Case 11.1

Polycystic Ovary ◽

Reproductive Age ◽

Polycystic Ovaries ◽

Endocrine Disorder ◽

Secondary Amenorrhea ◽

28-year-old woman with secondary amenorrhea and hirsutism Axial fat-suppressed 2D SSFP images (Figure 11.1.1) demonstrate multiple follicles arranged in the periphery of the ovaries bilaterally. Polycystic ovary syndrome PCOS is the most common endocrine disorder in women of reproductive age, affecting between 6% and 15%, depending on the criteria used for diagnosis. It typically presents with anovulatory or oligo-ovulatory menstrual cycles leading to oligomenorrhea, polycystic ovaries, and clinical and biochemical hyperandrogenism. PCOS is also associated with increased risk of obesity, insulin resistance, diabetes mellitus, metabolic syndrome, and infertility....

A study of metabolic syndrome in women with polycystic ovary syndrome at tertiary care center

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212187 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2427

Author(s):

Chelsae Kuntal ◽

Jyotsna Vyas ◽

Asha Chaudhary ◽

Sunita Hemani ◽

Lata Rajoria

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Urban Areas ◽

Polycystic Ovary ◽

Tertiary Care ◽

Reproductive Age ◽

Ovary Syndrome ◽

Hormonal Profile ◽

Background: Polycystic ovary syndrome is a common endocrinopathy in women of reproductive age with prevalence of 6-10% which is characterized by hyper androgenic features and chronic oligo – anovulation and polycystic ovary morphology. Most women with polycystic ovary syndrome are also characterized by metabolic abnormalities like insulin resistance, hyperinsulinemia, dyslipidemia and abdominal obesity, these forming risk factors for metabolic syndrome. The objective of the study was to compare the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients with and without metabolic syndrome.Methods: A comparative cross- sectional study was undertaken on 79 PCOS women diagnosed with PCOS according to Rotterdam criteria, in which the clinical data and hormonal profile of two groups of polycystic ovary syndrome women with and without metabolic syndrome was compared.Results: The mean age of 79 patients in this study group with and without metabolic syndrome was 26.17±3.18 and 25.57±3.41 years respectively. There were more patients from urban areas as compared to rural areas and maximum patients. Significantly higher number of PCOS women with metabolic syndrome had hirsutism and acanthosis nigricans than those without metabolic syndrome. Mean value of Waist circumference, systolic BP pressure, diastolic BP, S. Triglyceride and fasting glucose were higher and HDL levels were lower in women with metabolic syndrome than those without metabolic syndrome. Fasting insulin and HOMA-IR values were significantly higher in PCOS women with metabolic syndrome in comparison to those without metabolic syndrome.Conclusion: PCOS is not only is the most frequent cause of anovulation, but it is also associated with characteristic metabolic disturbances that may have important implications for the long term health. Metabolic syndrome is a cluster of endocrine disturbances, including insulin resistance, dyslipidemia, obesity, and hypertension. It is associated with a two-fold increased risk of cardiovascular disease and a five-fold increased risk of type 2 diabetes. This illustrates the importance of early detection of insulin resistance and metabolic syndrome with subsequent application of preventive measures in women with polycystic ovary syndrome.

Adiponectin and Polycystic Ovary Syndrome

Biological Research For Nursing ◽

10.1177/1099800410371824 ◽

2010 ◽

Vol 12 (1) ◽

pp. 62-72 ◽

Cited By ~ 15

Author(s):

