Effects of antioxidant supplementation for polycystic ovary syndrome
DOI:
https://doi.org/10.12775/JEHS.2024.61.50695Keywords
polycystic ovary syndrome, antioxidant, oxidative stressAbstract
Introduction and purpose: Polycystic ovary syndrome is the most common endocrinopathy in women, with a prevalence ranging from 10% to 13%. Oxidative stress and decreased antioxidant levels contribute to the development of various diseases, and one of them is polycystic ovary syndrome. The aim of this review is to provide an overview of the current knowledge about the effects of antioxidant administration in PCOS treatment.
A brief description of the state of knowledge: Oxidative stress is an imbalance between increased levels of reactive oxygen species and a decreased efficiency of antioxidant mechanisms, which can potentially cause damage. The harmful effects of free radicals might be neutralized by antioxidants obtained from the diet, such as polyphenols, vitamins C, and E. These compounds improve several aspects of the PCOS pathomechanism, including hormonal imbalance, glucose metabolism, lipid profile, and ovarian functionality.
Conclusions: The outcomes of all the reviewed studies in this paper indicate that antioxidants such as resveratrol, curcumin, vitamin C and E, N-acetylcysteine, and melatonin have therapeutic potential in the management of PCOS. However, currently antioxidant therapies cannot be recommended in PCOS therapy since there is a need for more prospective randomized clinical trials on a larger sample to establish a long-term effects of antioxidants supplementation in PCOS, the optimal dosage, and finally to assess which antioxidant is the most efficient in PCOS treatment.
References
Teede, H.J., Tay, C.T., Laven, J.J.E., Dokras, A., Moran, L.J., Piltonen, T.T., Costello, M.F., Boivin, J., Redman, L.M., Boyle, J.A., Norman, R.J., Mousa, A., Joham, A.E., Network, on behalf of the I.P.: Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 108, 2447–2469 (2023). https://doi.org/10.1210/CLINEM/DGAD463
Dennett, C.C., Simon, J.: The Role of Polycystic Ovary Syndrome in Reproductive and Metabolic Health: Overview and Approaches for Treatment. Diabetes Spectr. 28, 116 (2015). https://doi.org/10.2337/DIASPECT.28.2.116
Teede, H.J., Tay, C.T., Laven, J., Dokras, A., Moran, L.J., Piltonen, T.T., Costello, M.F., Boivin, J., M Redman, L., A Boyle, J., Norman, R.J., Mousa, A., Joham, A.E., International PCOS Network: Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 120, 767–793 (2023). https://doi.org/10.1016/j.fertnstert.2023.07.025
Hajam, Y.A., Rather, H.A., Neelam, Kumar, R., Basheer, M., Reshi, M.S.: A review on critical appraisal and pathogenesis of polycystic ovarian syndrome. Endocrine and Metabolic Science. 14, 100162 (2024). https://doi.org/10.1016/J.ENDMTS.2024.100162
Harada, M.: Pathophysiology of polycystic ovary syndrome revisited: Current understanding and perspectives regarding future research. Reprod Med Biol. 21, (2022). https://doi.org/10.1002/RMB2.12487
Rasquin, L.I., Anastasopoulou, C., Mayrin, J. V.: Polycystic Ovarian Disease. Encyclopedia of Genetics, Genomics, Proteomics and Informatics. 1528–1528 (2022). https://doi.org/10.1007/978-1-4020-6754-9_13178
Preiser, J.C.: Oxidative stress. JPEN J Parenter Enteral Nutr. 36, 147–154 (2012). https://doi.org/10.1177/0148607111434963
