The Difference of Endometrial Leptin Expression in Woman with Polycystic Ovarian Syndrome (PCOS) Compared to Normal

Authors

  • Dwi Sakti Berlian Besar Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret / Dr. Moewardi General Hospital, Surakarta, Indonesia
  • Uki Retno Budihastuti Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret / Dr. Moewardi General Hospital, Surakarta, Indonesia
  • Sri Sulistyowati Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret / Dr. Moewardi General Hospital, Surakarta, Indonesia
  • Eriana Melinawati Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret / Dr. Moewardi General Hospital, Surakarta, Indonesia

Abstract

Background: Decreased endometrial recep­ti­vity is suspected to be one of the factors causing in­fertility in women with Polycystic Ovary Syn­dro­me (PCOS). Endometrial abnormalities in PC­OS­ due to impaired balance include estrogen, pro­­­­gesterone, growth factors, cytokines and cell at­tach­­­ment modulators including leptin. This study aims to determine the expression of leptin in the endometrium which is suspected to be more common in PCOS patients and related factors.

Subjects and Method: A retrospective-case control study was conducted at Dr. Moe­wardi general hospital, Surakarta. A total of 60 women were involved; 30 infertile women with PCOS based on Rotterdam criteria (if found two of the three symptoms, including hyperandrogenism, ovu­la­tion dysfunction and/or polycystic ovaries from ultrasonography) and 30 normal women as con­trol group. Demographic data such as age, family history of PCOS, menarche, BMI, occupation, and edu­cation were recorded. Leptin expression was acquired from endometrium biopsy with IHC examination on day 19-24 of the menstrual cycle; under the condition that inclusion and exclusion cri­teria are fulfilled. The statistical analysis was per­formed using the Mann-Whitney test.

Results: Mean of leptin expression was found significantly higher in PCOS group (Mean= 59.16; SD= 49.34) compared to control group (Mean= 6.00; SD= 22.98, with p= 0.001. PCOS (b= 0.42; 95% CI= 0.10 to 0.73; p= 0.010) and obesity (b= 0.31; 95% CI= 0.41 to 0.58; p= 0.025) increased leptin expression.

Conclusion: There is a difference in leptin ex­pres­­sion in the endometrium of PCOS compared to nor­mal.  Leptin expression is higher in the en­do­metrium of women with PCOS and obesity compared to nor­mal.

Keywords: Leptin expressions, endometrium, polycystic ovarian syndrome.

Correspondence: Dwi Sakti Berlian Besar. Department of Obs­tetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi General Hos­pital, Surakarta, Indonesia. Email: dwiesakti@student.uns.ac.id. Mobile: +628121845054

Indonesian Journal of Medicine (2020), 05(01): 38-46
https://doi.org/10.26911/theijmed.2020.05.01.06


 

Author Biography

Eriana Melinawati, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret / Dr. Moewardi General Hospital, Surakarta, Indonesia

Background: Decreased endometrial recep­ti­vity is suspected to be one of the factors causing in­fertility in women with Polycystic Ovary Syn­dro­me (PCOS). Endometrial abnormalities in PC­OS­ due to impaired balance include estrogen, pro­­­­gesterone, growth factors, cytokines and cell at­tach­­­ment modulators including leptin. This study aims to determine the expression of leptin in the endometrium which is suspected to be more common in PCOS patients and related factors.Subjects and Method: A retrospective-case control study was conducted at Dr. Moe­wardi general hospital, Surakarta. A total of 60 women were involved; 30 infertile women with PCOS based on Rotterdam criteria (if found two of the three symptoms, including hyperandrogism, ovu­la­tion dysfunction and/or polycystic ovaries from ultrasonography) and 30 normal women as con­trol group. Demographic data such as age, family history of PCOS, menarche, BMI, occupation, and edu­cation were recorded. Leptin expression was acquired from endometrium biopsy with IHC examination on day 19-24 of menstrual cycle; under the condition that inclusion and exclusion cri­teria are fulfilled. The statistical analysis was per­formed using Mann-Whitney test.Results:Mean of leptin expression was found significantly higher in PCOS group (Mean= 59.16; SD= 49.34) com­pared to control group (Mean= 6.00; SD= 22.98, with p= 0.001. PCOS (b= 0.42; 95% CI= 0.10 to 0.73; p= 0.010) and obesity (b= 0.31; 95% CI= 0.41 to 0.58; p= 0.025) increased leptin expression.Conclusion:There is a difference in leptin ex­pres­­sion in endometrium of PCOS compared to nor­mal.  Leptin expression is higher in en­do­metrium of women with PCOS and obesity compared to nor­mal. Keywords:Leptin expressions, endometrium, polycystic ovarian syndrome. Correspondence: Dwi Sakti Berlian Besar. Department of Obs­tetrics and Gynecology, Faculty of Medicine, Uni­versitas Sebelas Maret/ Dr. Moewardi General Hos­pital, Surakarta, Indonesia. Email: dwie­sak­ti­@student.uns.ac.id. Mobile: +628121845054  

References

Altmäe S, Aghajanova L (2015). What do we know about endometrial receptivity in women with endometriosis? A molecular perspective. Reprod Biomed Online, 31: 581-583. https://doi.org.10.1016/j.rbmo.2015.09.008.

