Abstract
Purpose
Primary dysmenorrhea effects the life-quality of women negatively. The aim of this study was to evaluate heme oxygenase-1 (HO1) activity together with malondialdehyde (MDA) and nitric oxide (NO) levels in patients with primary dysmenorrhea.
Methods
A total of 28 nulliparous women with the diagnosis of primary dysmenorrhea and 26 healthy controls were included in this study. On the first day of menstruation, all patients underwent ultrasound examination to exclude pelvic pathology and the visual analogue scale was applied to patients. Patient’s visual analogue scale (VAS) scores, age, body mass index (BMI), menstrual cycle length (day), length of bleeding (day) were recorded. In the same day, fasting blood samples were taken from each patient for biochemical analysis.
Results
Serum MDA, NO and HO1 levels were found to be higher in women with primary dysmenorrhea compared to healthy controls (p = 0.012, p = 0.009, p < 0.001, respectively). There were no correlation among serum levels of HO1, NO and MDA, age, BMI, cycle length, pain score and menses duration in both groups. In Pearson’s correlation analysis, positive correlation was found between HO1 levels with the NO levels (r = 0.316, p < 0.05) and VAS scores (r = 0.520, p < 0.01). Also, positive correlation was found between MDA levels and VAS scores (r = 0.327, p < 0.05).
Conclusions
Serum HO1, NO and MDA levels increase in patients with primary dysmenorrhea. Antioxidant support might be helpful to reduce pain severity in primary dysmenorrhea.
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References
De Sanctis V, Soliman A, Bernasconi S, Bianchin L, Bona G, Bozzola M, Buzi F, De Sanctis C, Tonini G, Rigon F, Perissinotto E (2015) Primary dysmenorrhea in adolescents: prevalence, impact and recent knowledge. Pediatr Endocrinol Rev 13:512–520
Esen I, Oğuz B, Serin HM (2016) Menstrual characteristics of pubertal adolescent girls: a questionnaire based study in Turkey. J Clin Res Pediatr Endocrinol 8:192–196
Ju H, Jones M, Mishra G (2014) The prevalence and risk factors of dysmenorrhea. Epidemiol Rev 36:104–113
Habibi N, Huang MS, Gan WY, Zulida R, Safavi SM (2015) Prevalence of primary dysmenorrhea and factors associated with its intensity among undergraduate students: a cross-sectional study. Pain Manag Nurs 16:855–861
Liedman R, Hansson SR, Howe D, Igidbashian S, Russell RJ, Akerlund M (2008) Endometrial expression of vasopressin, oxytocin and their receptors in patients with primary dysmenorrhoea and healthy volunteers at ovulation. Eur J Obstet Gynecol Reprod Biol 137:189–192
Yang L, Cao Z, Yu B, Chai C (2015) An in vivo mouse model of primary dysmenorrhea. Exp Anim 64:295–303
Turhan N, Celik H, Duvan Cİ, Onaran Y, Aydın M, Armutcu F (2012) Investigation of oxidative balance in patients with dysmenorrhea by multiple serum markers. J Turk Ger Gynecol Assoc 13:233–236
Aksoy AN, Gözükara I, Kabil Kucur S (2014) Evaluation of the efficacy of Fructus agni casti in women with severe primary dysmenorrhea: a prospective comparative Doppler study. J Obstet Gynaecol Res 40:779–784
Shirvani MA, Motahari-Tabari N, Alipour A (2015) The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet 291:1277–1281
Iacovides S, Baker FC, Avidon I (2014) The 24-h progression of menstrual pain in women with primary dysmenorrhea when given diclofenac potassium: a randomized, double-blinded, placebo-controlled crossover study. Arch Gynecol Obstet 289:993–1002
Otterbein LE, Mantell LL, Choi AM (1999) Carbon monoxide provides protection against hyperoxic lung injury. Am J Physiol 276:688–694
