Improving the accuracy and efficacy of diagnosing polycystic ovary syndrome by integrating metabolomics with clinical characteristics: study protocol for a randomized controlled trial.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex endocrine syndrome with poorly understood mechanisms. To provide patients with PCOS with individualized therapy, it is critical to precisely diagnose the phenotypes of the disease. However, the criteria for diagnosing the different phenotypes are mostly based on symptoms, physical examination and laboratory results. This study aims to compare the accuracy and efficacy of diagnosing PCOS by integrating metabolomic markers with common clinical characteristics. METHODS: This is a prospective, multicenter, analyst-blinded, randomized controlled trial. Participants will be grouped into (1) people without PCOS (healthy control group), (2) patients diagnosed with PCOS based on clinical indices (experimental group 1), and (3) patients diagnosed with PCOS based on metabolomic indices (experimental group 2). A total of 276 participants, including 60 healthy people and 216 patients with PCOS, will be recruited. The 216 patients with PCOS will be randomly assigned to the two experimental groups in a 1:1 ratio, and each group will receive a different 6-month treatment. The primary outcome for the experimental groups will be the effect of PCOS treatment. DISCUSSION: The results of this trial should help to determine whether using metabolomic indices is more accurate and effective than using clinical characteristics in diagnosing the phenotypes of PCOS. The results could provide a solid foundation for the accurate diagnosis of different PCOS subgroups and for future research on individualized PCOS therapy. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR-INR-1800016346. Registered 26 May 2018.

Ameliorative effects of tannic acid on carbon tetrachloride-induced liver fibrosis in vivo and in vitro.

We investigated the ameliorative effects and potential mechanisms of tannic acid (TA) in carbon tetrachloride (CCl4)-intoxicated mice and hepatic stellate cells (HSCs). Liver fibrosis was observed in CCl4 (800 ml/kg)-induced mice, and high viability was observed in CCl4 (10 mM)-intoxicated HSCs. Pre-treatment of mice with TA (25 or 50 g/kg/day) significantly ameliorated hepatic morphology and coefficient values and reduced the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), the concentrations of malondialdehyde (MDA) and serum levels of endothelin-1 (ET-1). In addition, TA increased the activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and endothelial nitric oxide synthase (eNOS) and the serum level of NO. Moreover, TA reduced the expression of angiotensin II receptor-1 (ATR-1), interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α), transforming growth factor-ß (TGF-ß), caspase-3, c-fos, c-jun, the ratio of Bax/bcl-2, tissue inhibitor of metalloproteinase-1 (TIMP-1) and TA increased matrix metal proteinase-9 (MMP-9), matrix metalloproteinase-1 (MMP-1). Furthermore, TA (0.01 µM, 0.1 µM or 1 µM) decreased the TIMP-1/MMP-1 ratio and reduced the viability of HSCs. These results indicated that TA exerts significant liver-protective effects in mice with CCl4-induced liver fibrosis. The potential mechanism may rely on the inhibition of collagen accumulation, oxidative stress, inflammation and apoptosis.

[Contamination and health risk for heavy metals via consumption of vegetables grown in fragmentary vegetable plots from a typical nonferrous metals mine city].

A systematic survey of As, Ni, Cu, Pb, Cd and Zn concentrations in eight kinds of vegetables (involving 226 samples) and their corresponding soils at 35 sampling sites in the fragmentary vegetable plots of a typical nonferrous metals mine city, Tongling, was carried out for assessing heavy metal pollution, bio-accumulation ability and potential health risk to local inhabitants due to exposure via consumption of vegetables. The results showed that: (1) The soils of the studied vegetable plots were seriously contaminated by heavy metals and the mean concentrations of As, Ni, Cu, Pb, Cd and Zn reached 96.96, 56.64, 1 247.82, 313.59, 6.743 and 600.96 mg x kg(-1), respectively, all significantly exceeding the soil background value of Tongling city; (2) The mean values of integrated pollution index corresponding to eight varieties of vegetables were all higher than the threshold value (i. e. 3.0) of heavy pollution; (3) In general, the largest bioaccumulation factor of heavy metals in vegetables was As, followed by Ni and Cu, and the order of pollution degree of heavy metals in vegetables was Ni > Zn > Cu > Pb > As > Cd; (4) The target hazard quotients (THQs) of As, Ni, Cu, Pb, Cd and Zn were 17.92, 1.01, 10.14, 0.73, 0.21 and 1.93, respectively. Arsenic and copper were the major risk contributors for inhabitants since the THQs of them respectively mounted to 56.10% and 31.75% of the total THQ value according to the average vegetable consumption; (5) The estimated daily intake (DI) of As, Ni, Cu, Pb, Cd and Zn from vegetables was 324.38, 1 211.25, 24 326.25, 176.25, 12.75 and 34 800 microg x d(-1) for adult residents, respectively; and (6) The target cancer risk (TR) of vegetables polluted by As to individual human health was 8.06 x 10(-3), significantly higher than the management standard (i. e. 10(-6) - 10(-4)) of United States Environmental Protection Agency (US EPA) and the standard (i. e. 5.0 x 10(-5)) of International Commission on Radiological Protection (ICRP), indicating that it was quite unsafe for the general population to consume vegetables from the studied fragmentary plots.