Fenkci, V., Fenkci, S., Yilmazer, M., Serteser, M.: Decreased total antioxidant status and increased oxidative stress in women with polycystic ovary syndrome may contribute to the risk of cardiovascular disease. Fertil Steril. 80, 123–127 (2003). https://doi.org/10.1016/S0015-0282(03)00571-5
Murri, M., Luque-ramírez, M., Insenser, M., Ojeda-ojeda, M., Escobar-morreale, H.F.: Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): a systematic review and meta-analysis. Hum Reprod Update. 19, 268–288 (2013). https://doi.org/10.1093/HUMUPD/DMS059
Janciauskiene, S.: The Beneficial Effects of Antioxidants in Health and Diseases. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation. 7, 182 (2020). https://doi.org/10.15326/JCOPDF.7.3.2019.0152
Tan, D.X., Manchester, L.C., Esteban-Zubero, E., Zhou, Z., Reiter, R.J.: Melatonin as a Potent and Inducible Endogenous Antioxidant: Synthesis and Metabolism. Molecules. 20, 18886 (2015). https://doi.org/10.3390/MOLECULES201018886
Lobo, V., Patil, A., Phatak, A., Chandra, N.: Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 4, 118 (2010). https://doi.org/10.4103/0973-7847.70902
Meng, X., Zhou, J., Zhao, C.N., Gan, R.Y., Li, H. Bin: Health Benefits and Molecular Mechanisms of Resveratrol: A Narrative Review. Foods 2020, Vol. 9, Page 340. 9, 340 (2020). https://doi.org/10.3390/FOODS9030340
Hurst, W.J., Glinski, J.A., Miller, K.B., Apgar, J., Davey, M.H., Stuart, D.A.: Survey of the trans-resveratrol and trans-piceid content of cocoa-containing and chocolate products. J Agric Food Chem. 56, 8374–8378 (2008). https://doi.org/10.1021/JF801297W
Banaszewska, B., Wrotyńska-Barczyńska, J., Spaczynski, R.Z., Pawelczyk, L., Duleba, A.J.: Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial. J Clin Endocrinol Metab. 101, 4322–4328 (2016). https://doi.org/10.1210/JC.2016-1858
Brenjian, S., Moini, A., Yamini, N., Kashani, L., Faridmojtahedi, M., Bahramrezaie, M., Khodarahmian, M., Amidi, F.: Resveratrol treatment in patients with polycystic ovary syndrome decreased pro-inflammatory and endoplasmic reticulum stress markers. American Journal of Reproductive Immunology. 83, e13186 (2020). https://doi.org/10.1111/AJI.13186
Furat Rencber, S., Kurnaz Ozbek, S., Eraldemlr, C., Sezer, Z., Kum, T., Ceylan, S., Guzel, E.: Effect of resveratrol and metformin on ovarian reserve and ultrastructure in PCOS: An experimental study. J Ovarian Res. 11, 1–16 (2018). https://doi.org/10.1186/S13048-018-0427-7/FIGURES/6
Mansour, A., Samadi, M., Sanginabadi, M., Gerami, H., Karimi, S., Hosseini, S., Shirzad, N., Hekmatdoost, A., Mahdavi-Gorabi, A., Mohajeri-Tehrani, M.R., Qorbani, M.: Effect of resveratrol on menstrual cyclicity, hyperandrogenism and metabolic profile in women with PCOS. Clinical Nutrition. 40, 4106–4112 (2021). https://doi.org/10.1016/J.CLNU.2021.02.004
Prasad, S., Aggarwal, B.B.: Turmeric, the Golden Spice. Herbal Medicine: Biomolecular and Clinical Aspects: Second Edition. 263–288 (2011)
Jin, T.R.: Curcumin and dietary polyphenol research: beyond drug discovery. Acta Pharmacologica Sinica 2018 39:5. 39, 779–786 (2018). https://doi.org/10.1038/aps.2017.179
Wang, W., Trung, K., Nguyen, K., Zhao, C., Hung, H.-C.: A N T H R O P O LO G Y Earliest curry in Southeast Asia and the global spice trade 2000 years ago. (2023)
Indira Priyadarsini, K.: Chemical and structural features influencing the biological activity of curcumin. Curr Pharm Des. 19, 2093–2100 (2013). https://doi.org/10.2174/138161213805289228