Susan W. Groth

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Clinical Practice ◽

Disease Risk ◽

Polycystic Ovary ◽

Reproductive Age ◽

Ovary Syndrome ◽

Introduction. Polycystic ovary syndrome (PCOS) has a prevalence of 5—8% in women of reproductive age. Women with PCOS have an increased risk of metabolic syndrome and associated comorbidities. Adiponectin is a circulating protein produced by adipocytes. Circulating levels of adiponectin are inversely related to adipocyte mass. Low levels occur with insulin resistance, type 2 diabetes, metabolic syndrome, and obesity-related cardiovascular disease. This article reviews the literature on the link between adiponectin and PCOS and the potential use of adiponectin as a biomarker for PCOS. Method. Data-based studies on adiponectin and PCOS and adiponectin measurement were identified through the Medline (1950—2009) and ISI Web of Knowledge (1973—2009) databases. Results. Fifteen studies related to adiponectin and PCOS met inclusion criteria and were included in this review. These studies present evidence that adiponectin is linked to insulin resistance, insulin sensitivity, body mass index (BMI), and adiposity. In women with PCOS, lower levels, as opposed to higher levels, of adiponectin occur in the absence of adiposity. Conclusion. The relationships between adiponectin and insulin resistance and sensitivity, metabolic syndrome, and BMI in women with PCOS suggest that adiponectin potentially could serve as a marker for disease risk and provide opportunity for earlier intervention if knowledge is successfully translated from laboratory to clinical practice. However, further study of the relationship between adiponectin and PCOS is required before there can be direct application to clinical practice.

Polycystic ovary syndrome: reproductive aspects

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.0851 ◽

2011 ◽

pp. 1229-1234

Author(s):

Sophie Catteau-Jonard ◽

Cécile Gallo ◽

Didier Didier

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Polycystic Ovary ◽

Reproductive Age ◽

Therapeutic Approaches ◽

Women Of Reproductive Age ◽

Ovary Syndrome ◽

Common Cause ◽

The Metabolic Syndrome

The polycystic ovary syndrome (PCOS) is the most common cause of anovulation and hyperandrogenism in women, affecting between 5 and 10% of women of reproductive age worldwide (1). Although this difficult topic in endocrine gynaecology is under extensive research, controversies still remain about the pathophysiology, diagnosis, and therapy of PCOS. The PCOS phenotype can be structured in three components: manifestations of anovulation, hyperandrogenism, and the metabolic syndrome (of which hyperinsulinaemia secondary to insulin resistance is the central abnormality). The latter two are addressed in other chapters. Our knowledge about the mechanism of disturbed folliculogenesis in PCOS that is responsible for its reproductive aspects has much increased these last years, thus opening new avenues for the diagnostic and therapeutic approaches.

Mechanisms Involved in Intrauterine Growth Restriction in Patients With Polycystic Ovary Syndrome: Primary and Secondary Prevention of Metabolic Syndrome and Cancer Risk in the Adult Life of Offspring

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1508 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A741-A742

Author(s):

Domingo Mugnolo ◽

Erica Giraldo ◽

Maria Perez Lana ◽

Susana Beatriz Campeni

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Fetal Programming ◽

Intrauterine Growth Restriction ◽

Polycystic Ovary ◽

Adult Life ◽

Ovary Syndrome ◽

Intrauterine Growth ◽

Abstract Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders that affects between 5- 10% of women of reproductive age. It is currently considered a complex and multifactorial disease with metabolic, cardiovascular implications and represents per se an increased cancer risk. PATIENTS with PCOS routinely have menstrual disorders, hyperandrogenism, infertility and reproductive complications such as recurrent abortions, gestational diabetes, intrauterine growth restriction, pregnancy induced hypertension that give rise to underweight newborns and condition metabolic diseases to adult life and increased risk of cancer, especially breast and endometrial cancer. Insulin resistance and hyperandrogenism are the most important etiopathogenic factors in PCOS. On the other hand, subjects exposed to an adverse microenvironment in the intrauterine stage develop compensating responses to survive, a process called fetal programming. Prenatal exposure to androgens and/or insulin resistance may act as fetal programming factors and cause restriction of intrauterine growth, obesity and insulin resistance in offspring. Newborn may have an increased risk of metabolic syndrome, increased incidence of hypertensive, type 2 diabetes, heart disease and cerebrovascular disease. Prevention of these complications will be achieved if women with Polycystic Ovary Syndrome are treated appropriately throughout their lives, but especially before and during their pregnancy. Only in this way can the risk of them be reduced, representing a better quality and greater life expectancy.

