Metabolic syndrome associated with hyperandrogenism in the reproductive age. Hormonal profile in different ethnicities women

Background. Metabolic syndrome (MS) with hyperandrogenism comorbidity in women is considered a common concept; however, the contribution of the neuroendocrine regulation system indicators to this in reproductive age remains unclear.
The aim. To analyze the activity of neuroendocrine regulation system in women of reproductive age of different ethnic groups with metabolic syndrome associated with hyperandrogenism.
Materials and methods. The groups of women with MS of Russian (n = 209) and Buryat (n = 84) ethnic groups and a group of women with MS and polycystic ovary syndrome (PCOS) of Russian (n = 23) and Buryat (n = 10) ethnic groups were formed.
Results. In women of reproductive age of the Russian ethnic group with MS and PCOS the study noted higher levels of anti-Müllerian hormone (AMH) (p = 0.030), testosterone (Ts) (p = 0.026), free androgen index (FAI) (p < 0.0001), dehydroepiandrosterone sulfate (DHEA-S) (p < 0.0001), and reduced levels of sex hormone-binding globulin (SHBG) (p < 0.0001) in relation to the control; in relation to the group with MS, we discovered increased values of AMH (p < 0.001), Ts (p = 0.030), FAI (p < 0.001), DHEA-S (p < 0.0001), and decreased values of SHBG (p = 0.001). In women of the Buryat ethnic group with MS and PCOS the study recorded increased values of AMH (p = 0.045), Ts (p = 0.002), FAI (p < 0.0001), DHEA-S (p = 0.033), decreased SHBG (p = 0.016) and 17-OH-progesterone (p = 0.027) levels in comparison with the control; in comparison with the group with MS we noted a higher level of DHEA-S (p = 0.006) and a decreased level of SHBG (p = 0.028).
Conclusion. Women with metabolic syndrome associated with hyperandrogenism showed more intense changes in the neuroendocrine regulation system relative to control values regardless of ethnicity. In Russian women, the combined syndrome (MS with PCOS) was accompanied by a greater number of hormonal changes compared to the monosyndrome (MS) than in Buryat women. The data obtained indicate the need to assess and control the content of these metabolites in women with MS and PCOS, taking into account ethnicity.

1. Kayumov UK, Matmuratova SO, Khatamova DT, Saipova ML. Metabolic syndrome in women of childbearing age state of the main components. Central Asian Journal of Medical and Natural Science. 2023; 4(5): 959-963. doi: 10.17605/cajmns.v4i5.1948

2. Kim MJ, Lim NK, Choi YM, Kim JJ, Hwang KR, Chae SJ, et al. Prevalence of metabolic syndrome is higher among non-obese PCOS women with hyperandrogenism and menstrual irregularity in Korea. PloS One. 2014; 9(6): e99252. doi: 10.1371/journal.pone.0099252

3. Belenkaya LV, Darenskaya MA, Kolesnikov SI, Sholokhov LF, Danusevich IN, Lazareva LM, et al. Metabolic syndrome in reproductive age women of various ethnic groups. Neuroendocrine status and lipid peroxidation system. Bulletin of Experimental Biology and Medicine. 2024; 177(6): 683-688. (In Russ.). doi: 10.47056/0365-9615-2024-177-6-683-688

4. Delitala AP, Capobianco G, Delitala G, Cherchi PL, Dessole S. Polycystic ovary syndrome, adipose tissue and metabolic syndrome. Arch Gynecol Obstet. 2017; 296: 405-419. doi: 10.1007/s00404-017-4429-2

5. Chen W, Pang Y. Metabolic syndrome and PCOS: Pathogenesis and the role of metabolites. Metabolites. 2021; 11(12): 869. doi: 10.3390/metabo11120869

6. Engmann L, Jin S, Sun F, Legro RS, Polotsky AJ, Hansen KR, et al. Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype. Am J Obstet Gynecol. 2017; 216(5): 493-e1. doi: 10.1016/j.ajog.2017.04.007

7. Suturina L, Lizneva D, Lazareva L, Danusevich I, Nadeliaeva I, Belenkaya L, et al. Ethnicity and the prevalence of polycystic ovary syndrome: The Eastern Siberia PCOS epidemiology and phenotype study. J Clin Endocrinol Metab. 2024; dgae424. doi: 10.1210/clinem/dgae530

8. Wolf WM, Wattick RA, Kinkade ON, Olfert MD. Geographical prevalence of polycystic ovary syndrome as determined by region and race/ethnicity. Int J Environ Res Public Health. 2018; 15(11): 2589. doi: 10.3390/ijerph15112589

9. Dubey P, Reddy SY, Alvarado L, Manuel SL, Dwivedi AK. Prevalence of at-risk hyperandrogenism by age and race/ethnicity among females in the United States using NHANES III. Eur J Obstet Gynecol Reprod Biol. 2021; 260: 189-197. doi: 10.1016/j.ejogrb.2021.03.033

10. Zhu JL, Chen Z, Feng WJ, Long SL, Mo ZC. Sex hormonebinding globulin and polycystic ovary syndrome. Clin Chim Acta. 2019; 499: 142-148. doi: 10.1016/j.cca.2019.09.010

11. Kanbour SA, Dobs AS. Hyperandrogenism in women with polycystic ovarian syndrome: Pathophysiology and controversies. Androg Clin Res Ther. 2022; 3(1): 22-30. doi: 10.1089/andro.2021.0020

12. Darenskaya MA. Peculiarities of metabolic reactions in indigenous and migrant populations of the North and Siberia. Acta biomedica scientifica. 2014; 2(96): 97-103. (In Russ.).

