Identification of the Frequency and Prominence of Helicobacter pylori infection in Patients with Polycystic Ovary Syndrome referred to Several Tehran Private Hospitals, Iran

Document Type : Research Paper

Authors

Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran

Abstract

Polycystic ovary syndrome (PCOS) ranks among the most pervasive endocrine disorders experienced by premenopausal women. Helicobacter pylorus is a prevalent infection in human populations. The present study was designed to investigate the prevalence of Helicobacter pylori infection in PCOS patients. It was a case-control investigation comprising 100 female participants who sought medical care at the Tehran Army Hospital in Iran. Initially, fifty individuals diagnosed with polycystic ovary syndrome, based on the Rotterdam criteria and verified by two experienced physicians, were selected for inclusion in the study. Afterward, an equal number of women without said syndrome were included in a one-to-one comparison. Subsequent to acquiring blood samples of uniform volume from all donors, serum separation was performed, and the resulting samples were subsequently stored in a freezer at a temperature of -20 °C. The study involved quantifying IgG-antibody titer employing an ELISA reader in adherence to the protocol established by the kit manufacturer, namely Trinity Biotech. The study participants were found to have a mean age of 20-45 years with a standard deviation of 3.71. The age and body mass index (BMI) variables were found to be statistically insignificant between the two groups under investigation, indicating that the groups were comparable in terms of these factors. The Ig G serology results indicated a positive outcome among 64% (n=32) of the case group and 32% (n=16) of the control group. Statistical analysis using the chi-square test revealed a significantly different proportion between the two groups, as evidenced by a P-value of less than 0.05. The present study's findings indicate a significant disparity in the incidence of H. pylori infection between individuals diagnosed with polycystic ovary syndrome and their counterparts without the condition. Specifically, a higher prevalence of the infection was observed among patients with polycystic ovary syndrome. Ultimately, the proposition concerning the function of H. pylori was evaluated. It is posited that H. pylori may represent a potential risk factor for the acquisition of the mentioned condition. Therefore, carefully designed analytical and controlled investigations should be performed to substantiate this supposition.