Altmäe S, ltmäe S, Koel M, Võsa U (2017). Meta-signature of human endometrial receptivity: a meta-analysis and validation study of transcript micro biomarkers. Sci Rep, 7(1): 1-15. https://doi.org.10.1038/s41598-017-10098-3

Blesa D, Ruiz-Alonso M, Simón C (2014). Clinical Management of Endometrial Receptivity. Semin Reprod Med, 32(5): 410–414. https://doi.org.10.1055/s0034-1376360.

Craciunas L, Gallos L, Chu J, Bourne T, Quenby S, Brosens J, Coomarasamy A (2019). Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis. Hum Reprod Update, 25(2): 202–223. https://doi.org.10.1093/humupd/dmy044.

Daghestani MH, Daghestani M, Daghistani M, El-Mazny A, Bjørklund G, Chirumbolo S, Warsy A (2018). A study of ghrelin and leptin levels and their relationship to metabolic profiles in obese and lean Saudi women with polycystic ovary syndrome (SOPK). Lipids Health Dis, 17(1): 195. https://doi.org.10.1186/s12944-018-0839-9

Demiral İ, Murat D, Ercan B (2015). Genomic, proteomic and lipidomic evaluation of endometrial receptivity. Turk J Obstet Gynecol, 12(4): 237–243. https://doi.org.10.4274/tjod.98475.

Dornbush S, Aeddula NR (2018). Physiology, leptin, Stat Pearls. Retrieved form http://www.ncbi.nlm.nih.gov/pubmed/30725723

Lessey BA, Young SL (2019). What exactly is endometrial receptivity? Fertility Sterility. Elsevier Inc, 611–617. https://doi.0rg.10.1016/j.fertnstert.2019.02.009.

Méndez-López LF, Zavala-Pompa A, Cortés-Gutiérrez EI, Cerda-Flores R M, Davila-Rodriguez MI (2017). Leptin receptor expression during the progression of endometrial carcinoma is correlated with estrogen and progesterone receptors. Arch Med Sci, 13(1): 228–235. https://doi.org.10.5114/aoms.2017.647-21

Miravet-Valenciano, J. Ricon-Bertolin, A. Vilella F, Simon C (2015). Understanding and improving endometrial receptivity. Curr Opin Obstet Gynecol, 27(3): 187–192. https://doi.0rg.10.1097/GCO.00000-00000000173.

Pérez-Pérez A, Sánchez-Jiménez F, Maymó J (2014). Role of leptin in female reproduction. Clin Chem Lab Med, 53(1): 15-28. https://doi.org.10.1515/cc-lm-2014-0387

Pérez-Pérez A, Toro A, Vilarino-Gracia T, Maymo J (2017). Leptin action in normal and pathological pregnancies. J Cell Mol Med. https://doi.org.10.1111/jcmm.13369.

Raheem KA (2018). Cytokines, growth factors and macromolecules as mediators of implantation in mammalian species. International Journal of Veterinary Science and Medicine, 6: S6–S14. https://doi.org.10.1016/J.IJVSM.2017-.12.001.

Rarani F Z, Borhani F, and Rashidi B. (2018) Endometrial Pinopode biomarkers: Molecules and microRNAs’, J Cell Physio. Wiley-Liss Inc, 9145–9158. https://doi.org.10.1002/jcp.26852.Rizk

NM, Sharif E (2015). Leptin as well as Free Leptin Receptor Is Associated with Polycystic Ovary Syndrome in Young Women. Int J Endocrinol. https://doi.org.10.1155/2015/927805

Ruiz-Alonso M, Blesa D, Díaz-Gimeno P, Gómez E (2013). The endometrial receptivity array for diagnosis and personalized embryo transfer as a treatment for patients with repeated implantation failure. Fertil Steril, 100(3): 818–824. https://doi.org.10.1016/j.fertnstert.2013.05.004.

Sumadewi K (2017). Korelasi antara kadar leptin dengan IMT, lingkar pinggang dan RLPP pada orang dewasa obesitas usia 19-25 tahun di Universitas Warmadewa. Warmadewa Medical Journal, 1: 71. https://doi.org.10.22225/wmj.1.2.30.71-82.

Wu F, Chen X, Liu Y, Liang B, Xu H, Li TC, Wang CC (2018). Decreased MUC1 in endometrium is an independent receptivity marker in recurrent implantation failure during implantation window. Reprod Biol Endocrin, 16(1): 60. https://doi.org.10.1186/s12958-0180-379-1.

Downloads

Published

2020-01-10

Issue

Section

Articles