13. Belenkaia LV, Suturina LV, Darenskaya MA, Atalyan AV, Lazareva LM, Nadelyaeva IG, et al. Age-related determinants of the metabolic syndrome in women of reproductive age of the main ethnic groups of the Baikal Region. Acta biomedica scientifica. 2023; 8(4), 39-48. (In Russ.). doi: 10.29413/ABS.2023-8.4.5

14. Mychka VB, Vertkin AL, Vardaev LI, Druzhilov MA, Ipatkin RV, Kalinkin AL. et al. Experts’ consensus on the interdisciplinary approach towards the management, diagnostics, and treatment of patients with metabolic syndrome. Cardiovascular Therapy and Prevention. 2013; 12(6): 41-82. (In Russ.).

15. Rotterdam EA-SPcwg. Revised 2003 (2004) consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004; 19(1): 41-47. doi: 10.1093/humrep/deh098

16. Vilson NI, Belenkaya LV, Sholokhov LF, Igumnov IA, Nadelyaeva YaG, Suturina LV. Metabolic syndrome: Epidemiology, diagnostic criteria, racial characteristics. Acta biomedica scientifica. 2021; 6(4): 180-191. (In Russ.). doi: 10.29413/ABS.2021-6.4.16

17. Agarkov NM, Titov AA, Korneeva SI, Kolomiets VI, Aksenov VV, Kolpina LV. Metabolic syndrome as an actual health problem (analytical review). Health Care of the Russian Federation. 2023; 67(2): 136-141. (In Russ.). doi: 10.47470/0044-197X-2023-67-2-136-141

18. Sosnova E.A. Metabolic syndrome. V.F. Snegirev Archives of Obstetrics and Gynecology. 2016; 3(4): 172-180. (In Russ.). doi: 10.18821/2313-8726-2016-3-4-172-180

19. Kolesnikova LI, Kolesnikov SI, Darenskaya MA, Grebenkina LA, Nikitina OA, Lazareva LM, et al. Activity of LPO processes in women with polycystic ovarian syndrome and infertility. Bulletin of Experimental Biology and Medicine. 2017; 162(3): 320-322. doi: 10.1007/s10517-017-3605-5

20. Zhou L, Han L, Liu M, Lu J, Pan S. Impact of metabolic syndrome on sex hormones and reproductive function: A metaanalysis of 2923 cases and 14062 controls. Aging (Albany NY). 2021; 13(2): 1962. doi: 10.18632/aging.202160

21. Krusko OV, Sholokhov LF, Belenkaya LV, Rashidova MA, Danusevich IN, Nadelyaeva YG, et al. Features of the functional state of the pituitary-ovarian systems in women with polycystic ovary syndrome at different periods of reproductive age. Annals of the Russian Academy of Medical Sciences. 2020; 75(6): 653-660. (In Russ.). doi: 10.15690/vramn1251

22. Li H, Xu X, Wang X, Liao X, Li L, Yang G, et al. Free androgen index and Irisin in polycystic ovary syndrome. J Endocrinol Invest. 2016; 39: 549-556. doi: 10.1007/s40618-015-0403-7

23. Liu J, Wang Q, Zhang L, Fu J, An Y, Meng H, et al. Increased prolactin is an adaptive response to protect against metabolic disorders in obesity. Endocr Pract. 2021; 27(7): 728-735. doi: 10.1016/j.eprac.2021.01.002

24. Spinedi E, Cardinali DP. The polycystic ovary syndrome and the metabolic syndrome: A possible chronobiotic-cytoprotective adjuvant therapy. Int J Endocrinol. 2018; 1: 1349868. doi: 10.1155/2018/1349868

25. Lim SS, Kakoly NS, Tan JWJ, Fitzgerald G, Bahri Khomami M, Joham AE, et al. Metabolic syndrome in polycystic ovary syndrome: A systematic review, meta-analysis and meta-regression. Obes Rev. 2019; 20(2): 339-352. doi: 10.1111/obr.12762

26. Behboudi-Gandevani S, Ramezani Tehrani F, Rostami Dovom M, Farahmand M, Bahri Khomami M, Noroozzadeh M, et al. Insulin resistance in obesity and polycystic ovary syndrome: Systematic review and meta-analysis of observational studies. Gynecol Endocrinol. 2016; 32(5): 343-353. doi: 10.3109/09513590.2015.1117069

27. Pasquali R. Metabolic syndrome in polycystic ovary syndrome. Front Horm Res. 2018; 49: 114-130. doi: 10.1159/000485995

28. Saldívar Cerón HI, Castañeda Ramírez AE, Quiñones LE, Vargas Camacho JA, López Desidero NG. Relationship between polycystic ovary syndrome and metabolic syndrome. Journal of Reproduction. 2023; 2(1): 5-14.

29. Kim JJ, Choi YM. Phenotype and genotype of polycystic ovary syndrome in Asia: Ethnic differences. J Obstet Gynaecol Res. 2019; 45(12): 2330-2337. doi: 10.1111/jog.14132

30. Chahal N, Quinn M, Jaswa EA, Kao CN, Cedars MI, Huddleston HG. Comparison of metabolic syndrome elements in White and Asian women with polycystic ovary syndrome: Results of a regional, American cross-sectional study. F S Rep. 2020; 1(3): 305-313. doi: 10.1016/j.xfre.2020.09.008