Ryter SW, Tyrrell RM (2000) The heme synthesis and degradation pathways: role in oxidant sensitivity. Heme oxygenase has both pro- and antioxidant properties. Free Radic Biol Med 28:289–309
Wagener FA, Volk HD, Willis D, Abraham NG, Soares MP, Adema GJ, Figdor CG (2003) Different faces of the heme-heme oxygenase system in inflammation. Pharmacol Rev 55:551–571
Tanaka S, Akaike T, Fang J, Beppu T, Ogawa M, Tamura F, Miyamoto Y, Maeda H (2003) Antiapoptotic effect of haem oxygenase-1 induced by nitric oxide in experimental solid tumour. Br J Cancer 88:902–909
Soares MP, Marguti I, Cunha A, Larsen R (2009) Immunoregulatory effects of HO-1: how does it work? Curr Opin Pharmacol 9:482–489
Gaweł S, Wardas M, Niedworok E, Wardas P (2004) Malondialdehyde (MDA) as a lipid peroxidation marker. Wiad Lek 57:453–455
Waltz P, Escobar D, Botero AM, Zuckerbraun BS (2015) Nitrate/nitrite as critical mediators to limit oxidative injury and inflammation. Antioxid Redox Signal 23:328–339
Lee SJ, Zhang J, Choi AM, Kim HP (2013) Mitochondrial dysfunction induces formation of lipid droplets as a generalized response to stress. Oxid Med Cell Longev 2013: 327167.
Dikensoy E, Balat O, Pençe S, Balat A, Cekmen M, Yurekli M (2008) Malondialdehyde, nitric oxide and adrenomedullin levels in patients with primary dysmenorrhea. J Obstet Gynaecol Res 34:1049–1053
Crichton N (2000) Information point: Visual Analogue Scale (VAS). J Clin Nurse 10:706
Ohkawa H, Ohishi N, Yagi K (1979) Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem 95:351–358
Lundberg JO, Weitzberg E (2005) NO generation from nitrite and its role in vascular control. Arterioscler Thromb Vasc Biol 25:915–922
Erdemli HK, Yıldırımlar P, Alper TY, Kocabaş R, Salis O, Bedir A (2014) Increased serum heme oxygenase-1 levels as a diagnostic marker of oxidative stress in preeclampsia. Hypertens Pregnancy 33:488–497
Lenth RV (2006) Java applets for power and sample size (computer software). http://www.stat.uiowa.edu/~rlenth/Power
Yeh ML, Chen HH, So EC, Liu CF (2004) A study of serum malondialdehyde and interleukin-6 levels in young women with dysmenorrhea in Taiwan. Life Sci 75:669–673
Facchinetti F, Sgarbi L, Piccinini F, Volpe A (2002) A comparison of glyceryl trinitrate with diclofenac for the treatment of primary dysmenorrhea: an open, randomized, cross-over trial. Gynecol Endocrinol 16:39–43
Sun MF, Huang HC, Lin SC, Chang LP, Liu CF (2005) Evaluation of nitric oxide and homocysteine levels in primary dysmenorrheal women in Taiwan. Life Sci 76:2005–2009
Akdemir N, Cinemre H, Bilir C, Akin O, Akdemir R (2010) Increased serum asymmetric dimethylarginine levels in primary dysmenorrhea. Gynecol Obstet Invest 69:153–156
Xin G, Du J, Wang YT, Liang TT (2014) Effect of oxidative stress on heme oxygenase-1 expression in patients with gestational diabetes mellitus. Exp Ther Med 7:478–482
Author contributions
ANA: project development, data collection, manuscript writing and editing. EL: project development, data collection and management, manuscript editing. ALO: project development, data analysis, manuscript editing. EPTY: project development, data collection, manuscript writing and editing.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Aksoy, A.N., Laloglu, E., Ozkaya, A.L. et al. Serum heme oxygenase-1 levels in patients with primary dysmenorrhea. Arch Gynecol Obstet 295, 929–934 (2017). https://doi.org/10.1007/s00404-017-4312-1
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DOI: https://doi.org/10.1007/s00404-017-4312-1