Markers assessing bone and metabolic health in polycystic ovary syndrome

• Main Author: Lingaiah, S. (Shilpa)
• Other Authors: Tapanainen, J. (Juha S.)
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Oulun yliopisto 2021
• Subjects: adipokines; bone formation; bone resorption; bone turnover markers; carboxy-terminal cross-linking telopeptide of type I collagen; fatty acid-binding protein 2; indican; intestinal permeability; metformin; osteocalcin; polycystic ovary syndrome; procollagen type I amino-terminal propeptide; retinol-binding protein 4; zonulin; adipokiinit; indigaani; luun resorptio; luun vaihtuvuusmerkkiaineet; luunmuodostus; metformiini; munasarjojen monirakkulatauti; osteokalsiini; rasvahappoja sitova proteiini 2; retinolia sitova proteiini 4; suoliston läpäisevyys; tyypin I kollageenin karboksiterminaalinen telopeptidi; tyypin I prokollageenin aminoterminaalinen propeptidi; zonuliini; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526228938

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. The main features of the syndrome include menstrual irregularities, hyperandrogenism, polycystic ovaries, chronic inflammation, and insulin resistance, predisposing these women to reproductive, metabolic, and cardiovascular health implications across the life span. Adipose tissue dysfunction, via the secretion of adipocytokines and altered intestinal permeability have been thought to influence the pathogenesis of the syndrome. Moreover, women with PCOS display changes in several hormonal systems, which can affect bone metabolism and bone mass. The main objectives of the study were to evaluate the association between PCOS and bone metabolism, and to study the effect of metformin, a common drug used in the management of PCOS, on bone health in women with PCOS. Further, adipokines and intestinal permeability markers were studied to evaluate their association in women with PCOS. The study populations were a Nordic population including 298 women with PCOS and 194 controls, and a population derived from the Northern Finland Birth Cohort 1966 consisting of 104 women with PCOS and 203 controls. Decreased levels of bone formation markers and unchanged levels of bone resorption marker were observed in women with PCOS under the age of 30 compared with age-matched controls. Furthermore, metformin treatment in premenopausal women with PCOS for three months was associated with reduced bone turnover as assessed by decreases in bone formation and resorption markers. These findings suggest that bone formation is decreased in women with PCOS under the age of 30. However, treatment with metformin was associated with reduced bone turnover and slower bone remodeling, possibly preventing bone loss. Even though increased levels of retinol-binding protein 4 (RBP4), an adipokine influencing systemic insulin sensitivity, were seen in women with PCOS under the age of 30, the impact of RBP4 on the metabolic derangements in PCOS could ...