Volume 21, Issue 2 (February 2023)                   IJRM 2023, 21(2): 167-174 | Back to browse issues page

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Asanidze E, Kristesashvili J, Parunashvili N, Urjumelashvili M, Tsetskhladze Z, Asanidze A. Hyperhomocysteinemia and pregnancy outcomes in women with polycystic ovary syndrome: A case-control study. IJRM 2023; 21 (2) :167-174
URL: http://ijrm.ir/article-1-2584-en.html
1- Department of Medical Faculty of Teaching University Geomedi, Tbilisi, Georgia. , elene.asanidze@geomedi.edu.ge
2- Department of Medical Faculty of Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.
3- University of Toronto, Faculty of Medicine, Physician Assistant Program, Toronto, Canada.
4- Teaching University Geomedi, Tbilisi, Georgia.
5- Tbilisi State Medical University, Tbilisi, Georgia.
Abstract:   (670 Views)
Background: One of the reproductive medicine challenges is to determine the role of hyperhomocysteinemia in the pathogenesis of polycystic ovary syndrome (PCOS), especially in women with recurrent pregnancy loss (RPL).
Objective: Determine the correlation between hyperhomocysteinemia and pregnancy outcome in women with PCOS.
Material and Methods: This case-control study involved 245 women (20-30 yr) and was conducted in Georgia, Tbilisi from 2019-2022. Of these, 175 were women with PCOS (study group) and 70 were healthy women (control group). Women with PCOS were divided into- group I with RPL (n = 90), and group II with live births (n = 85). Group I was divided into subgroups A and B with and without insulin resistance. The investigation measured homocysteine (Hcy), follicle-stimulating, luteinizing, anti-Mullerian hormones, total and free testosterone were determined. To determine the ovarian volume and antral follicle count, participants also underwent an ultrasound examination.
Results: In women with PCOS, the average Hcy level was significantly higher than in the controls, p < 0.05. In group I, the average Hcy level was significantly higher than in group II and controls, p < 0.05. There was no significant difference in average Hcy level between group II and controls. The average Hcy level in group I, subgroup A was significantly higher than in subgroup B, p < 0.05. The average total, free testosterone levels, and homeostatic model assessment-insulin resistance levels (HOMA-IR) in group I was significantly higher than in group II and controls. HOMA-IR in group II and controls did not differ significantly. The average anti-Mullerian hormone levels in women with PCOS were significantly higher than controls, p < 0.05. No significant difference was observed in average anti-Mullerian hormone level, ovarian volume, antral follicle count, and body mass index between the comparison groups of PCOS. In group I, a positive correlation between Hcy with HOMA-IR was detected.
Conclusion: Serum Hcy levels are elevated in women with PCOS and RPL, which correlates with their insulin resistance status.
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Type of Study: Original Article | Subject: Reproductive Pattology

