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      Heme oxygenase 2 genetic variants alter hormonal and metabolic traits in polycystic ovary syndrome

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          Abstract

          Oxidative stress and metabolic disorders are involved in the pathogenesis of polycystic ovary syndrome (PCOS). Heme oxygenase 2 (HMOX2) plays a critical role in preserving heme metabolism as well as in modulating glycolipid metabolism, oxidative stress, and inflammation. This study examined the correlation between HMOX2 G554A (rs1051308) and A-42G (rs2270363) genetic variants with the risk of PCOS and assessed the effects of these genotypes on clinical, hormonal, metabolic, and oxidative stress indices using a case–control design that included 1014 patients with PCOS and 806 control participants. We found that the allelic and genotypic frequencies of the HMOX2 G554A and A-42G polymorphisms were comparable between the PCOS and control groups in Chinese women ( P > 0.05). Nevertheless, it was discovered that patients with the AA or AG genotype of A-42G polymorphism had notably elevated levels of estradiol (E 2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH ratio, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo)B, and/or apoB/apoA1 ratio than those with the GG genotypes ( P < 0.05). Patients with the GG or AG genotype of G554A polymorphism had elevated serum levels of LH, FSH, E 2, LH/FSH ratio, TC, HDL-C, LDL-C, apoB, and/or apoB/apoA1 ratio and lower 2-h glucose concentration compared with those with the AA genotype ( P < 0.05). Our findings indicate a potential association between the genetic variants and endocrine abnormalities in the reproductive system and metabolic irregularities in glycolipid levels in patients, thus suggesting their potential role in the pathogenesis of PCOS.

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          Most cited references48

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          Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome

          (2004)
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            Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment

            Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in premenopausal women. Heterogeneous by nature, PCOS is defined by a combination of signs and symptoms of androgen excess and ovarian dysfunction in the absence of other specific diagnoses. The aetiology of this syndrome remains largely unknown, but mounting evidence suggests that PCOS might be a complex multigenic disorder with strong epigenetic and environmental influences, including diet and lifestyle factors. PCOS is frequently associated with abdominal adiposity, insulin resistance, obesity, metabolic disorders and cardiovascular risk factors. The diagnosis and treatment of PCOS are not complicated, requiring only the judicious application of a few well-standardized diagnostic methods and appropriate therapeutic approaches addressing hyperandrogenism, the consequences of ovarian dysfunction and the associated metabolic disorders. This article aims to provide a balanced review of the latest advances and current limitations in our knowledge about PCOS while also providing a few clear and simple principles, based on current evidence-based clinical guidelines, for the proper diagnosis and long-term clinical management of women with PCOS.
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              Polycystic Ovary Syndrome

              Polycystic ovary syndrome (PCOS) is a highly prevalent disorder, representing the single most common endocrine-metabolic disorder in reproductive-aged women. Currently there are four recognized phenotypes of PCOS: 1) hyperandrogenism+oligo-anovulation+polycystic ovarian morphology; 2) hyperandrogenism+oligo-anovulation; 3) hyperandrogenism+polycystic ovarian morphology; and 4) oligo-anovulation+polycystic ovarian morphology, each with different long-term health and metabolic implications. Clinicians should clearly denote a patient's phenotype when making the diagnosis of PCOS. Polycystic ovary syndrome is a highly inherited complex polygenic, multifactorial disorder. Pathophysiologically abnormalities in gonadotropin secretion or action, ovarian folliculogenesis, steroidogenesis, insulin secretion or action, and adipose tissue function, among others, have been described in PCOS. Women with PCOS are at increased risk for glucose intolerance and type 2 diabetes mellitus; hepatic steatosis and metabolic syndrome; hypertension, dyslipidemia, vascular thrombosis, cerebrovascular accidents, and possibly cardiovascular events; subfertility and obstetric complications; endometrial atypia or carcinoma, and possibly ovarian malignancy; and mood and psychosexual disorders. The evaluation of patients suspected of having PCOS includes a thorough history and physical examination, assessment for the presence of hirsutism, ovarian ultrasonography, and hormonal testing to confirm hyperandrogenism and oligo-anovulation as needed and to exclude similar or mimicking disorders. Therapeutic decisions in PCOS depend on the patients' phenotype, concerns, and goals, and should focus on 1) suppressing and counteracting androgen secretion and action, 2) improving metabolic status, and 3) improving fertility. However, despite significant progress in understanding the pathophysiology and diagnosis of the disorder over the past 20 years, the disorder remains underdiagnosed and misunderstood by many practitioners.

                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                12 February 2024
                22 January 2024
                01 March 2024
                : 13
                : 3
                : e230463
                Affiliations
                [1 ]Laboratory of Genetic Disease and Perinatal Medicine , Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
                [2 ]School of Life Science and Engineering , Southwest Jiaotong University, Chengdu, Sichuan, China
                [3 ]Department of Obstetrics and Gynecology , West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
                Author notes
                Correspondence should be addressed to P Fan: fanping15@ 123456scu.edu.cn
                Author information
                http://orcid.org/0000-0003-1167-5858
                Article
                EC-23-0463
                10.1530/EC-23-0463
                10895317
                38251965
                9c0b3931-2882-4978-bb4f-b9ce739315ab
                © the author(s)

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 09 November 2023
                : 22 January 2024
                Funding
                Funded by: National Natural Science Foundation of China, doi http://dx.doi.org/10.13039/501100001809;
                Funded by: Ministry of Education, doi http://dx.doi.org/10.13039/501100002701;
                Categories
                Research

                polycystic ovary syndrome,heme oxygenase 2,genetic polymorphism,metabolism,oxidative stress

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