Keywords

Main Subjects


 
[1] Alexander, S.M., Retnakumar, R.J., Chouhan, D., Devi, T.N.B., Dharmaseelan, S., Devadas, K., Thapa, N., Tamang, J.P., Lamtha, S.C. and Chattopadhyay, S. (2021) Helicobacter pylori in Human Stomach: The Inconsistencies in Clinical Outcomes and the Probable Causes. Front Microbiol 12:713955. doi: 10.3389/fmicb.2021.713955.
[2] Amabebe, E. and Anumba, DOC. (2020) Female Gut and Genital Tract Microbiota-Induced Crosstalk and Differential Effects of Short-Chain Fatty Acids on Immune Sequelae. Front Immunol 11:2184. doi: 10.3389/fimmu.2020.02184.
[3] Bravo, D., Hoare, A., Soto, C., Valenzuela, M.A. and Quest, A.F. (2018) Helicobacter pylori in human health and disease: Mechanisms for local gastric and systemic effects. World J Gastroenterol 24(28):3071-3089. doi: 10.3748/wjg. v24.i28.3071.
[4] Buggs, C. and Rosenfield, R.L. (2005) Polycystic ovary syndrome in adolescence. Endocrinol Metab Clin North Am 34(3):677-705, x. doi: 10.1016/j.ecl.2005.04.005.
[5] Campuzano-Maya, G. (2014) Hematologic manifestations of Helicobacter pylori infection. World J Gastroenterol 20(36):12818-38. doi: 10.3748/wjg.v20.i36.12818.
[6] Chen, X., Wang, N., Wang, J., Liao, B., Cheng, L. and Ren, B. (2022) The interactions between oral-gut axis microbiota and Helicobacter pylori. Front. Cell. Infect. Microbiol 12:914418. doi: 10.3389/fcimb.2022.914418
[7] Darvishi, M., Forootan, M., Azmodeh, O., Forootan, M. and Matinfar, H. (2017) Studying the Frequency of Helicobacter Pylori Infection Among Women Suffering from Polycystic ovary Resorting to Hospital Infertility Center. Biomed Pharmacol J 10(1).
[8] Dennett, C.C. and Simon, J. (2015) The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment. Diabetes Spectr 28(2):116-20. doi: 10.2337/diaspect.28.2.116.
[9] Deswal, R., Narwal, V., Dang, A. and Pundir, C.S. (2020) The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci 13(4):261-271. doi: 10.4103/jhrs.JHRS_95_18.
[10] Dimitriadi, D. (2014) Helicobacter pylori: a sexually transmitted bacterium? Cent European J Urol 67(4):407-9. doi: 10.5173/ceju.2014.04.art18.
[11] El Hayek, S., Bitar, L., Hamdar, L.H., Mirza, F.G. and Daoud, G. (2016) Poly Cystic Ovarian Syndrome: An Updated Overview. Front. Physiol. 7:124. doi: 10.3389/fphys.2016.00124
[12] Eslick, G.D. (2000) Helicobacter pylori infection transmitted sexually via oral-genital contact: a hypothetical model. Sex Transm Infect 76(6):489-92. doi: 10.1136/sti.76.6.489.
[13] Faghri, J., Poursina, F., Moghim, S., Zarkesh Esfahani, H., Nasr Esfahani B., et al. (2014) Morphological and Bactericidal Effects of Different Antibiotics on Helicobacter pylori. Jundishapur J Microbiol 7(1):e8704.
[14] Farhadi-Azar, M., Behboudi-Gandevani, S., Rahmati, M., Mahboobifard F., Khalili Pouya E., Ramezani Tehrani F. and Azizi F. (2022) The Prevalence of Polycystic Ovary Syndrome, Its Phenotypes and Cardio-Metabolic Features in a Community Sample of Iranian Population: Tehran Lipid and Glucose Study. Front. Endocrinol 13:825528. doi: 10.3389/fendo.2022.825528
[15] Figura, N., Piomboni, P., Ponzetto, A., Gambera, L., Lenzi, C., Vaira, D., et al. (2002) Helicobacter pylori infection and infertility. Eur J Gastroenterol Hepatol 14: 663-9.
[16] Foroozanfard, F., Moosavi, S.G., Mansouri, F. and Bazarganipour, F. (2014) Obstetric and Neonatal Outcome in PCOS with Gestational Diabetes Mellitus. J Family Reprod Health 8(1):7-12.
[17] Hernandez, C.D., Shin, H., Troncoso, P.A., Vera, M.H., Villagran, A.A., Rodriguez-Rivera, S.M., Ortiz, M.A., Serrano, C.A., Borzutzky, A., Dominguez-Bello, M.G. and Harris, P.R. (2020) Maternal H. pylori is associated with differential fecal microbiota in infants born by vaginal delivery. Sci Rep 10(1):7305. doi: 10.1038/s41598-020-64296-7.
[18] Jabeen, A., Yamini, V., Rahman, Amberina, A., Dinesh Eshwar, M., Vadakedath, S., Begum, G.S. and Kandi, V. (2022) Polycystic Ovarian Syndrome: Prevalence, Predisposing Factors, and Awareness Among Adolescent and Young Girls of South India. Cureus 14(8):e27943. doi: 10.7759/cureus.27943.
[19] Kazemi, E. and Khazaei, M. (2018). 'A review of the effects of Helicobacter pylori infection on reproduction, pregnancy and gynecologic diseases', The Iranian Journal of Obstetrics, Gynecology and Infertility, 21(Supplement), 67-75. doi: 10.22038/ijogi.2018.11622
[20] Khalili, Sharifi yazdi, Sadeh. (2007) Correlation of H. pylori infection and infertility; a survey in Yazd infertility clinic.Tehran University Medical Journal; Vol. 65, No. 3, Jun 2007: 72-77.
[21] Kiani, A.H., Asadbeik, E., Bibalan, M.H., Sedighi, M., Eshaghi, M., Gholami, M. and Pournajaf, A. (2015) Serological diagnosis of Helicobacter pylori infection in patients with a polycystic ovary syndrome. Archives of Clinical Infectious Diseases, 10 (2).
[22] Krzyżek, P. and Gościniak, G. (2018) Morphology of Helicobacter pylori as a result of peptidoglycan and cytoskeleton rearrangements. Prz Gastroenterol 13(3):182-195. doi: 10.5114/pg.2018.78284.
[23] Kshetrimayum, C., Sharma, A., Mishra, V.V. and Kumar, S. (2019) Polycystic ovarian syndrome: Environmental/occupational, lifestyle factors; an overview. J Turk Ger Gynecol Assoc 20(4):255-263. doi: 10.4274/jtgga.galenos.2019.2018.0142.
[24] Li, J., Fan, M., Ma, F., Zhang, S. and Li, Q. (2021) The effects of Helicobacter pylori infection on pregnancy-
