Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Department of Clinical and Experimental Endocrinology, Medical University of Gdansk, 80-211 Gdansk, Poland.
Nutrients. 2023 Sep 26;15(19):4153. doi: 10.3390/nu15194153.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects reproductive-age women and predisposes them to the development of metabolic disturbances. Recent research has shown that several metabolic factors may play a role in PCOS pathogenesis, and it has been suggested that an alteration in the amino acid profile might be a predictive sign of metabolic disorders. Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) are concepts that have attracted scientific attention; however, a universal definition has not been established yet for these terms. Already existing definitions of MHO involve the coexistence of obesity with the absence or minimal presence of other metabolic syndrome parameters. A group of 326 women, 209 diagnosed with PCOS and 117 healthy individuals, participated in this study. Multiple parameters were assessed, including anthropometrical, biochemical, and hormonal ones, and gas-liquid chromatography, combined with tandem mass spectrometry, was used to investigate the amino acid profile. Statistical analysis revealed noticeably higher levels of all aromatic amino acids in PCOS women compared to the control group: phenylalanine 47.37 ± 7.0 vs. 45.4 ± 6.09 nmol/mL ( = 0.01), tyrosine 61.69 ± 9.56 vs. 58.08 ± 8.89 nmol/mL ( < 0.01), and tryptophan 53.66 ± 11.42 vs. 49.81 ± 11.18 nmol/mL ( < 0.01); however, there was no significant difference in the "tryptophan ratio" between the PCOS and control group ( = 0.88). A comparison of MHO and MUO PCOS women revealed that LAP, leucine, and isoleucine concentrations were significantly higher among the MUO subgroup: respectively, 101.98 ± 34.74 vs. 55.80 ± 24.33 ( < 0.001); 153.26 ± 22.26 vs. 137.25 ± 25.76 nmol/mL ( = 0.04); and 92.92 ± 16.09 vs. 82.60 ± 18.70 nmol/mL ( = 0.02). No significant differences in BMI, fasting glucose, and HOMA-IR between MHO and MUO were found: respectively, 35.0 ± 4.8 vs. 36.1 ± 4.6 kg/m ( = 0.59); 88.0 ± 6.0 vs. 87.73 ± 6.28 mg/dL ( = 0.67); and 3.36 ± 1.70 vs. 4.17 ± 1.77 ( = 0.1). The identification of altered amino acid profiles in PCOS holds potential clinical implications. Amino acids may serve as biomarkers for diagnosing and monitoring the metabolic status of individuals with PCOS. The alteration of BCAAs and AAAs may be involved in PCOS pathogenesis, but the underlying mechanism should be further investigated.
多囊卵巢综合征（PCOS）是一种常见的内分泌疾病，影响育龄妇女，使她们易发生代谢紊乱。最近的研究表明，几种代谢因素可能在 PCOS 的发病机制中起作用，并且有人提出氨基酸谱的改变可能是代谢紊乱的预测标志。代谢健康肥胖（MHO）和代谢不健康肥胖（MUO）是引起科学界关注的概念；然而，这些术语尚未建立通用定义。现有的 MHO 定义涉及肥胖与其他代谢综合征参数的缺失或最小存在共存。326 名女性参与了这项研究，其中 209 名被诊断为 PCOS，117 名健康女性。评估了多种参数，包括人体测量、生化和激素参数，并使用气-液色谱法，结合串联质谱法，研究了氨基酸谱。统计分析显示，与对照组相比，PCOS 女性的所有芳香族氨基酸水平明显升高：苯丙氨酸 47.37 ± 7.0 对 45.4 ± 6.09 nmol/mL（= 0.01），酪氨酸 61.69 ± 9.56 对 58.08 ± 8.89 nmol/mL（<0.01），色氨酸 53.66 ± 11.42 对 49.81 ± 11.18 nmol/mL（<0.01）；然而，PCOS 组和对照组之间的“色氨酸比值”没有显著差异（= 0.88）。比较 MHO 和 MUO 的 PCOS 女性发现，MUO 亚组的 LAP、亮氨酸和异亮氨酸浓度明显较高：分别为 101.98 ± 34.74 对 55.80 ± 24.33（<0.001）；153.26 ± 22.26 对 137.25 ± 25.76 nmol/mL（= 0.04）；92.92 ± 16.09 对 82.60 ± 18.70 nmol/mL（= 0.02）。MHO 和 MUO 之间的 BMI、空腹血糖和 HOMA-IR 没有显著差异：分别为 35.0 ± 4.8 对 36.1 ± 4.6 kg/m（= 0.59）；88.0 ± 6.0 对 87.73 ± 6.28 mg/dL（= 0.67）；3.36 ± 1.70 对 4.17 ± 1.77（= 0.1）。PCOS 中氨基酸谱的改变具有潜在的临床意义。氨基酸可以作为诊断和监测 PCOS 患者代谢状况的生物标志物。支链氨基酸和芳香族氨基酸的改变可能与 PCOS 的发病机制有关，但具体机制仍需进一步研究。
