Effect of dietary approaches to stop hypertension, and standard diets with and without curcumin on interleukin-1 alpha, 5-alpha reductase gene expressions, and androgenic and glycemic profile in polycystic ovary syndrome women undergoing IVF

Abstract

Full Title: Effect of dietary approaches to stop hypertension, and standard diets with and without curcumin on interleukin-1 alpha, 5-alpha reductase gene expressions, and androgenic and glycemic profile in polycystic ovary syndrome women undergoing in vitro fertilization treatment: A study protocol


Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases with major reproductive and metabolic complications with an impact on public health. Hyperandrogenism and chronic inflammation have been suggested as the leading cause of pathophysiology and clinical manifestations associated with PCOS. It seems that the altered expression of genes involved in the synthesis of proinflammatory cytokine and androgens contribute to the promotion of PCOS.


Objective: This trial aims to determine the effects of dietary approaches to stop hypertension (DASH) and standard diets with and without curcumin supplementation on the gene expression of interleukin (IL)-1α alpha, IL-5α reductase and androgenic and glycemic profile among PCOS patients, who are candidates for in vitro fertilization.


Materials and Methods: 96 infertile women with PCOS, aged 18-40 yr, will participate in this randomized, placebo-controlled clinical trial. Based on treatment conditions and body mass index, the participants will be randomly divided into 4 equal groups using a randomized block design. They will receive a DASH or standard diet containing 52% carbohydrate, 18% protein, and 30% total fat, with the same prescribed sodium, plus 500 mg twice daily curcumin or placebo for 12 wk. The mRNA expression of IL-1α, 5α reductase, and androgenic and glycemic profiles will be measured at baseline and at the end of the study.


Conclusion: Concomitant administration of DASH diet and curcumin supplementation may reduce IL-1α, 5α reductase gene expressions, and improve glycemic and androgenic profiles.


Key words: Polycystic ovary syndrome, Dietary approaches to stop hypertension, Curcumin, Fertilization in vitro, Gene expression.

References
[1] Ding T, Hardiman PJ, Petersen I, Wang F-F, Qu F, Baio G. The prevalence of polycystic ovary syndrome in reproductive-aged women of different ethnicity: A systematic review and meta-analysis. Oncotarget 2017; 8: 96351–96358.

[2] Yasmin A, Roychoudhury S, Paul Choudhury A, Ahmed ABF, Dutta S, Mottola F, et al. Polycystic ovary syndrome: An updated overview foregrounding impacts of ethnicities and geographic variations. Life 2022; 12: 1974.

[3] Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod 2018; 33: 1602–1618.

[4] Aboeldalyl S, James C, Seyam E, Ibrahim EM, Shawki HED, Amer S. The role of chronic inflammation in polycystic ovarian syndrome-A systematic review and meta-analysis. Int J Mol Sci 2021; 22: 2734.

[5] Kannenberg F, Fobker M, Schulte E, Pierscinski G, Kelsch R, Zitzmann M, et al. The simultaneous measurement of serum testosterone and 5α-dihydrotestosterone by gas chromatography-mass spectrometry (GC-MS). Clin Chim Acta 2018; 476: 15–24.

[6] Wu C, Wei K, Jiang Z. 5α-reductase activity in women with polycystic ovary syndrome: A systematic review and metaanalysis. Reprod Biol Endocrinol 2017; 15: 21.

[7] Batista RL, Mendonca BB. Integrative and analytical review of the 5-alpha-reductase type 2 deficiency worldwide. Appl Clin Genet 2020; 13: 83–96.

[8] Wu C, Jiang F, Wei K, Jiang Z. Exercise activates the PI3KAKT signal pathway by decreasing the expression of 5α- reductase type 1 in PCOS rats. Sci Rep 2018; 8: 7982.

[9] Zafari Zangeneh F, Naghizadeh MM, Masoumi M. Polycystic ovary syndrome and circulating inflammatory markers. Int J Reprod BioMed 2017; 15: 375–382.

[10] Dinarello CA. Overview of the IL-1 family in innate inflammation and acquired immunity. Immunol Rev 2018; 281: 8–27.

[11] Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, et al. Chronic low grade inflammation in pathogenesis of PCOS. Int J Mol Sci 2021; 22: 3789.

