Significance of oxidative stress and antioxidant capacity tests as biomarkers of premature ovarian insufficiency: A case control study - PubMed
- ️Mon Jan 01 2024
Significance of oxidative stress and antioxidant capacity tests as biomarkers of premature ovarian insufficiency: A case control study
Kaoru Kakinuma et al. World J Clin Cases. 2024.
Abstract
Background: Premature ovarian insufficiency (POI) is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage. Early follicular depletion results in intractable infertility, thereby considerably reducing the quality of life of females. Given the continuum in weakened ovarian function, progressing from incipient ovarian failure (IOF) to transitional ovarian failure and further to POI, it is necessary to develop biomarkers for predicting POI. The oxidative stress states in IOF and POI were comprehensively evaluated via oxidative stress [diacron-reactive oxygen metabolites (d-ROMs)] test and antioxidant capacity [biological antioxidant potential (BAP)].
Aim: To explore the possibilities of oxidative stress and antioxidant capacity as biomarkers for the early detection of POI.
Methods: Females presenting with secondary amenorrhea over 4 mo and a follicle stimulating hormone level of > 40 mIU/mL were categorized into the POI group. Females presenting with a normal menstrual cycle and a follicle stimulating hormone level of > 10.2 mIU/mL were categorized into the IOF group. Healthy females without ovarian hypofunction were categorized into the control group. Among females aged < 40 years who visited our hospital from January 2021 to June 2022, we recruited 11 patients into both POI and IOF groups. For the potential antioxidant capacity, the relative oxidative stress index (BAP/d-ROMs × 100) was calculated, and the oxidative stress defense system was comprehensively evaluated.
Results: d-ROMs were significantly higher in the POI and IOF groups than in the control group, (478.2 ± 58.7 U.CARR, 434.5 ± 60.6 U.CARR, and 341.1 ± 35.1 U.CARR, respectively) (U.CARR is equivalent to 0.08 mg/dL of hydrogen peroxide). However, no significant difference was found between the POI and IOF groups. Regarding BAP, no significant difference was found between the control, IOF, and POI groups (2078.5 ± 157.4 μmol/L, 2116.2 ± 240.2 μmol/L, and 2029.0 ± 186.4 μmol/L, respectively). The oxidative stress index was significantly higher in the POI and IOF groups than in the control group (23.7 ± 3.3, 20.7 ± 3.6, and 16.5 ± 2.1, respectively). However, no significant difference was found between the POI and IOF groups.
Conclusion: High levels of oxidative stress suggest that evaluating the oxidative stress state may be a useful indicator for the early detection of POI.
Keywords: Biological antioxidant potential; Biomarker; Diacron-reactive oxygen metabolites test; Infertility; Oxidative stress; Premature ovarian insufficiency.
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Conflict of interest statement
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest related to the manuscript.
Figures
Comparison of anti-Mullerian hormone levels, the antral follicle count, the mean levels of plasma diacron-reactive oxygen metabolites, the mean levels of plasma biological antioxidant potential, and the mean levels of oxidative stress index. A: Comparison of anti-Mullerian hormone levels. Values are expressed as means, with the error bar representing the standard deviation. A significant difference between the control (Cont) and premature ovarian insufficiency (POI) groups was observed (P < 0.01). A significant difference between the Cont and incipient ovarian failure (IOF) groups was observed (P < 0.05). There were no significant differences between the IOF and POI groups; B: Comparison of the antral follicle count. Values are expressed as means, with the error bar representing the standard deviation. A significant difference between the control and premature ovarian insufficiency groups was observed (P < 0.01). A significant difference between the Cont and incipient ovarian failure groups was observed (P < 0.01). A significant difference between the IOF and POI was observed (P < 0.01); C: Comparison of the mean levels of plasma diacron-reactive oxygen metabolites. Values are expressed as means, with the error bar representing the standard deviation. A significant difference between the control and incipient ovarian failure groups was observed (P < 0.01). A significant difference between the Cont and premature ovarian insufficiency groups was observed (P < 0.01). There were no significant differences between the IOF and POI groups; D: Comparison of the mean levels of plasma biological antioxidant potential. Values are expressed as means, with the error bar representing the standard deviation. There were no significant differences among the three groups; E: Comparison of the mean levels of oxidative stress index. Values are expressed as means, with the error bar representing the standard deviation. A significant difference between the control and incipient ovarian failure groups was observed (P < 0.01). A significant difference between the Cont and premature ovarian insufficiency groups was observed (P < 0.01). There were no significant differences between the IOF and POI groups. BAP: Biological antioxidant potential; Cont: Control; IOF: Incipient ovarian failure; POI: Premature ovarian insufficiency; d-ROMs: Diacron-reactive oxygen metabolites.
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