related diseases and fetal development in diabetes in pregnancy. Ann Transl Med 9(8):686. doi: 10.21037/atm-21-1209.
[25] Manoharan, V. and Wong, VW. (2020) Impact of comorbid polycystic ovarian syndrome and gestational diabetes mellitus on pregnancy outcomes: a retrospective cohort study. BMC Pregnancy Childbirth 20(1):484. doi: 10.1186/s12884-020-03175-5.
[26] Melo, A.S., Ferriani, R.A. and Navarro P.A. (2015) Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo) 70(11):765-9. doi: 10.6061/clinics/2015(11)09.
[27] Moretti, E., Figura, N., Collodel, G. and Ponzetto, A. (2014) Can Helicobacter pylori infection influence human reproduction? World J Gastroenterol 20(19):5567-74. doi: 10.3748/wjg.v20.i19.5567.
[28] Ndefo, U.A., Eaton, A. and Green, MR. (2013) Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. PT 38(6):336-55.
[29] Niknam, R., Fattahi, M.R., Sepehrimanesh, M. and Safarpour, A. (2018) Prevalence of Helicobacter pylori in Southern Part of Iran. Jundishapur J Microbiol 11(6): e62379.
[30] Pakniat H., Kazemi F., Movahed F., Haji Seyed Abotorabi, SH.S., Soufizadeh, N. and Yaghobi, F. (2022) Evaluation of Pregnancy consequences in Women with Polycystic Ovary Syndrome: A Case-Control Study in Qazvin, Iran. SJKU 27(1):74-83.
[31] Pattnaik, L., Naaz, S.A., Das, B., Dash, P., Pattanaik, M. (2022) Adverse Pregnancy Outcome in Polycystic Ovarian Syndrome: A Comparative Study. Cureus 14(6): e25790. doi: 10.7759/cureus.25790.
[32] Ranathunga, I., Athukorala, T.G., Sumanatilleke, M.R. et al. (2022) Evaluation of socio-demographic and clinical characteristics of PCOS patients attending a tertiary care institute in Colombo. BMC Endocr Disord 22, 289.
[33] Rojas, J., Chávez, M., Olivar, L., Rojas, M., Morillo, J., Mejías, J., Calvo, M. and Bermúdez, V. (2014) Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. Int J Reprod Med 719050. doi: 10.1155/2014/719050.
[34] Roussos, A., Philippou, N. and Gourgoulianis, K.I. (2003) Helicobacter pylori infection and respiratory diseases: a review. World J Gastroenterol 9(1):5-8. doi: 10.3748/wjg.v9.i1.5.
[35] Salih, B.A. (2009) Helicobacter pylori infection in developing countries: the burden for how long? Saudi J Gastroenterol 15(3):201-7. doi: 10.4103/1319-3767.54743.
[36] Sánchez-Alonzo, K., Matamala-Valdés, L., Parra-Sepúlveda, C., Bernasconi, H., Campos, V.L., Smith, C.T., Sáez, K. and García-Cancino, A. (2021) Intracellular Presence of Helicobacter pylori and Its Virulence-Associated Genotypes within the Vaginal Yeast of Term Pregnant Women. Microorganisms 9(1):131. doi: 10.3390/microorganisms9010131.
[37] Sawant, S. and Bhide, P. (2023) Fertility Treatment Options for Women with Polycystic Ovary Syndrome. Clin Med Insights Reprod Health. 2019. doi: 10.1177/1179558119890867.
[38] Singh, S, Pal, N, Shubham, S, Sarma, DK, Verma, V, Marotta, F, Kumar, M. (2023) Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. Journal of Clinical Medicine 12(4):1454.
[39] Sohrabvand, F., Shariat, M., Farahvash, M.J., Haghollahi, F., Khosravi, M., Maasomi, M., et al. (2014) Serological study of Helicobacter pylori infection in patients with Polycystic Ovary Syndrome. Tehran Univ Med J 71 (10) :660-664
[40] Torabi, R, Tebyanian, H, Heiat, M. and Choopani, A. (2022) Seroepidemiological Prevalence of Helicobacter pylori in the south of Tehran, Iran. Novelty in Clinical Medicine 1(1): 55-58. doi: 10.22034/ncm.2022.140810
[41] Vinette, K.M., Gibney, K.M., Proujansky, R. et al. (2002) Growth of Helicobacter pylori in a long spiral form does not alter expression of immunodominant proteins. BMC Microbiol 2, 24.
[42] Witchel, S.F., Oberfield, S.E., and Peña A.S. (2019) Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment with Emphasis on Adolescent Girls. J Endocr Soc 3(8):1545-1573. doi: 10.1210/js.2019-00078.
[43] Xia, B., Wang, W., Lu, Y. and Chen, C. (2020) Helicobacter pylori infection increases the risk of metabolic syndrome in pregnancy: a cohort study. Ann Transl Med 8(14):875. doi: 10.21037/atm-20-4863.
[44] Yang, S.W., Yoon, S.H., Kim, M., Seo, Y.S. and Yuk, J.S. (2023) Risk of Gestational Diabetes and Pregnancy-Induced Hypertension with a History of Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study. Journal of Clinical Medicine 12(5):1738.
[45] Yavasoglu, I., Kucuk, M., Cildag, B., Arslan, E., Gok, M., and Kafkas, S. (2009) A novel association between polycystic ovary syndrome and Helicobacter pylori. Am J Med Sci 338(3):174–177. doi: 10.1097/MAJ.0b013e3181a63c8a
[46] Yavaşoglu, I. and Küçük, M. (2012) Anti-Helicobacter pylori antibodies and polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol, 1-12. https://doi.org/10.1007/s12374-021-09329-y
 
[47] Yee, J.K.C. (2017) Are the view of Helicobacter pylori colonized in the oral cavity an illusion? Exp Mol Med 49(11): e397. doi: 10.1038/emm.2017.225.
[48] Zargham, R., Moteshakker-Arani, M. and Soleimani-Meigooni, S. (2015) Prevalence of Helicobacter pylori infection on polycystic ovary syndrome in the women visiting Shariati hospital in 2013. NPWJM 3 (6) :61-65.
[49] Zhang, L., Chen, X., Ren, B., Zhou, X. and Cheng, L. (2022) Helicobacter pylori in the Oral Cavity: Current Evidence and Potential Survival Strategies. Int. J. Mol. Sci 23, 13646.