متلازمة تكيس المبايض وبوليمر مغلف الميلاتونين: دراسة منظورية هرمونية

Polycystic Ovarian Syndrome and Melatonin Encapsulation polymer: A hormonal perspective study

Background: Polycystic ovary syndrome is the most prevalent endocrine disorder in women of reproductive age and is characterized by irregular menstrual cycles, hyperandrogenism, infertility, frequently with a characteristic ovarian morphology on ultrasonography. The pathophysiology is still vague. A diagnosis is made based on the internationally agreed “Rotterdam” diagnostic criteria for PCOS. The syndrome is associated with central obesity, dyslipidemia, and mood disorders especially anxiety. Visceral obesity has a marked impact on the metabolic complications of PCOS, the lipid accumulation product (LAP) and the visceral adiposity index (VAI), are used to evaluate visceral obesity more easily and with high precision. PCOS patients are treated according to their clinical and biochemical presentation. however, there are still several unanswered problems, particularly in relation to the ideal long-term management. New studies showed that melatonin has some benefits by improving both biochemical and clinical manifestations of PCOS. Melatonin is produced by the pineal gland mainly, its effects on female reproductive physiology are mediated by its receptors in hypothalamic, pituitary, and ovarian sites, also it improves peripheral tissue uptake of glucose, and reduces insulin resistance thus may contribute to the management of PCOS patients. The advancement of nanomedicine by drug encapsulation is a very promising technique. Modern encapsulation techniques also provide various benefits over traditional medicinal procedures.
Objectives of this study: The aim of study is to investigate a new treatment to PCOS through using the nanotechnology by synthesis the melatonin@PLGA nanohydrgel then evaluate the effect on the LH hormone in sera of women with PCOS. Determine the association between body mass index and biochemical presentation. Determine LAP and VAI and identify the most effective markers that can predict insulin resistance (IR) in women with PCOS in Karbala city.
Subject & Methods: This case-control study was done at Kerbala teaching hospital for obstetrics and gynecology from November 2022 to August 2023. Eighty-five PCOS patients were divided on the basis of BMI in to less than 25kg/m2 and above 25kg/m2, and the same way, eighty-five control were divided. The consultant gynecologist diagnosed according to Rotterdan criteria. Hormonal (LH, FSH, PRL and F.T) and biochemical tests were performed and measuring homeostasis model assessment for resistance (HOMA-IR), LAP and VAI. Melatonin@PLGA was synthesized using the emulsion method then observe its effect on LH hormones in sera of PCOS women.
Results: There was statistically significant higher LH level, LH/FSH ratio, Prolactin, Insulin level and HOMA-IR in both PCOS groups (1, 2) groups compared to controls groups (1, 2) respectively (p-value = 0.001). In contrast, LDL, HDL and TG in PCOS2 in comparison to control group (2) were significant different but total cholesterol was not significant different, there was not significant different for lipid profile in group PCOS1 compare with control group 1.
Melatonin@PLGA nanohyderogels was examination by using scanning electron microscope (SEM) and transmission electron microscope (TEM) to characterize structure and morphology, furthermore, the zeta potentials and dynamic light scattering (DLS) have been used to determine the surface charge transforming and particles size after encapsulation of melatonin within PLGA polymer. When Melatonin@PLGA nanohyderogels was applied to the LH hormonal of the serum in PCOS women and the results shows significant decrease in LH levels
In conclusion Melatonin@PLGA nanohyderogel has an inhibitory effect on LH hormone, which may provide a promising idea for PCOS therapy.