Influence of Helicobacter pylori infection on hormonal and metabolic indicators and chronic inflammation markers in women with polycystic ovary syndrome
Keywords:polycystic ovary syndrome, Helicobacter pylori infection, hyperandrogenemia, dyslipidemia, insulin resistance, C-reactive protein, interleukin-6
AbstractBackground. The purpose of this study was to evaluate the impact of Helicobacter pylori (H.pylori) infection on hormonal and metabolic parameters, markers of chronic inflammation in patients with polycystic ovary syndrome (PCOS). Materials and methods. Sixty patients with PCOS (26.4 ± 0.2 years) and 40 healthy women of corresponding age were examined. We have investigated blood lipid spectrum, parameters of carbohydrate metabolism, levels of total testosterone, estradiol, sex hormone-binding globulin, C-reactive protein, interleukin-6, IgG antibodies to H.pylori, homocysteine. Evaluation of these indicators was performed depending on the presence or absence of H.pylori infection. Results. It was found that in the control group, elevated levels of IgG antibodies to H.pylori were detected in 17.5 % of women, and they had a decrease in the concentration of sex hormone-binding globulin and an increase in the level of C-reactive protein and homocysteine. Among patients with PCOS, H.pylori infection was significantly more common (χ2 = 7.7; p < 0.01), and its presence exacerbated existing dyslipidemia, insulin resistance, hyperandrogenemia by increasing the levels of total testosterone and decreasing the content of sex hormone-binding globulin, it was accompanied by the formation of hyperhomocysteinemia and a significant increase in inflammatory markers. It was found that in patients with PCOS, increased concentration of C-reactive protein in the blood serum was associated with insulin resistance and dyslipidemia, and increased levels of interleukin-6 — with the severity of insulin resistance and hyperandrogenemia. Conclusions. The results indicate a strong relationship between PCOS and H.pylori infection, which enhances the existing metabolic and hormonal disorders characteristic of PCOS, leads to an increase in C-reactive protein and interleukin-6 levels. However, it cannot be said that this infection is a new pathogenic factor for the formation of PCOS.
Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E; American Association of Clinical Endocrinologists (AACE); American College of Endocrinology (ACE); Androgen Excess and PCOS Society (AES). State clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome – part 1. Endocr Pract. 2015;21(11):1291-300. doi: 10.4158/EP15748.DSC.
Yavasoglu I, Kucuk M, Cildag B, Arslan E, Gok M, Kafkas S. A novel association between polycystic ovary syndrome and Helicobacter pylori. Am J Med Sci. 2009 Sep;338(3):174-7. doi: 10.1097/MAJ.0b013e3181a63c8a.
Kolesnikova OV, Kozyreva TE. Is Infection Helicobacter pylori only problem of gastroenterology? Modern Gastroenterology. 2014;6(80):137-141. (in Ukrainian).
Bravo D, Hoare A, Soto C, Valenzuela MA, Quest AF. Helicobacter pylori in human health and disease: Mechanisms for local gastric and systemic effects. World J Gastroenterol. 2018 Jul 28;24(28):3071-3089. doi: 10.3748/wjg.v24.i28.3071.
Polyzos SA, Kountouras J, Zavos C, Deretzi G. The association between Helicobacter pylori infection and insulin resistance: a systematic review. Helicobacter. 2011 Apr;16(2):79-88. doi: 10.1111/j.1523-5378.2011.00822.x.
Chen TP, Hung HF, Chen MK, et al. Helicobacter Pylori Infection is Positively Associated with Metabolic Syndrome in Taiwanese Adults: a Cross-Sectional Study. Helicobacter. 2015;20(3):184-91. doi: 10.1111/hel.12190.
Papamichael KX, Papaioannou G, Karga H, Roussos A, Mantzaris GJ. Helicobacter pylori infection and endocrine disorders: Is there a link? World J Gastroenterol. 2009 Jun 14;15(22):2701-7. doi: 10.3748/wjg.15.2701.
Chen LW, Kuo SF, Chen CH, Chien CH, Lin CL, Chien RN. A community-based study on the association between Helicobacter pylori infection and obesity. Sci Rep. 2018;8(1):10746. doi: 10.1038/s41598-018-28792-1.
Carabotti M, D’Ercole C, Iossa A, Corazziari E, Silecchia G, Severi C. Helicobacter pylori infection in obesity and its clinical outcome after bariatric surgery. World J Gastroenterol. 2014;20(3):647-653. doi: 10.3748/wjg.v20.i3.647.
Chen LW, Chien CY, Yang KJ, Kuo SF, Chen CH, Chien RN. Helicobacter pylori Infection Increases Insulin Resistance and Metabolic Syndrome in Residents Younger than 50 Years Old: A Community-Based Study. PLoS One. 2015;10(5):e0128671. doi: 10.1371/journal.pone.0128671.
Polyzos SA, Kountouras J, Zavos C, Deretzi G. The association between Helicobacter pylori infection and insulin resistance: a systematic review. Helicobacter. 2011;16(2):79-88. doi: 10.1111/j.1523-5378.2011.00822.x.
Hossain IA, Akter S, Bhuiyan FR, Shah MR, Rahman MK, Ali L. Subclinical inflammation in relation to insulin resistance in prediabetic subjects with nonalcoholic fatty liver disease. BMC Res Notes. 2016;9:266. doi: 10.1186/s13104-016-2071-x.
