en نگاهی دقیق‌تر به نیتریک‌اکسید در گردش و ارتباط آن با سندرم تخمدان پلی‌کیستیک: یک بررسی متاآنالیز Reproductive Endocrinology Review article Review Article <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span b="" lang="FA" mitra="" style="font-family:">مقدمه: </span></b><span b="" lang="FA" mitra="" style="font-family:">سندرم تخمدان پلی&shy;کیستیک (</span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" lang="FA" mitra="" style="font-family:">) سایه گسترده&shy;ای بر سلامت باروری میلیون&shy;ها زن، در سراسر جهان می&shy;اندازد و به عنوان یکی از پیچیده&shy;ترین و چندوجهی&shy;ترین اختلالات غدد درون&shy;ریز ظاهر می&shy;شود. علاوه بر این، نیتریک اکسید (</span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span><span b="" lang="FA" mitra="" style="font-family:">) به عنوان یک مولکول سیگنال محوری برجسته است که مجموعه</span><span arial="" dir="LTR" style="font-family:">&shy;</span><span b="" lang="FA" mitra="" style="font-family:">ای از فرآیندهای فیزیولوژیکی را تنظیم می</span><span arial="" dir="LTR" style="font-family:">&shy;</span><span b="" lang="FA" mitra="" style="font-family:">کند.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span b="" lang="FA" mitra="" style="font-family:">هدف: </span></b><span b="" lang="FA" mitra="" style="font-family:">این متاآنالیز با هدف روشن کردن ارتباط بین سطوح </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span> <span b="" lang="FA" mitra="" style="font-family:">و اختلال </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" mitra="" style="font-family:"> در زنان شکل گرفته است، این مطالعه بررسی پتانسیل </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span><span b="" mitra="" style="font-family:"> را به عنوان یک نشانگر زیستی برای تشخیص </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" mitra="" style="font-family:"> و ارزیابی اهمیت بالینی آن نشان می‌دهد.</span><b><span dir="LTR" style="font-family:"Arial","sans-serif""></span></b></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span b="" lang="FA" mitra="" style="font-family:">مواد و روش&shy; ها: </span></b><span b="" lang="FA" mitra="" style="font-family:">جستجوی سیستماتیک در چندین پایگاه داده الکترونیکی از جمله </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PubMed</span></span><span b="" lang="FA" mitra="" style="font-family:">، </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Web of Science</span></span><span b="" lang="FA" mitra="" style="font-family:">، </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Cochrane Library</span></span><span b="" lang="FA" mitra="" style="font-family:">، </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Scopus</span></span><span b="" lang="FA" mitra="" style="font-family:">، </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">EMBASE</span></span><span b="" mitra="" style="font-family:"> و </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Google Scholar</span></span><span b="" mitra="" style="font-family:"> برای شناسایی مطالعات مرتبط منتشر شده تا ژانویه 2024 انجام شد. تفاوت میانگین استاندارد شده (</span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">SMD</span></span><span b="" lang="FA" mitra="" style="font-family:">) و </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">CI</span></span><span b="" mitra="" style="font-family:"> %95 با استفاده از یک مدل اثرات تصادفی برای ارزیابی اندازه اثر کلی محاسبه شد. متارگرسیون و تجزیه و تحلیل زیر گروهی برای بررسی منابع ناهمگنی انجام شد.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span b="" lang="FA" mitra="" style="font-family:">نتایج: </span></b><span b="" lang="FA" mitra="" style="font-family:">متاآنالیز 14 مطالعه با 1171 شرکت‌کننده نشان داد که سطوح </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span><span b="" mitra="" style="font-family:"> در گروه </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" mitra="" style="font-family:"> به طور معنی‌داری کمتر از گروه کنترل بود. تجزیه و تحلیل ادغام شده یک تفاوت میانگین استاندارد (</span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">SMD</span></span><span b="" lang="FA" mitra="" style="font-family:">) از 482/0- را به همراه داشت (027/0 </span><span lang="FA" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">= </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p</span></span><span b="" lang="FA" mitra="" style="font-family:">، 056/0- تا 908/0- </span><span lang="FA" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">=</span></span> <span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">CI</span></span><span b="" lang="FA" mitra="" style="font-family:"> %95). تجزیه و تحلیل&shy;های زیرگروهی تغییرات بیشتری را در سطوح </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span><span b="" mitra="" style="font-family:"> بین فنوتیپ&shy;های مختلف </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" mitra="" style="font-family:"> و در رابطه با پارامترهای متابولیک نشان داد.