Endometrium and polycystic ovary syndrome

Journal of obstetrics and women s diseases ◽

10.17816/jowd67460-66 ◽

2018 ◽

Vol 67 (4) ◽

pp. 60-66

Author(s):

Pavel P Yakovlev ◽

Igor Yu Kogan

Keyword(s):

Endometrial Cancer ◽

Pregnancy Outcomes ◽

Polycystic Ovary ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Ovary Syndrome ◽

Endocrine Disorder ◽

Increased Risk ◽

Adverse Pregnancy

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Patients with PCOS present with several endometrial abnormalities possibly explaining some of the adverse endometrium-related outcomes in these women. PCOS is inconsistently associated adverse pregnancy outcomes and an increased risk of endometrial cancer. The purpose of this review is to systematize the available data on endometrial dysfunction associated with PCOS. (For citation: Yakovlev PP, Kogan IYu. Endometrium and polycystic ovary syndrome. Journal of Obstetrics and Women’s Diseases. 2018;67(4):60-66. doi: 10.17816/JOWD67460-66).

COMPLICATIONS OF PREGNANCY IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Fetal and Maternal Medicine Review ◽

10.1017/s0965539511000088 ◽

2011 ◽

Vol 22 (3) ◽

pp. 188-206

Author(s):

MALLIKA AZIZIA ◽

PAUL HARDIMAN

Keyword(s):

Diabetes Mellitus ◽

Metabolic Syndrome ◽

Polycystic Ovarian Syndrome ◽

Polycystic Ovary ◽

Reproductive Function ◽

Reproductive Age ◽

Polycystic Ovaries ◽

Women Of Reproductive Age ◽

Ovary Syndrome ◽

Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting around 5–8% of women of reproductive age. It has a variable clinical spectrum including hyperandrogenism, menstrual abnormalities, polycystic ovaries and metabolic features like diabetes mellitus, obesity and dyslipidaemia. The manifestation of PCOS and its impact especially on reproductive function and pregnancy are profoundly affected by associated features of obesity/raised body mass index and metabolic syndrome.

Specificities of the treatment for polycystic ovary syndrome and metabolic syndrome

Russian Journal of Woman and Child Health ◽

10.32364/2618-8430-2020-3-4-254-259 ◽

2020 ◽

Vol 3 (4) ◽

pp. 254-259

Author(s):

I.Yu. Il’ina ◽

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Metabolic Disorders ◽

Negative Impact ◽

Polycystic Ovary ◽

Cardiovascular Complications ◽

Polycystic Ovaries ◽

Ovary Syndrome ◽

Psychic Disorders

This paper discusses polycystic ovary syndrome (PCOS), a common endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Insulin resistance which is considered the major causative factor for both PCOS and metabolic syndrome is emphasized. The early diagnosis of metabolic disorders which increase the risk of cardiovascular complications and the complications of pregnancy (including gestational diabetes and hypertension which may result in preeclampsia and placental abruption) is of particular importance. The presence of metabolic syndrome in PCOS is associated with poor prognosis in terms of fertility and has a negative impact on the outcomes of in vitro fertilization in infertile women with PCOS. When describing treatment approaches, the role of metformin, inositol, folates, vitamin D, and statins in treating metabolic disorders in PCOS and metabolic syndrome, reducing the risks of cardiovascular complications, and realizing fertile function is highlighted. The course of PCOS is complicated by psychic disorders (i.e., depression, anxiety, bipolar disorder, or eating disorders) which are common in these women and should be considered when prescribing medications. KEYWORDS: polycystic ovary syndrome, insulin resistance, infertility, metabolic syndrome, cardiovascular complications, inositol, folates. FOR CITATION: Il’ina I.Yu. Specificities of the treatment for polycystic ovary syndrome and metabolic syndrome. Russian Journal of Woman and Child Health. 2020;3(4):254–259. DOI: 10.32364/2618-8430-2020-3-4-254-259.