Hotamisligil GS, Johnson RS, Distel RJ, Ellis R, Papaioannou VE, Spiegelman BM. Uncoupling of obesity from insulin resistance through a targeted mutation in aP2, the adipocyte fatty acid binding protein. Science.1996;274(5291):1377-9. doi: 10.1126/science.274.5291.1377.
Chimienti G, Russo F, Lamanuzzi BL, et al. Helicobacter pylori is associated with modified lipid profile: impact on Lipoprotein(a). Clin Biochem. 2003;36(5):359-65. doi: 10.1016/s0009-9120(03)00063-8.
Kurotsuchi S, Ando H, Iwase A, Ishida Y, Hamajima N, Kikkawa F. The plausibility of Helicobacter pylori-related infertility in Japan. Fertil Steril. 2008;90(3):866-868. doi: 10.1016/j.fertnstert.2007.06.097.
Yavasoglu I, Kucuk M, Cildag B, Arslan E, Gok M, Kafkas S. A novel association between polycystic ovary syndrome and Helicobacter pylori. Am J Med Sci. 2009;338(3):174-177. doi: 10.1097/MAJ.0b013e3181a63c8a.
Tokmak A, Doğan Z, Sarıkaya E, Timur H, Kekilli MJ. Helicobacter pylori infection and polycystic ovary syndrome in adolescent and young adult patients. Obstet Gynaecol Res. 2016;42(12):1768-1772. doi: 10.1111/jog.13103.
Nehir Aytan A, Bastu E, Demiral I, Bulut H, Dogan M, Buyru F. Relationship between hyperandrogenism, obesity, inflammation and polycystic ovary syndrome. Gynecol Endocrinol. 2016;32(9):709-713. doi: 10.3109/09513590.2016.1155208.
Castell JV, Gómez-Lechón MJ, David M, et al. Interleukin-6 is the major regulator of acute phase protein synthesis in adult human hepatocytes. FEBS Lett. 1989;242(2):237-239. doi: 10.1016/0014-5793(89)80476-4.
Tumu VR, Govatati S, Guruvaiah P, Deenadayal M, Shivaji S, Bhanoori M. An interleukin-6 gene promoter polymorphism is associated with polycystic ovary syndrome in South Indian women. J Assist Reprod Genet. 2013;30(12):1541-1546. doi: 10.1007/s10815-013-0111-1.
Diamanti-Kandarakis E, Alexandraki K, Piperi C. Inflammatory and endothelial markers in women with polycystic ovary syndrome. Eur J Clin Invest. 2006;36(10):691-697. doi: 10.1111/j.1365-2362.2006.01712.x.
Bravo D, Hoare A, Soto C, Valenzuela M, Quest AFG. Helicobacter pylori in human health and disease: Mechanisms for local gastric and systemic effects. World J Gastroenterol. 2018;24(28):3071-3089. doi: 10.3748/wjg.v24.i28.3071.
Ezeh U, Pall M, Mathur R, Azziz R. Association of fat to lean mass ratio with metabolic dysfunction in women with polycystic ovary syndrome. Hum Reprod. 2014;29(7):1508-1517. doi: 10.1093/humrep/deu096.
Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-419. doi: 10.1007/bf00280883.
Dale PO, Tanbo T, Ertzeid G, Bjercke S, Oldereid N, Fedorcsák P, Abyholm T. The impact of insulin resistance on the outcome of laparoscopic ovarian electrocautery in infertile women with the polycystic ovary syndrome. Gynecol Endocrinol. 2004;19(4):182-9. doi: 10.1080/09513590400012093.
Kandaraki E, Chatzigeorgiou A, Livadas S, et al. Endocrine disruptors and polycystic ovary syndrome (PCOS): elevated serum levels of bisphenol A in women with PCOS. J Clin Endocrinol Metab. 2011;96(3):480-4. doi: 10.1210/jc.2010-1658.
Moshage HJ, Roelofs HM, van Pelt JF. et al. The effect of interleukin-1, interleukin-6 and its interrelationship on the synthesis of serum amyloid A and C-reactive protein in primary cultures of adult human hepatocytes. Biochem Biophys Res Commun. 1988;155(1):112-117. doi: 10.1016/s0006-291x(88)81056-8.
Diamanti-Kandarakis E, Alexandraki K, Piperi C. et al. Inflammatory and endothelial markers in women with polycystic ovary syndrome. Eur J Clin Invest. 2006;36(10):691-697. doi: 10.1111/j.1365-2362.2006.01712.x.
Gromnitskaya EE. Homocysteine exchange in women with polycystic ovary syndrome. Problemy reproduktsii. 2010;16(3):49-52. (in Russian).
Kim J, Pyo S, Yoon DW, et al. The co-existence of elevated high sensitivity C-reactive protein and homocysteine levels is associated with increased risk of metabolic syndrome: A 6-year follow-up study. PLoS One. 2018;13(10):e0206157. doi:10.1371/journal.pone.0206157.
How to Cite
Copyright (c) 2019 T.L. Arkhypkina, V.A. Bondarenko, L.P. Lyubimovа
This work is licensed under a Creative Commons Attribution 4.0 International License.