</span><b><span dir="LTR" style="font-family:"Arial","sans-serif""></span></b></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span b="" lang="FA" mitra="" style="font-family:">نتیجه&shy; گیری: </span></b><span b="" lang="FA" mitra="" style="font-family:">این متاآنالیز شواهدی را برای ارتباط بین </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" mitra="" style="font-family:"> و سطوح متفاوتی از </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span><span b="" mitra="" style="font-family:"> ارائه می‌کند و نقش بالقوه </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NO</span></span><span b="" mitra="" style="font-family:"> را به عنوان یک نشانگر زیستی در تشخیص و پاتوژنز </span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span b="" mitra="" style="font-family:"> نشان می‌دهد.</span><b><span dir="LTR" style="font-family:"Arial","sans-serif""></span></b></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Background:&nbsp; </b>Polycystic ovary syndrome (PCOS) casts a wide shadow over the reproductive health of millions of women worldwide, emerging as one of the most complex and multifaceted endocrine disorders. In addition, nitric oxide (NO) stands out as a pivotal signaling molecule, orchestrating a symphony of physiological processes.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Objective: </b>This meta-analysis aims to elucidate the association between NO levels and PCOS, investigate the potential of NO as a biomarker for PCOS diagnosis, and evaluate its clinical significance.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Materials and Methods:</b> A systematic review was conducted in several electronic databases, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and Google Scholar, to identify relevant studies published up to January 2024. Standardized mean difference and 95% CI were calculated using a random effects model to assess the overall effect size. Meta-regressions and subgroup analysis were performed to investigate sources of heterogeneity.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Results:</b> A meta-analysis of 14 studies with 1171 participants showed that NO levels were significantly lower in the PCOS group than in the control group. The pooled analysis yielded a standardized mean difference of -0.482; 95% CI: -0.908 to -0.056; p = 0.027. Subgroup analyses further demonstrated variations in NO levels between different PCOS phenotypes and in relation to metabolic parameters.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Conclusion:</b> This meta-analysis provides evidence for an association between PCOS and dysregulated NO levels and suggests a potential role of NO as a biomarker in the diagnosis and pathogenesis of PCOS.</span></span><br> &nbsp;</div> <div style="text-align: center;"><span style="font-size:14px;"><span style="line-height:normal"><span new="" roman="" style="font-family:" times=""><b><i>Registration ID in PROSPERO: CRD42024507048</i></b></span></span></span></div> <div style="text-align: justify;"><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><span style="font-size:10.0pt"></span></span></span></div> سندرم تخمدان پلی‌کیستیک, نیتریک اکسید, استرس اکسیداتیو, متاآنالیز. Polycystic ovary syndrome, Nitric oxide, Oxidative stress, Meta-analysis. 943 962 http://ijrm.ir/browse.php?a_code=A-10-2780-1&slc_lang=en&sid=1 Seyed Sobhan Bahreiny bahreiny.s@ajums.ac.ir 0000-0003-2148-1205 No Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Akram Ahangarpour akramahangarpour@gmail.com 0000-0002-9534-9699 No Medical Basic Sciences Research Institute, Physiology Research Center, Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Elnaz Harooni elnazharooni@gmail.com 0000-0002-0775-7933 No Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Mahdi Amraei mahdiamraei1996@gmail.com 0000-0001-9693-4673 No Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Mojtaba Aghaei mojtabaaghaei745@gmail.com 0000-0002-6382-6657 No Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Reza Mohammadpour Fard rezamohammadpour1377@gmail.com 0009-0008-3588-1633 Yes Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran