Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review
Obesity reduces nitric oxide (NO) production due to endothelial nitric oxide synthase (eNOS) dysfunction, resulting in oxidative stress, mitochondrial dysfunction, and chronic inflammation. These factors have a negative impact on reproductive health, including oocyte quality, endometrial receptivity...
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2024-12-01
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| author | Charalampos Voros Despoina Mavrogianni Aspasia Minaoglou Alexios Karakasis Anthi-Maria Papahliou Vasileios Topalis Antonia Varthaliti Raphail Mantzioros Panagiota Kondili Menelaos Darlas Regina Sotiropoulou Diamantis Athanasiou Dimitrios Loutradis Georgios Daskalakis |
| author_facet | Charalampos Voros Despoina Mavrogianni Aspasia Minaoglou Alexios Karakasis Anthi-Maria Papahliou Vasileios Topalis Antonia Varthaliti Raphail Mantzioros Panagiota Kondili Menelaos Darlas Regina Sotiropoulou Diamantis Athanasiou Dimitrios Loutradis Georgios Daskalakis |
| author_sort | Charalampos Voros |
| collection | DOAJ |
| description | Obesity reduces nitric oxide (NO) production due to endothelial nitric oxide synthase (eNOS) dysfunction, resulting in oxidative stress, mitochondrial dysfunction, and chronic inflammation. These factors have a negative impact on reproductive health, including oocyte quality, endometrial receptivity, and embryo implantation. When oxidative stress affects eNOS function, the nitrate–nitrite–nitric oxide (NO<sub>3</sub>-NO<sub>2</sub>-NO) pathway provides an alternate route for NO production. Bariatric surgery has been found to restore NO production, reduce oxidative stress, and improve fertility in morbidly obese women. This review investigates the molecular mechanisms by which bariatric surgery affects eNOS activity, the NO<sub>3</sub>-NO<sub>2</sub>-NO pathway, and oxidative stress reduction, with an emphasis on intracellular activities including mitochondrial biogenesis and NO production. A systematic review employing PRISMA criteria included articles published between 2000 and 2024 from PubMed, Scopus, and Embase that investigated NO<sub>3</sub>-NO<sub>2</sub> pathways, oxidative stress markers, hormonal alterations, and reproductive outcomes in morbidly obese women following bariatric surgery. After evaluating 1542 studies, 11 were selected for the final analysis. Results showed a 45% increase in NO<sub>3</sub>-NO<sub>2</sub> levels (<i>p</i> < 0.001), a 35% reduction in oxidative stress indicators (<i>p</i> < 0.01), a 60% increase in pregnancy rates, and a 50% increase in spontaneous ovulation rates following surgery. These benefits were connected to improved mitochondrial function and endometrial receptivity as a result of reduced oxidative stress and inflammation. The NO<sub>3</sub>-NO<sub>2</sub>-NO route is critical in compensating for lower NO generation under oxidative stress and hypoxia, and bariatric surgery significantly improves this pathway to optimize blood flow, mitochondrial function, and reproductive results. |
| format | Article |
| id | doaj-art-25cf7c07798b41c39755769093cd50c9 |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-25cf7c07798b41c39755769093cd50c92025-01-24T13:23:53ZengMDPI AGBiomedicines2227-90592024-12-011316410.3390/biomedicines13010064Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic ReviewCharalampos Voros0Despoina Mavrogianni1Aspasia Minaoglou2Alexios Karakasis3Anthi-Maria Papahliou4Vasileios Topalis5Antonia Varthaliti6Raphail Mantzioros7Panagiota Kondili8Menelaos Darlas9Regina Sotiropoulou10Diamantis Athanasiou11Dimitrios Loutradis12Georgios Daskalakis131st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, GreeceDepartment of Internal Medicine, Hospital of Thun, 3600 Thun, Switzerland1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, GreeceIVF Athens Reproduction Center V. Athanasiou, 15123 Maroussi, GreeceFertility Institute-Assisted Reproduction Unit, Paster 15, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, GreeceObesity reduces nitric oxide (NO) production due to endothelial nitric oxide synthase (eNOS) dysfunction, resulting in oxidative stress, mitochondrial dysfunction, and chronic inflammation. These factors have a negative impact on reproductive health, including oocyte quality, endometrial receptivity, and embryo implantation. When oxidative stress affects eNOS function, the nitrate–nitrite–nitric oxide (NO<sub>3</sub>-NO<sub>2</sub>-NO) pathway provides an alternate route for NO production. Bariatric surgery has been found to restore NO production, reduce oxidative stress, and improve fertility in morbidly obese women. This review investigates the molecular mechanisms by which bariatric surgery affects eNOS activity, the NO<sub>3</sub>-NO<sub>2</sub>-NO pathway, and oxidative stress reduction, with an emphasis on intracellular activities including mitochondrial biogenesis and NO production. A systematic review employing PRISMA criteria included articles published between 2000 and 2024 from PubMed, Scopus, and Embase that investigated NO<sub>3</sub>-NO<sub>2</sub> pathways, oxidative stress markers, hormonal alterations, and reproductive outcomes in morbidly obese women following bariatric surgery. After evaluating 1542 studies, 11 were selected for the final analysis. Results showed a 45% increase in NO<sub>3</sub>-NO<sub>2</sub> levels (<i>p</i> < 0.001), a 35% reduction in oxidative stress indicators (<i>p</i> < 0.01), a 60% increase in pregnancy rates, and a 50% increase in spontaneous ovulation rates following surgery. These benefits were connected to improved mitochondrial function and endometrial receptivity as a result of reduced oxidative stress and inflammation. The NO<sub>3</sub>-NO<sub>2</sub>-NO route is critical in compensating for lower NO generation under oxidative stress and hypoxia, and bariatric surgery significantly improves this pathway to optimize blood flow, mitochondrial function, and reproductive results.https://www.mdpi.com/2227-9059/13/1/64infertilitybariatricsobesitynitric oxide (NO)oxidative stressendothelial nitric oxide synthase (eNOS) |
| spellingShingle | Charalampos Voros Despoina Mavrogianni Aspasia Minaoglou Alexios Karakasis Anthi-Maria Papahliou Vasileios Topalis Antonia Varthaliti Raphail Mantzioros Panagiota Kondili Menelaos Darlas Regina Sotiropoulou Diamantis Athanasiou Dimitrios Loutradis Georgios Daskalakis Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review Biomedicines infertility bariatrics obesity nitric oxide (NO) oxidative stress endothelial nitric oxide synthase (eNOS) |
| title | Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review |
| title_full | Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review |
| title_fullStr | Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review |
| title_full_unstemmed | Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review |
| title_short | Nitrate–Nitrite–Nitric Oxide Pathway, Oxidative Stress, and Fertility Outcomes in Morbidly Obese Women Following Bariatric Surgery: A Systematic Review |
| title_sort | nitrate nitrite nitric oxide pathway oxidative stress and fertility outcomes in morbidly obese women following bariatric surgery a systematic review |
| topic | infertility bariatrics obesity nitric oxide (NO) oxidative stress endothelial nitric oxide synthase (eNOS) |
| url | https://www.mdpi.com/2227-9059/13/1/64 |
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