote NS, Minium J, Kirwan JP. Reactive oxygen species-induced oxidative stress in the development of insulin resistance and hyperandrogenism in polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(1):336–40.
[10]. Karabulut AB, Cakmak M, Kiran RT, Sahin I. Oxidative stress status, metabolic profile and cardiovascular risk factors in patients with polycystic ovary syndrome. Med Sci (Turkey) 2012;1:27-34. [11]. Sulaiman MAH, 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.
[12]. Rahbarian R, Sadoughi SD. Effect of Catechin on Serum Levels of Inflammatory Cytokines, Antioxidant Enzymes Activity and DNA Oxidative Damage of Ovarian Tissue in Polycystic Ovarian Syndrome Rat Model. Pars J Med Sci 2017;15(1):23-35
[13]. Tošić-Pajić J, Šeklić D, Radenković J, et al. Augmented oxidative stress in infertile women with persistent chlamydial infection. Reprod Biol. 2017;17(2):120–5.
[14]. Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: a review. Reprod Biol Endocrinol. 2012;10:49.
[15]. Shatha Abdul Wadood, Nada Abdal Kareem Kadhum, Maysoon Khalid Hussien . Immunoglobulins IgG, IgA, IgM, complement C3 and C4 levels in sera of patients with polycystic ovary syndrome and the risk of cardiovascular diseases. J Biotechnol. 2015; 14(2) :329-38.
[16]. Zafari Zangeneh F, Abdollahi AR, Naghizadeh MM, Bagheri M. A low-grade chronic inflammation in polycystic ovary syndrome: Role of interleukin-1 alpha, 1 beta, 17A and TNFα . Iran J Obstet Gynaecol Infertility .2015 ;17( 135). 9 5393.
[17]. Enechukwu CI, Onuegbu AJ, Olisekodiaka MJ, Eleje GU, Ikechebelu JI, Ugboaja JO, Amah UK, Okwara JE, Igwegbe AO..Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital. Obstet Gynecol Sci. 2019;62 (5):335-43.
[18]. Yilmaz N, Inal HA, Gorkem U, SarginOruc A, Yilmaz S, TurkkaniA. Follicular fluid total antioxidant capacity levels in PCOS . J Obstet Gynaecol. 2016; 36 (5):654-7.
[19]. Karajibani M, Hashemi M, Montazerifar F, Dikshit M . Antioxidant Status before and after Dietary Intervention in Cardiovascular Disease (CVD) Patients. Mal J Nutr .2010;16(3):1-12.
[20]. Dos Santos ACS, Azevedo GD, Lemos TMAM. The influence of oxidative stress in inflammatory process and insulin resistance in obese women with polycystic ovary syndrome. Transl Biomed .2016; 7:4.
[21]. Karadeniz M, Erdogan M, Tamsel S, Zengi A, Alper GE, Caglayan O, et al. Oxidative stress markers in young patients with polycystic ovary syndrome, the relationship between insulin resistances. Exp Clin Endocrinol Diabetes. 2008; 116 (4):231–5.
[22]. Yilmaz M, Bukan N, Ayvaz G, Karakoc A, Toruner 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 (12):3333–40.
[23]. Wu Y, Zhang J, Wen Y, Wang H, Zhang M, Cianflone K. Increased acylation-stimulating protein, C-reactive protein, and lipid levels in young women with polycystic ovary syndrome. Fertil Steril. 2009; 91:213–9.
[24]. Yang S, Li Q, Song Y, Tian B, Cheng Q, Qing H, et al. Serum complement C3 has a stronger association with insulin resistance than high-sensitivity C-reactive protein in women with polycystic ovary syndrome. Fertil Steril. 2011; 95:1749–53.
[25]. Yaghmaei M, Mokhtari M , Roudbari M , Harati M , Rashidi H , Dabiri S,et al. Comparison of the CRP and ESR Levels between Women with Polycystic Ovarian Syndrome and Control Group. J Guilan Uni Med Sci 2008, 17(65): 108-116.
[26]. Bentley-Lewis R, Seely E, Dunaif A. Ovarian Hypertension: Polycystic Ovary Syndrome.Endocrinol Metab Clin North Am. 2011; 40(2): 433–x.
[27]. Moti, M, Amini L, Mirhoseini Ardakani SS, Kamalzadeh S, Masoomikarimi M, jafarisani M, Oxidative stress and anti-oxidant defense system in Iranian women with polycystic ovary syndrome . Iran J Reprod Med. 2015; 13(6): 373–8.