Ardebili, A., Pouriayevali, M.H., Aleshikh, S., Zahani, M., Ajorloo, M., Izanloo, A., Siyadatpanah, A., Nikoo, H.R., Wilairatana, P., Coutinho, H.D.M.: Antiviral Therapeutic Potential of Curcumin: An Update. Molecules. 26, (2021). https://doi.org/10.3390/MOLECULES26226994
Martins, C.V.B., Da Silva, D.L., Neres, A.T.M., Magalhães, T.F.F., Watanabe, G.A., Modolo, L. V., Sabino, A.A., De Fátima, Â., De Resende, M.A.: Curcumin as a promising antifungal of clinical interest. J Antimicrob Chemother. 63, 337–339 (2009). https://doi.org/10.1093/JAC/DKN488
Shen, W., Qu, Y., Jiang, H., Wang, H., Pan, Y., Zhang, Y., Wu, X., Han, Y., Zhang, Y.: Therapeutic effect and safety of curcumin in women with PCOS: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 13, 1051111 (2022). https://doi.org/10.3389/FENDO.2022.1051111/BIBTEX
Jamilian, M., Foroozanfard, F., Kavossian, E., Aghadavod, E., Shafabakhsh, R., Hoseini, A., Asemi, Z.: Effects of curcumin on body weight, glycemic control and serum lipids in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. Clin Nutr ESPEN. 36, 128–133 (2020). https://doi.org/10.1016/J.CLNESP.2020.01.005
Ghanbarzadeh-Ghashti, N., Ghanbari-Homaie, S., Shaseb, E., Abbasalizadeh, S., Mirghafourvand, M.: The effect of Curcumin on metabolic parameters and androgen level in women with polycystic ovary syndrome: a randomized controlled trial. BMC Endocr Disord. 23, 1–10 (2023). https://doi.org/10.1186/S12902-023-01295-5/TABLES/4
Abdullah, M., Jamil, R.T., Attia, F.N.: Vitamin C (Ascorbic Acid). Encyclopedia of Toxicology: Third Edition. 962–963 (2023). https://doi.org/10.1016/B978-0-12-386454-3.01250-1
Padayatty, S.J., Katz, A., Wang, Y., Eck, P., Kwon, O., Lee, J.H., Chen, S., Corpe, C., Levine, M., Dutta, A., Dutta, S.K.: Vitamin C as an Antioxidant: Evaluation of Its Role in Disease Prevention. J Am Coll Nutr. 22, 18–35 (2003). https://doi.org/10.1080/07315724.2003.10719272
Gęgotek, A., Skrzydlewska, E.: Ascorbic acid as antioxidant. Vitam Horm. 121, 247–270 (2023). https://doi.org/10.1016/BS.VH.2022.10.008
Olaniyan, O.T., Femi, A., Iliya, G., Ayobami, D., Godam, E., Olugbenga, E., Bamidele, O., Chand Mali, P.: Vitamin C suppresses ovarian pathophysiology in experimental polycystic ovarian syndrome. Pathophysiology. 26, 331–341 (2019). https://doi.org/10.1016/J.PATHOPHYS.2019.08.003
Bafor, E.E., Uchendu, A.P., Osayande, O.E., Omoruyi, O., Omogiade, U.G., Panama, E.E., Elekofehinti, O.O., Oragwuncha, E.L., Momodu, A.: Ascorbic Acid and Alpha-Tocopherol Contribute to the Therapy of Polycystic Ovarian Syndrome in Mouse Models. Reproductive Sciences. 28, 102–120 (2021). https://doi.org/10.1007/S43032-020-00273-9/TABLES/2
Heidari, H., Hajhashemy, Z., Saneei, P.: A meta-analysis of effects of vitamin E supplementation alone and in combination with omega-3 or magnesium on polycystic ovary syndrome. Scientific Reports 2022 12:1. 12, 1–13 (2022). https://doi.org/10.1038/s41598-022-24467-0
Raghu, G., Berk, M., Campochiaro, P.A., Jaeschke, H., Marenzi, G., Richeldi, L., Wen, F.-Q., Nicoletti, F., Calverley, P.M.A.: The Multifaceted Therapeutic Role of N-Acetylcysteine (NAC) in Disorders Characterized by Oxidative Stress. Curr Neuropharmacol. 19, 1202–1224 (2021). https://doi.org/10.2174/1570159X19666201230144109
Hristov, B.D.: The Role of Glutathione Metabolism in Chronic Illness Development and Its Potential Use as a Novel Therapeutic Target. Cureus. 14, (2022). https://doi.org/10.7759/CUREUS.29696