[12] Foroozanfard F, Rafiei H, Samimi M, Gilasi HR, Gorjizadeh R, Heidar Z, et al. The effects of dietary approaches to stop hypertension diet on weight loss, anti-müllerian hormone and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial. Clin Endocrinol 2017; 87: 51–58.

[13] Campbell AP. DASH eating plan: An eating pattern for diabetes management. Diabetes Spectr 2017; 30: 76–81.

[14] Akhlaghi M. Dietary approaches to stop hypertension (DASH): Potential mechanisms of action against risk factors of the metabolic syndrome. Nutr Res Rev 2020; 33: 1–18.

[15] Soltani S, Chitsazi MJ, Salehi-Abargouei A. The effect of dietary approaches to stop hypertension (DASH) on serum inflammatory markers: A systematic review and metaanalysis of randomized trials. Clin Nutr 2018; 37: 542–550.

[16] Azadi-Yazdi M, Karimi-Zarchi M, Salehi-Abargouei A, Fallahzadeh H, Nadjarzadeh A. Effects of dietary approach to stop hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: A randomised controlled trial. J Hum Nutr Diet 2017; 30: 275–283.

[17] Leri M, Scuto M, Ontario ML, Calabrese V, Calabrese EJ, Bucciantini M, et al. Healthy effects of plant polyphenols: Molecular mechanisms. Int J Mol Sci 2020; 21: 1250.

[18] Hewlings SJ, Kalman DS. Curcumin: A review of its effects on human health. Foods 2017; 6: 92.

[19] Urosevic M, Nikolic L, Gajic I, Nikolic V, Dinic A, Miljkovic V. Curcumin: Biological activities and modern pharmaceutical forms. Antibiotics (Basel) 2022; 11: 135.

[20] Chien Y-J, Chang C-Y, Wu M-Y, Chen C-H, Horng Y-S, Wu H-C. Effects of curcumin on glycemic control and lipid profile in polycystic ovary syndrome: Systematic review with meta-analysis and trial sequential analysis. Nutrients 2021; 13: 684.

[21] Heshmati J, Golab F, Morvaridzadeh M, Potter E, Akbari- Fakhrabadi M, Farsi F, et al. The effects of Curcumin supplementation on oxidative stress, Sirtuin-1 and peroxisome proliferator activated receptor γ coactivator 1α gene expression in polycystic ovarian syndrome (PCOS) patients: A randomized placebo-controlled clinical trial. Diabetes Metab Syndr 2020; 14: 77–82.

[22] Tabrizi R, Vakili S, Akbari M, Mirhosseini N, Lankarani KB, Rahimi M, et al. The effects of curcumin-containing supplements on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2019; 33: 253–262.

[23] Asemi Z, Esmaillzadeh A. DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: A randomized controlled clinical trial. Horm Metab Res 2015; 47: 232–238.

[24] Koetsier G, Cantor E. A practical guide to analyzing nucleic acid concentration and purity with microvolume spectrophotometers. New England Biolabs Inc 2019; 1–8.

[25] Eggestol HO, Lunde HS, Knutsen TM, Haugland GT. Interleukin-1 ligands and receptors in lumpfish (Cyclopterus lumpus L.): Molecular characterization, phylogeny, gene expression, and transcriptome analyses. Front Immunol 2020; 11: 502.

[26] Khantham C, Yooin W, Sringarm K, Sommano SR, Jiranusornkul S, Carmona FD, et al. effects on steroid 5- alpha reductase gene expression of Thai rice bran extracts and molecular dynamics study on SRD5A2. Biology (Basel) 2021; 10: 319.

[27] Toupchian O, Abdollahi Sh, Salehi-Abargouei A, Heshmati J, Clark CCT, Sheikhha MH, et al. The effects of resveratrol supplementation on PPARα, p16, p53, p21 gene expressions, and sCD163/sTWEAK ratio in patients with type 2 diabetes mellitus: A double-blind controlled randomized trial. Phytother Res 2021; 35: 3205–3213.

[28] de Almeida Mendes M, da Silva I, Ramires V, Reichert F, Martins R, Ferreira R, et al. Metabolic equivalent of task (METs) thresholds as an indicator of physical activity intensity. PLoS One 2018; 13: e0200701.