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- Lindholm, Åsa Maria, 1958-, et al.
(författare)
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Adipose tissue inflammation in polycystic ovary syndrome (PCOS)
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Context: Previous studies have indicated that peripheral circulating markers of inflammation are elevated in women with polycystic ovary syndrome (PCOS). Thus far, no studies concerning adipose tissue expression of inflammatory markers have been conducted in PCOS patients. Objectives: The aim of the study was to investigate if PCOS patients display increased adipose tissue expression of inflammatory markers. Design and Settings: Cross-sectional study at three out-patient gynecologic departments. Participants and Approach: Ten lean PCOS patients, 20 overweight PCOS patients, and 20 overweight controls underwent subcutaneous fat biopsies and blood samples. Main Outcome Measures: Adipose tissue gene expression of inflammatory markers, circulating markers of inflammation, and obesity-related metabolic disturbances. Results: Overweight PCOS patients had higher relative amounts of adipose tissue CCL2, CCR2, TNF-a, IL-18, CD14 and CD163 mRNA expression compared to lean PCOS women. There were no differences between overweight PCOS patients and overweight control subjects in this respect. Within the PCOS group, markers of adipose tissue inflammation correlated significantly with obesity-related metabolic disturbances, but when data were adjusted for age and BMI most correlations were lost. Conclusion: Overweight, rather than the PCOS diagnosis per se, appears to be the main explanatory variable for elevated adipose tissue inflammation in PCOS patients. Our findings suggest that lean PCOS patients carry less risk for metabolic complications later on in life.
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| 2. |
- Lindholm, Åsa Maria, 1958-
(författare)
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Metabolic Aspects in the Polycystic Ovary Syndrome
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of childbearing age and is associated with a number of metabolic disturbances. It has been hypothesised these women carry an increased risk of developing cardiovascular diseases (CVD) with advancing age. The first aim of this thesis was to establish the prevalence of PCOS-related symptoms in Northern Sweden. The Northern part of the WHO MONICA project was used for this purpose. Based on self-reported menstrual disturbances and hirsutism together with biochemical analyses of free androgen index, the estimated prevalence of PCOS in Northern Sweden was 4.8%, which corresponded with previous prevalence studies. Disturbances in the fibrinolytic system are predictors of future cardiovascular events and measurements of plasminogen activator inhibitor 1 (PAI-1) activity and tissue plasminogen activator (tPA) mass concentration may be used to assess fibrinolytic activity in women with PCOS. From the findings, over-weight women with PCOS had impaired fibrinolysis, especially if they displayed objective biochemical markers of hyperandrogenism. Conversely, lean women with PCOS, displayed no signs of disturbed fibrinolysis. The adipose tissue is an active endocrine organ that produces and releases hormones, pro- and anti-inflammatory cytokines, and chemoattractant cytokines. Proinflammatory molecules produced by adipose tissue can be active participants in the development of insulin resistance and the increased risk of cardiovascular disease associated with obesity. The findings suggested being overweight, rather than the PCOS diagnosis per se, was the main explanatory variable for elevated adipose tissue inflammation in PCOS patients. Weight reduction is the primary target for intervention in overweight and obese women with PCOS. When this thesis was planned, no placebo-controlled trials on anti-obesity drugs in women with PCOS had been conducted. Sibutramine in combination with lifestyle intervention resulted in significant weight reduction in overweight women with PCOS. In addition to the weight loss, sibutramine appeared to have a beneficial effect on metabolic and cardiovascular risk factors.
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| 3. |
- Lindholm, Åsa Maria, 1958-, et al.
(författare)
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Tissue Plasminogen Activator and Plasminogen Activator Inhibitor 1 in Overweight and Lean Patients with Polycystic Ovary Syndrome
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Annan publikation (populärvet., debatt m.m.)abstract
- Objective: Disturbances in the fibrinolytic system are predictors of future cardiovascular events. The aim of the present study was to compare PAI-1 activity and tPA mass concentration between patients with polycystic ovary syndrome (PCOS) and control subjects. Design: 135 PCOS patients (lean and overweight) and 81 healthy controls were recruited for the study. Blood samples for PAI-1 activity and tPA mass were collected together with anthropometric measures. Results: Overweigth PCOS patients displayed increased tPA mass concentration in comparison with controls (p < 0.05), and this finding was consistent regardless of whether patients displayed signs of hyperandrogenism or not. When hyperandrogenism was introduced as a prerequisite for the PCOS diagnosis, overweight PCOS patients displayed increased PAI-1 activity as well, p < 0.05. Lean PCOS patients did not differ in terms of PAI-1 activity or tPA mass concentration in comparison to controls. Conclusion: Overweight women with PCOS have impaired fibrinolysis, in particular if they also display objective biochemical markers of hyperandrogenism.
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