Aldini, G., Altomare, A., Baron, G., Vistoli, G., Carini, M., Borsani, L., Sergio, F.: N-Acetylcysteine as an antioxidant and disulphide breaking agent: the reasons why. Free Radic Res. 52, 751–762 (2018). https://doi.org/10.1080/10715762.2018.1468564
Tenório, M.C.D.S., Graciliano, N.G., Moura, F.A., de Oliveira, A.C.M., Goulart, M.O.F.: N-Acetylcysteine (NAC): Impacts on Human Health. Antioxidants 2021, Vol. 10, Page 967. 10, 967 (2021). https://doi.org/10.3390/ANTIOX10060967
Shahveghar Asl, Z., Parastouei, K., Eskandari, E.: The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis. British Journal of Nutrition. 130, 202–210 (2023). https://doi.org/10.1017/S0007114522003270
Thakker, D., Raval, A., Patel, I., Walia, R.: N-Acetylcysteine for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. Obstet Gynecol Int. 2015, 1–13 (2015). https://doi.org/10.1155/2015/817849
Liu, J., Su, H., Jin, X., Wang, L., Huang, J.: The effects of N-acetylcysteine supplement on metabolic parameters in women with polycystic ovary syndrome: a systematic review and meta-analysis. Front Nutr. 10, 1209614 (2023). https://doi.org/10.3389/FNUT.2023.1209614/FULL
Song, Y., Wang, H., Huang, H., Zhu, Z.: Comparison of the efficacy between NAC and metformin in treating PCOS patients: a meta-analysis. Gynecol Endocrinol. 36, 204–210 (2020). https://doi.org/10.1080/09513590.2019.1689553
Pereira, J.C., Pradella Hallinan, M., Alves, R.C.: Secondary to excessive melatonin synthesis, the consumption of tryptophan from outside the blood-brain barrier and melatonin over-signaling in the pars tuberalis may be central to the pathophysiology of winter depression. Med Hypotheses. 98, 69–75 (2017). https://doi.org/10.1016/J.MEHY.2016.11.020
Chrustek, A., Olszewska-Słonina, D.: Melatonin as a powerful antioxidant. Acta Pharmaceutica. 71, 335–354 (2021). https://doi.org/10.2478/ACPH-2021-0027
Reiter, R.J., Mayo, J.C., Tan, D.X., Sainz, R.M., Alatorre-Jimenez, M., Qin, L.: Melatonin as an antioxidant: under promises but over delivers. J Pineal Res. 61, 253–278 (2016). https://doi.org/10.1111/JPI.12360
Reiter, R.J., Tan, D.X., Mayo, J.C., Sainz, R.M., Leon, J., Czarnocki, Z.: Melatonin as an antioxidant: Biochemical mechanisms and pathophysiological implications in humans, (2003)
Li, H., Liu, M., Zhang, C.: Women with polycystic ovary syndrome (PCOS) have reduced melatonin concentrations in their follicles and have mild sleep disturbances. BMC Womens Health. 22, 1–9 (2022). https://doi.org/10.1186/S12905-022-01661-W/TABLES/4
Jamilian, M., Foroozanfard, F., Mirhosseini, N., Kavossian, E., Aghadavod, E., Bahmani, F., Ostadmohammadi, V., Kia, M., Eftekhar, T., Ayati, E., Mahdavinia, M., Asemi, Z.: Effects of Melatonin Supplementation on Hormonal, Inflammatory, Genetic, and Oxidative Stress Parameters in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne). 10, 273 (2019). https://doi.org/10.3389/FENDO.2019.00273
Al-Qadhi, H.I.: Effect of Melatonin Supplementation on Serum LH Level and BMI in Women with Polycystic Ovarian Syndrome.
Rudnicka, E., Suchta, K., Grymowicz, M., Calik‐ksepka, A., Smolarczyk, K., Duszewska, A.M., Smolarczyk, R., Meczekalski, B.: Chronic Low Grade Inflammation in Pathogenesis of PCOS. International Journal of Molecular Sciences 2021, Vol. 22, Page 3789. 22, 3789 (2021). https://doi.org/10.3390/IJMS22073789
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