Polycystic ovarian syndrome is linked to increased oxidative stress in Omani women

Figures & data

Table 1 Sociodemographic and clinical characteristics of the study groups, Oman, 2017

Characteristics	Total	Cases	Controls	P-value
	(N=96)	(N=51)	(N=45)
	n (%)	n (%)	n (%)
Age (years)				0.43
≤25	19 (19.8)	11 (21.6)	8 (17.8)
26–34	49 (51.0)	28 (54.9)	21 (46.7)
≥35	28 (29.2)	12 (23.5)	16 (35.5)
Marital status				0.14
Unmarried	8 (8.3)	2 (3.9)	6 (13.3)
Married	88 (91.7)	49 (96.1)	39 (86.7)
Education level				0.63
School educated	43 (44.8)	24 (47.1)	19 (42.2)
University educated	53 (55.2)	27 (52.9)	26 (57.8)
Employment status				0.21
Employed	51 (53.1)	24 (47.1)	27 (60.0)
Unemployed	45 (46.9)	27 (52.9)	18 (40.0)
Monthly family income (OMR)				0.68
<400	15 (15.6)	6 (11.8)	9 (20.0)
400–799	26 (27.1)	14 (27.5)	12 (26.7)
800–1,199	18 (18.8)	11 (21.5)	7 (15.5)
>1,200	37 (38.5)	20 (39.2)	17 (37.8)
Irregular menses	55 (57.3)	42 (82.4)	13 (28.9)	<0.001
Presence of hirsutism	44 (45.8)	43 (84.3)	1 (2.2)	<0.001
Presence of acne	20 (20.8)	15 (29.4)	5 (11.1)	0.04
History of vitamin B12 intake	12 (12.5)	6 (11.8)	6 (13.3)	0.82
History of folate intake				0.15
Regular supplementation	32 (33.3)	15 (29.4)	17 (37.8)
Irregular supplementation	50 (52.1)	31 (60.8)	19 (42.2)

Abbreviation: OMR, Omani Rials.

Table 2 Anthropometric characteristics of the study groups, Oman, 2017

Characteristics	Total	Cases	Controls	OR (95% CI)	P-value
	(N=96)	(N=51)	(N=45)
	n (%)	n (%)	n (%)
BMI					0.47
Normal	24 (25.0)	11 (21.6)	13 (28.9)	1.0
Overweight	27 (28.1)	13 (25.5)	14 (31.1)	1.10 (0.36, 3.30)
Obese	45 (46.9)	27 (52.9)	18 (40.0)	1.77 (0.65, 4.82)
WHR					0.004
Low riska	18 (18.8)	5 (9.8)	13 (28.9)	1.0
Moderate riska	25 (26.0)	10 (19.6)	15 (33.3)	1.73 (0.47, 6.39)
High riska	53 (55.2)	36 (70.6)	17 (37.8)	5.51 (1.69, 17.95)
WC					0.28
Low riska	31 (32.3)	13 (25.5)	18 (40.0)	1.0
Moderate riska	17 (17.7)	9 (17.6)	8 (17.8)	1.56 (0.47, 5.12)
High riska	48 (50.0)	29 (56.9)	19 (42.2)	2.11 (0.84, 5.29)

Note:

a Risk for chronic diseases/metabolic complications.

Abbreviations: BMI, body mass index; WHR, waist-hip ratio; WC, waist circumference.

Figure 1 GSH levels among controls vs PCOS cases.

Note: Results are expressed as mean±SEM.
Abbreviations: GSH, glutathione; PCOS, polycystic ovarian syndrome; SEM, standard error of mean.

Figure 2 TAC levels among controls vs PCOS cases.

Notes: Results are expressed as mean±SEM. P>0.05.
Abbreviations: TAC, total antioxidant capacity; PCOS, polycystic ovarian syndrome; SEM, standard error of mean.

Table 3 Mean levels of sex hormones and oxidative stress biomarkers among the study groups, Oman, 2017

Parameter	Cases	Controls	P-value
	(N=51)	(N=45)
	Mean±SEM	Mean±SEM
Testosterone (nmol/L)	1.83±0.81	1.10±0.60	<0.001
DHEAS (µmol/L)	5.31±2.37	3.80±1.90	0.001
Estradiol (nmol/L)	0.45±0.63	0.24±0.24	0.30
Progesterone (nmol/L)	15.38±16.86	34.75±19.82	<0.001
GPx (U/L)	9,174.58±1,063.20	7,498.73±639.96	0.43
GR (U/L)	499.92±79.84	435.12±25.29	0.25
GSH (mg/mL)	6.32±1.59	11.22±4.22	0.006
TAC (mmol/L)	3.80±0.12	4.04±0.14	0.49

Abbreviations: DHEAS, dehydroepiandrosterone sulfate; GPx, glutathione peroxidase; GR, glutathione reductase; GSH, glutathione; TAC, total antioxidant capacity; SEM, standard error of mean.

Table 4 Correlation between oxidative stress biomarkers and sex hormones, Oman, 2017

	GPx	GR	TAC	GSH
Testosterone	0.062	−0.074	0.079	−0.173
DHEAS	0.080	−0.061	0.045	−0.170
Estradiol	−0.151	−0.163	−0.284a	0.029
Progesterone	−0.063	0.018	−0.099	0.221

Notes:

a Correlation is significant. P=0.005.

Abbreviations: DHEAS, dehydroepiandrosterone sulfate; GPx, glutathione peroxidase; GR, glutathione reductase; TAC, total antioxidant capacity; GSH, glutathione.

Table 5 Multilinear regression modeling of the association between TAC levels and each of the sex hormones and anthropometric parameters, Oman, 2017

Predictor	Regression statistics		P-value
	Standardized β	SE
Testosterone	0.049	0.132	0.68
DHEAS	0.084	0.045	0.46
Estradiol	−0.380	0.182	<0.001
Progesterone	0.031	0.005	0.76
BMI	−0.341	0.033	0.23
WC	2.692	0.121	0.22
WHR	−0.900	12.306	0.28

Notes: R² value for the full model is 20.3%; R² value for the stepwise model (estradiol only) is 8.1%. (P=0.005).

Abbreviations: DHEAS, dehydroepiandrosterone sulfate; BMI, body mass index; WC, waist circumference; WHR, waist-hip ratio; SE, standard error.