Increased serum advanced glycation end-products is a distinct finding in lean women with polycystic ovary syndrome (PCOS)

• Published in: Clinical endocrinology (Oxford) Vol. 69; no. 4; pp. 634 - 641
• Main Authors: Diamanti-Kandarakis, Evanthia, Katsikis, Ilias, Piperi, Christina, Kandaraki, Eleni, Piouka, Athanasia, Papavassiliou, Athanasios G., Panidis, Dimitrios
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2008; Blackwell
• Subjects: Adult; Biological and medical sciences; Body Mass Index; Case-Control Studies; Endocrinopathies; Female; Female genital diseases; Fundamental and applied biological sciences. Psychology; Glycation End Products, Advanced - blood; Gynecology. Andrology. Obstetrics; Humans; Insulin Resistance; Lysine - analogs & derivatives; Lysine - analysis; Lysine - blood; Medical sciences; Non tumoral diseases; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - classification; Polycystic Ovary Syndrome - complications; Sensitivity and Specificity; Thinness - blood; Thinness - complications; Up-Regulation; Vertebrates: endocrinology; Waist-Hip Ratio; Young Adult; Human; Female sterility; Polycystic ovary; Female genital diseases; Ovarian diseases; Advanced glycation end products; Cyst; Adult; Female; Serum; Benign neoplasm; Woman; Endocrinology
• ISSN: 0300-0664; 1365-2265; 1365-2265
• DOI: 10.1111/j.1365-2265.2008.03247.x

Summary Background  Nonenzymatic advanced glycation and oxidation end‐products, advanced glycation end‐products (AGEs), impart a potent impact on vessels and other tissues in diabetic state and in euglycaemic conditions with increased oxidative stress. Insulin resistant (IR) polycystic ovary syndrome (PCOS) women, have elevated serum AGEs, increased receptor (RAGE) expression, and increased deposition with differential localization in the polycystic ovarian tissue (theca and granulosa) compared to normal. Objective  To determine whether the raised AGE levels in noninsulin resistant women with PCOS is a distinct finding compared with those presenting the isolated components of the syndrome and among PCOS subphenotypes. Noninsulin resistant women were selected in order to show that serum AGEs are elevated in PCOS independently of the presence of IR. Design  Clinical trial. Patients  One hundred and ninety‐three age‐ and BMI‐matched young lean noninsulin resistant women were studied. Among them, 100 women were diagnosed with PCOS according to Rotterdam criteria, and divided to subphenotypes (hyperandrogenaemia with or without PCO morphology and with or without anovulation). Sixty‐eight women with the isolated components of the PCOS phenotype were also studied along with 25 healthy women. Measurements  Serum AGE levels, metabolic, hormonal profiles and intravaginal ultrasound were determined in all subjects. Results  The studied population did not differ in BMI, fasting insulin concentration, waist : hip and glucose : insulin ratios. PCOS women exhibited statistically higher AGEs levels (7·96 ± 1·87 U/ml, P < 0·001) compared with those with isolated hyperandrogenaemia (5·61 ± 0·61 U/ml), anovulation (5·53 ± 1·06 U/ml), US‐PCO morphology (5·26 ± 0·25 U/ml) and controls (5·86 ± 0·89 U/ml). Conclusions  In PCOS, serum AGEs are distinctly elevated compared with women having the isolated characteristics of the syndrome. No difference was observed between PCOS subphenotypes. As chronic inflammation and increased oxidant stress have been incriminated in the pathophysiology of PCOS, the role of AGEs as inflammatory and oxidant mediators, may be linked with the metabolic and reproductive abnormalities of the syndrome.