1. Fauser BCJM, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R. at al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): The Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012; 97: 28-38. [DOI:10.1016/j.fertnstert.2011.09.024] [PMID]
2. Goldrat O, Delbaere A. PCOS: Update and diagnostic approach. Clin Biochem 2018; 62: 24-31. [DOI:10.1016/j.clinbiochem.2018.09.001] [PMID]
3. Chakraborty P, Goswami SK, Rajani Sh, Sharma S, Kabir SN, Chakravarty B, et al. Recurrent pregnancy loss in polycystic ovary syndrome: Role of hyperhomocysteinemia and insulin resistance. PLoS One 2013; 8: e64446. [DOI:10.1371/journal.pone.0064446] [PMID] [PMCID]
4. Cavalcante MB, Sarno M, Cavalcante CTMB, Araujo Júnior E, Barini R. Coagulation biomarkers in women with recurrent miscarriage and polycystic ovarian syndrome: Systematic review and meta-analysis. Geburtshilfe Frauenheilkd 2019; 79: 697-704. [DOI:10.1055/a-0884-3212] [PMID] [PMCID]
5. Wanderley MDS, Pereira LCR, Santos CB, Cunha VSD, Neves MVJ. Association between insulin resistance and cardiovascular risk factors in polycystic ovary syndrome patients. Rev Bras Ginecol Obstet 2018; 40: 188-195. [DOI:10.1055/s-0038-1642634] [PMID]
6. Mayrhofer D, Hager M, Walch K, Ghobrial S, Rogenhofer N, Marculescu R, et al. The prevalence and impact of polycystic ovary syndrome in recurrent miscarriage: A retrospective cohort study and meta-analysis. J Clin Med 2020; 9: 2700. [DOI:10.3390/jcm9092700] [PMID] [PMCID]
7. Zehravi M, Maqbool M, Ara I. Polycystic ovary syndrome and infertility: An update. Int J Adolesc Med Health 2021; 34: 1-9 [DOI:10.1515/ijamh-2021-0073] [PMID]
8. Barber TM, Kyrou I, Randeva HS, Weickert MO. Mechanisms of insulin resistance at the crossroad of obesity with associated metabolic abnormalities and cognitive dysfunction. Int J Mol Sci 2021; 22: 546. [DOI:10.3390/ijms22020546] [PMID] [PMCID]
9. Wang J, Wu D, Guo H, Li M. Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sci 2019; 236: 116940. [DOI:10.1016/j.lfs.2019.116940] [PMID]
10. Azziz R. Polycystic ovary syndrome. Obstet Gynecol 2018; 132: 321-336. [DOI:10.1097/AOG.0000000000002698] [PMID]
11. Kumar A, Palfrey HA, Pathak R, Kadowitz PJ, Gettys TW, Murthy SN. The metabolism and significance of homocysteine in nutrition and health. Nutr Metab (Lond) 2017; 14: 78. [DOI:10.1186/s12986-017-0233-z] [PMID] [PMCID]
12. Tinelli C, Di Pino A, Ficulle E, Marcelli S, Feligioni M. Hyperhomocysteinemia as a risk factor and potential nutraceutical target for certain pathologies. Front Nutr 2019; 6: 49 [DOI:10.3389/fnut.2019.00049] [PMID] [PMCID]
13. Chang H, Xie L, Ge H, Wu Q, Wen Y, Zhang D et al. Effects of hyperhomocysteinaemia and metabolic syndrome on reproduction in women with polycystic ovary syndrome: A secondary analysis. Reprod Biomed Online 2019; 38: 990-998. [DOI:10.1016/j.rbmo.2018.12.046] [PMID]
14. Laskowska M, Laskowska K, Terbosh M, Oleszczuk J. A comparison of maternal serum levels of endothelial nitric oxide synthase, asymmetric dimethylarginine, and homocysteine in normal and preeclamptic pregnancies. Med Sci Monit 2013; 19: 430-437. [DOI:10.12659/MSM.883932] [PMID] [PMCID]
15. Bhushan R, Sinha P. Correlation of serum homocysteine levels and hyperinsulinaemia with body mass index in polycystic ovarian syndrome. J Hum Reprod Sci 2022; 15: 34-41. [DOI:10.4103/jhrs.jhrs_147_21] [PMID] [PMCID]
16. El Safoury OS, Ezzat M, Abdelhamid MF, Shoukry N, Badawy E. The evaluation of the impact of age, skin tags, metabolic syndrome, body mass index, and smoking on homocysteine, endothelin-1, high-sensitive C-reactive protein, and on the heart. Indian J Dermatol 2013; 58: 326. [DOI:10.4103/0019-5154.113947] [PMID] [PMCID]
17. Meng Y, Chen X, Peng Zh, Liu X, Sun Y, Dai S. Association between high serum homocysteine levels and biochemical characteristics in women with polycystic ovarian syndrome: A systematic review and meta-analysis. PLoS One 2016; 11: e0157389. [DOI:10.1371/journal.pone.0157389] [PMID] [PMCID]
18. Razi Y, Eftekhar M, Fesahat F, Dehghani Firouzabadi R, Razi N, Sabour M, et al. Concentrations of homocysteine in follicular fluid and embryo quality and oocyte maturity in infertile women: A prospective cohort. J Obstet Gynaecol 2021; 41: 588-593. [DOI:10.1080/01443615.2020.1785409] [PMID]
19. Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: A committee opinion. Fertil Steril 2020; 113: 533-535. [DOI:10.1016/j.fertnstert.2019.11.025] [PMID]
20. Gordon RA. Applied statistics for the social and health sciences. UK: Routledge; 2012. [DOI:10.4324/9780203135297]
21. Kondapaneni V, Gutlapalli SD, Poudel S, Zeb M, Toulassi IA, Cancarevic I. Significance of homocysteine levels in the management of polycystic ovarian syndrome: A literature review. Cureus 2020; 12: e11110. [DOI:10.7759/cureus.11110]
22. Chen Y, Guo J, Zhang Q, Zhang C. Insulin resistance is a risk factor for early miscarriage and macrosomia in patients with polycystic ovary syndrome from the first embryo transfer cycle: A retrospective cohort study. Front Endocrinol (Lausanne) 2022; 13: 853473. [DOI:10.3389/fendo.2022.853473] [PMID] [PMCID]
23. Qi X, Zhang B, Zhao Y, Li R, Chang HM, Pang Y, et al. Hyperhomocysteinemia promotes insulin resistance and adipose tissue inflammation in PCOS mice through modulating M2 macrophage polarization via estrogen suppression. Endocrinology 2017; 158: 1181-1193. [DOI:10.1210/en.2017-00039] [PMID]
24. Wu X, Li Zh, Sun W, Zheng H. Homocysteine is an indicator of arterial stiffness in Chinese women with polycystic ovary syndrome. Endocr Connect 2021; 10: 1073-1079. [DOI:10.1530/EC-21-0224] [PMID] [PMCID]
25. Chakraborty P, Mitra I, Kalapahar S, Sharma S, Chattopadhyay R, Chakravarty B. Significance of hyperhomocysteinemia in immediate as well as long-term health risk/s in women with polycystic ovary syndrome: A probabilistic model using dynamic bayesian network analysis. Reprod Sci 2022; ahead of print. [DOI:10.1007/s43032-022-01028-4] [PMID]
26. Bhushan R, Sinha P. Correlation of serum homocysteine levels and hyperinsulinaemia with body mass index in polycystic ovarian syndrome. J Hum Reprod Sci 2022; 15: 34-41. [DOI:10.4103/jhrs.jhrs_147_21] [PMID] [PMCID]
27. Krysiak R, Szkróbka W, Okopień B. The impact of atorvastatin on cardiometabolic risk factors in brothers of women with polycystic ovary syndrome. Pharmacol Rep 2021; 73: 261-268. https://doi.org/10.1007/s43440-021-00276-6 [DOI:10.1007/s43440-020-00135-w] [PMCID]
28. Asanidze E, Khristesashvili J, Pkhaladze L, Barbakadze L. [Correlation of anti-mullerian hormone with hormonal and ovarian morphological characteristics in patients with polycystic ovary syndrome with and without insulin resistance]. Georgian Med News 2018; 275: 34-40. (in Russian)
29. Ran Y, Yi Q, Li C. The relationship of anti-Mullerian hormone in polycystic ovary syndrome patients with different subgroups. Diabetes Metab Syndr Obes 2021; 14: 1419-1424. [DOI:10.2147/DMSO.S299558] [PMID] [PMCID]

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