title: Metabolic heterogeneity of follicular amino acids in polycystic ovary syndrome is affected by obesity and related to pregnancy outcome.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder frequently accompanied by obesity and by insulin resistance, and patients with this syndrome suffer from infertility and poor pregnancy outcome. Disturbances in plasma amino acid (AA) metabolism have been implicated in women with PCOS. However, direct evidence on follicular AA metabolic profiles in PCOS patients and their relationship with pregnancy outcome is sparse.
  
  
  METHODS
  We conducted a prospective study in 63 PCOS patients and 48 controls in the Division of Reproductive Center, Peking University Third Hospital. Follicular AA levels were measured by the liquid chromatography-tandem mass spectrometric method, and the results were analyzed based on different grouping criteria.
  
  
  RESULTS
  The levels of aromatic amino acid (AAA) increased in PCOS patients independent of obesity (P < 0.05), whereas the levels of branched-chain amino acid (BCAA), glutamic acid, phenylalanine, alanine, and arginine increased with body mass index irrespective of the PCOS status (all P < 0.05). In addition, compared with non insulin resistant-PCOS patients and controls, insulin resistant-PCOS group had higher levels of leucine, valine and glutamic acid (all P < 0.05). In PCOS group, aspartic acid and serine levels were elevated in pregnant patients compared with the non-pregnant subjects (both P < 0.05). Moreover, the levels of BCAA and valine were higher in the non-pregnant group than in the pregnant group (both P < 0.05). The pregnancy rate (45.00%) of subjects with elevated BCAA level was significantly lower than that (66.67%) in control subjects (P = 0.036) at a BCAA cutoff value of 239.10 μM, while the abortion rate was much higher (33.33% versus 2.78%, P = 0.004).
  
  
  CONCLUSIONS
  Both PCOS and obesity were accompanied by follicular AA metabolic disturbances, with obesity exerting a more pronounced effect on AA metabolic profiles. The disruptions in specific AAs in the follicular fluid might account for the inferior pregnancy outcome in obese patients and increased risk of abortion in PCOS patients.
authors.forename: Chun-mei
authors.initials: CM
authors.lastname: Zhang
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao
authors.forename: Rong
authors.initials: R
authors.lastname: Li
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Li-ying
authors.initials: LY
authors.lastname: Yan
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Na-na
authors.initials: NN
authors.lastname: Liu
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No, 49 Huayuan North Road, Beijing, Haidian District, 100191, People's Republic of China. jie.qiao@263.net.
authors.forename: Jie
authors.initials: J
authors.lastname: Qiao
mesh_terms: D000022:Abortion, Spontaneous / Q000378:metabolism*; D000328:Adult; D000596:Amino Acids / Q000378:metabolism*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D009765:Obesity / Q000378:metabolism*; D006080:Ovarian Follicle / Q000378:metabolism*; D011085:Polycystic Ovary Syndrome / Q000378:metabolism*; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D000596:Amino Acids