Nutrition, insulin and polycystic ovary syndrome

Franks, Stephen

doi:10.1530/ror.0.0010047

Cited by 64 publications

(17 citation statements)

References 22 publications

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“…As a result of the enhanced steroidogenesis due to insulin and its interaction with LH, the unfavorable milieu causes cessation of the follicle growth. Thus, premature luteinization and follicular arrest develops and leads to menstrual cycle disorders and obesity-induced oligo-anovulation (37). The increased estrogen due to peripheral convesion disturbs the HPG axis.…”

Section: Anovulation and Menstrual Disturbancesmentioning

confidence: 99%

Impact of obesity on infertility in women

Dağ

Dilbaz

2015

J Turkish German Gynecol Assoc

223

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Review 111 IntroductionObesity, which is an important health issue, is a common problem among women of reproductive age. Obesity and overweight involves an abnormal and excessive fat accumulation that negatively affects the health of the body. According to the World Health Organization (WHO), if the body mass index (BMI) equals to or is greater than 25 kg/m 2 , it is considered overweight, whereas if the BMI equals to or is greater than 30 kg/m 2 , it is considered obesity (1). Obesity brings out many problems such as social, psychological, demographic, and health problems. It is related to increased health risks such as diabetes mellitus, hypertension, coronary heart disease, and osteoarthritis and is linked to various malignancies, particularly endometrium, breast, and colon cancers. Obesity also plays a significant role in reproductive disorders, particularly in women. It is associated with anovulation, menstrual disorders, infertility, difficulties in assisted reproduction, miscarriage, and adverse pregnancy outcomes. In obese women, gonadotropin secretion is affected because of the increased peripheral aromatization of androgens to estrogens. The insulin resistance and hyperinsulinemia in obese women leads to hyperandrogenemia. The sex hormone-binding globulin (SHBG), growth hormone (GH), and insulin-like growth factor binding proteins (IGFBP) are decreased and leptin levels are increased. Thus, the neuroregulation of the hypothalamic-pituitary-gonadal (HPG) axis deteriorates (2). These alterations may explain impaired ovulatory function and so reproductive health. Because of lower implantation and pregnancy rates, higher miscarriage rates, and increased maternal and fetal complications during pregnancy, obese women have a lower chance to give birth to a healthy newborn (3)(4)(5)(6). In this review, the effects of obesity on fertility and effective management of infertility in obese and overweight women is summarized. Epidemiology of obesityThe prevalence of obesity is increasing significantly worldwide. The International Obesity Task Force reported that 1,1 billion adults are overweight. They also reported that 312 million of them are obese (7). Approximately 3,4 million adults die each year because of health problems associated with obesity and being overweight. Of these, 44% of the problems are related to diabetes, 23% to ischemic heart disease, and between 7% and 41% to some malignancies associated with overweight and obesity (7). The prevelence of obesity has increased in developed countries because of a change in lifestyle, including reduced physical activity, changes in nutrition style, and an increased calorie intake (8). However, some other factors such as endocrine disorders, hormonal disorders, psychological disorders, and use of some drugs such as steroids and antidepressants may lead to obesity (9). The World Health Organization reported that 60% of women are overweight (≥25 kg/m 2 ) in the United States and most European countries and 30% of these are obese (≥30 kg/m 2 ) and 6% of these are mo...

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Section: Anovulation and Menstrual Disturbancesmentioning

confidence: 99%

Impact of obesity on infertility in women

Dağ

Dilbaz

2015

J Turkish German Gynecol Assoc

223

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“…These small antral follicles are due to the arrest of growth after reaching a diameter of 5 to 8mm. The arrest of small follicles may be caused by premature activation of LH-mediated terminal differentiation of granulosa cells (S. Franks, et al 1996). In the normal menstrual cycle, granulosa cells of the dominant follicle become responsive to LH in mid-follicular phase at a follicular diameter of 10mm (SG.…”

Section: Insulin Resistance / Hyperinsulinemia and Ovulatory Disordersmentioning

confidence: 99%

Implications of Insulin Resistance / Hyperinsulinemia on Reproductive Function in Infertile Women with Polycystic Ovary Syndrome

Sakumoto¹,

Tokunaga²,

Terada³

et al. 2012

Polycystic Ovary Syndrome

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“…For example, if cellular energy balance is positive, such as in the case of obesity and insulin resistance, there is a reduction in reproductive ability in both sexes (Chou et al 2014). Abnormal amenorrhoea in females is the first sign of these adverse effects (Franks et al 1996), and in males there is a decrease in sperm production usually associated with altered sex hormone secretion (Rato et al 2014). One of the most frequent causes of female infertility is polycystic ovary syndrome (PCOS), which affects 5 -10% of women of reproductive age and is frequently associated with insulin resistance.…”

Section: Introductionmentioning

confidence: 99%

The insulin sensitiser metformin regulates chicken Sertoli and germ cell populations

Faure¹,

Guibert²,

Alves³

et al. 2016

Reproduction

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Metformin, an insulin sensitiser from the biguanide family of molecules, is used for the treatment of insulin resistance in type 2 diabetes individuals. It increases peripheral glucose uptake and may reduce food intake. Based on the tight link between metabolism and fertility, we investigated the role of metformin on testicular function using in vitro culture of Sertoli cells and seminiferous tubules, complemented by in vivo data obtained following metformin administration to prepubertal chickens. In vitro, metformin treatment reduced Sertoli cell proliferation without inducing apoptosis and morphological changes. The metabolism of Sertoli cells was affected because lactate secretion by Sertoli cells increased approximately twofold and intracellular free ATP was negatively impacted. Two important pathways regulating proliferation and metabolism in Sertoli cells were assayed. Metformin exposure was not associated with an increased phosphorylation of AKT or ERK. There was a 90% reduction in the proportion of proliferating germ cells after a 96-h exposure of seminiferous tubule cultures to metformin. In vivo, 6-week-old chickens treated with metformin for 3 weeks exhibited reduced testicular weight and a 50% decrease in testosterone levels. The expression of a marker of undifferentiated germ cells was unchanged in contrast to the decrease in expression of 'protamine', a marker of differentiated germ cells. In conclusion, these results suggest that metformin affects the testicular energy content and the proliferative ability of Sertoli and germ cells.

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Nutrition, insulin and polycystic ovary syndrome

Cited by 64 publications

References 22 publications

Impact of obesity on infertility in women

Impact of obesity on infertility in women

Implications of Insulin Resistance / Hyperinsulinemia on Reproductive Function in Infertile Women with Polycystic Ovary Syndrome

The insulin sensitiser metformin regulates chicken Sertoli and germ cell populations

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