PMID- 30979610
OWN - NLM
STAT- MEDLINE
DCOM- 20200710
LR  - 20200710
IS  - 1472-6491 (Electronic)
IS  - 1472-6483 (Linking)
VI  - 38
IP  - 6
DP  - 2019 Jun
TI  - Effects of hyperhomocysteinaemia and metabolic syndrome on reproduction in women 
      with polycystic ovary syndrome: a secondary analysis.
PG  - 990-998
LID - S1472-6483(19)30024-0 [pii]
LID - 10.1016/j.rbmo.2018.12.046 [doi]
AB  - RESEARCH QUESTION: What is the association between hyperhomocysteinaemia (HHCY), 
      metabolic syndrome, and reproductive outcomes among women with polycystic ovary 
      syndrome (PCOS). DESIGN: A secondary analysis of PCOSAct with 21 sites in China. 
      A total of 1000 women with PCOS were enrolled; 936 women with baseline 
      homocysteine (HCY) were analysed. RESULTS: Higher HCY was associated with higher 
      body mass index, free testosterone and lower FSH, fasting glucose (P < 0.001; P < 
      0.001; P = 0.005; P < 0.001) and ovulation rate among all participants (OR 0.59, 
      95% CI 0.41 to 0.86; OR 0.57, 95% CI 0.39 to 0.83 tertiles 2 and 3 versus tertile 
      1, respectively). The HHCY group had lower oestradiol and higher free 
      testosterone (P = 0.04; P < 0.001) than the controls. In the metabolic syndrome 
      group, LH, LH-FSH ratio and sex hormone-binding globulin were lowest in the 
      metabolic syndrome group (all P < 0.001). In the HHCY group, ovulation rate 
      decreased and the second or third trimester pregnancy loss rate increased 
      compared with controls (OR 1.678, 95% CI 1.04 to 2.70; OR 0.03, 95% CI 0.00 to 
      0.42) with treatment adjustment. Compared with the controls, ovulation, 
      conception, pregnancy, second or third trimester pregnancy loss and live birth 
      rates were statistically lower in the metabolic syndrome group after adjusting 
      treatment (OR 1.76, 95% CI 1.15 to 2.70; OR 1.75, 95% CI 1.15 to 2.65; OR 2.09, 
      95% CI 1.27 to 3.44; OR 0.02, 95% CI 0.00 to 0.33; OR 2.42 95% CI 1.42 to 4.10), 
      and pregnancy, pregnancy loss and live birth rates remained significantly 
      different after adjusting for treatment and sex-hormone factors (OR 1.77, 95% CI 
      1.05 to 2.99; OR 0.14, 95% CI 0.02 to 0.82; OR 2.02, 95% CI 1.16 to 3.50). 
      CONCLUSIONS: In women with PCOS, HHCY contributes to increased pregnancy loss and 
      reduced ovulation, and metabolic syndrome was related to defects in ovulation, 
      conception, pregnancy, pregnancy loss and live birth, indicating that the two 
      conditions lead to defects at various reproductive stages.
CI  - Copyright (c) 2019. Published by Elsevier Ltd.
FAU - Chang, Hui
AU  - Chang H
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China; Heilongjiang University of Chinese Medicine, Harbin, China.
FAU - Xie, Liangzhen
AU  - Xie L
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China.
FAU - Ge, Hang
AU  - Ge H
AD  - Heilongjiang University of Chinese Medicine, Harbin, China.
FAU - Wu, Qi
AU  - Wu Q
AD  - Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong 
      Kong, China.
FAU - Wen, Yan
AU  - Wen Y
AD  - Heilongjiang University of Chinese Medicine, Harbin, China.
FAU - Zhang, Duojia
AU  - Zhang D
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China.
FAU - Zhang, Yuehui
AU  - Zhang Y
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China.
FAU - Ma, Hongli
AU  - Ma H
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China.
FAU - Gao, Jingshu
AU  - Gao J
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China.
FAU - Wang, Chi Chiu
AU  - Wang CC
AD  - Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong 
      Kong, China.
FAU - Stener-Victorin, Elisabet
AU  - Stener-Victorin E
AD  - Karolinska Institutet, Stockholm, Sweden.
FAU - Ng, Ernest Hy
AU  - Ng EH
AD  - The University of Hong Kong, Hong Kong, China.
FAU - Wu, Xiaoke
AU  - Wu X
AD  - First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 
      China. Electronic address: xiaokewu2002@vip.sina.com.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20190118
PL  - Netherlands
TA  - Reprod Biomed Online
JT  - Reproductive biomedicine online
JID - 101122473
RN  - 0 (Fertility Agents, Female)
RN  - 1HRS458QU2 (Clomiphene)
RN  - 3XMK78S47O (Testosterone)
RN  - 4G7DS2Q64Y (Progesterone)
SB  - IM
MH  - Abortion, Spontaneous
MH  - Acupuncture Therapy
MH  - Adult
MH  - Body Mass Index
MH  - China
MH  - Clomiphene/therapeutic use
MH  - Data Interpretation, Statistical
MH  - Female
MH  - Fertility Agents, Female/therapeutic use
MH  - Humans
MH  - Hyperhomocysteinemia/*complications
MH  - Infertility, Female/*complications/therapy
MH  - Metabolic Syndrome/*complications
MH  - Ovulation Induction
MH  - Phenotype
MH  - Polycystic Ovary Syndrome/*complications
MH  - Pregnancy
MH  - Pregnancy Outcome
MH  - Pregnancy Rate
MH  - Progesterone
MH  - Testosterone/blood
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Hyperhomocysteinemia
OT  - Metabolic syndrome
OT  - Polycystic ovary syndrome
OT  - Reproductive outcomes
EDAT- 2019/04/14 06:00
MHDA- 2020/07/11 06:00
CRDT- 2019/04/14 06:00
PHST- 2018/07/13 00:00 [received]
PHST- 2018/12/12 00:00 [revised]
PHST- 2018/12/18 00:00 [accepted]
PHST- 2019/04/14 06:00 [pubmed]
PHST- 2020/07/11 06:00 [medline]
PHST- 2019/04/14 06:00 [entrez]
AID - S1472-6483(19)30024-0 [pii]
AID - 10.1016/j.rbmo.2018.12.046 [doi]
PST - ppublish
SO  - Reprod Biomed Online. 2019 Jun;38(6):990-998. doi: 10.1016/j.rbmo.2018.12.046. 
      Epub 2019 Jan 18.