Polycystic Ovary Syndrome, Obesity and Reproductive Implications

Women s Health ◽

10.2217/whe.09.39 ◽

2009 ◽

Vol 5 (5) ◽

pp. 529-542 ◽

Cited By ~ 24

Author(s):

Angelica Lindén Hirschberg

Keyword(s):

Polycystic Ovary ◽

Reproductive Function ◽

Negative Influence ◽

Reproductive Age ◽

Polycystic Ovaries ◽

Ovary Syndrome ◽

Increased Risk ◽

Important Challenge ◽

Pharmacologic Treatments

Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility, affecting 5–10% of women of reproductive age. The syndrome is characterized by anovulation, hyperandrogenism and polycystic ovaries. Furthermore, PCOS is associated with insulin resistance and obesity, which is present in approximately 50% of women with PCOS. Reproductive function in women with PCOS is strongly dependent on bodyweight and metabolic status. Obesity is associated with an increased risk of infertility and may also have a negative influence on pregnancy outcome. Considering the worldwide epidemic of obesity, clinical problems relating to PCOS may worsen and increase in frequency. Lifestyle interventions resulting in weight loss comprise the most successful strategy to improve symptoms of PCOS. However, many patients fail to lose weight or may quickly regain weight. It is an important challenge to develop effective lifestyle programs and adjuvant pharmacologic treatments in order to improve reproductive and metabolic health among women with PCOS.

Prevalence and Characteristics of the Metabolic Syndrome in Women with Polycystic Ovary Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2004-1045 ◽

2005 ◽

Vol 90 (4) ◽

pp. 1929-1935 ◽

Cited By ~ 536

Author(s):

Teimuraz Apridonidze ◽

Paulina A. Essah ◽

Maria J. Iuorno ◽

John E. Nestler

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

General Population ◽

Acanthosis Nigricans ◽

Polycystic Ovary ◽

Total Testosterone ◽

Ovary Syndrome ◽

The Metabolic Syndrome ◽

Abstract The polycystic ovary syndrome (PCOS) is characterized by insulin resistance with compensatory hyperinsulinemia. Insulin resistance also plays a role in the metabolic syndrome (MBS). We hypothesized that the MBS is prevalent in PCOS and that women with both conditions would present with more hyperandrogenism and menstrual cycle irregularity than women with PCOS only. We conducted a retrospective chart review of all women with PCOS seen over a 3-yr period at an endocrinology clinic. Of the 161 PCOS cases reviewed, 106 met the inclusion criteria. The women were divided into two groups: 1) women with PCOS and the MBS (n = 46); and 2) women with PCOS lacking the MBS (n = 60). Prevalence of the MBS was 43%, nearly 2-fold higher than that reported for age-matched women in the general population. Women with PCOS had persistently higher prevalence rates of the MBS than women in the general population, regardless of matched age and body mass index ranges. Acanthosis nigricans was more frequent in women with PCOS and the MBS. Women with PCOS and the MBS had significantly higher levels of serum free testosterone (P = 0.002) and lower levels of serum SHBG (P = 0.001) than women with PCOS without the MBS. No differences in total testosterone were observed between the groups. We conclude that the MBS and its components are common in women with PCOS, placing them at increased risk for cardiovascular disease. Women with PCOS and the MBS differ from their counterparts lacking the MBS in terms of increased hyperandrogenemia, lower serum SHBG, and higher prevalence of acanthosis nigricans, all features that may reflect more severe insulin resistance.

Gestational Diabetes Mellitus in Women with Polycystic Ovary Syndrome Undergoing Assisted Reproduction

MedPharmRes ◽

10.32895/ump.mpr.2.4.26 ◽

2019 ◽

Vol 2 (4) ◽

pp. 26-31

Author(s):

Chau Tran ◽

Lan Vuong

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Polycystic Ovary ◽

First Trimester ◽

Reproductive Age ◽

Ovary Syndrome ◽

Logistic Regression Models ◽

Polycystic ovary syndrome (PCOS) is a common endocrine metabolic disorder in women of reproductive age. PCOS is often associated with insulin resistance and carries an increased risk of gestational diabetes mellitus (GDM). The aim of this study was to evaluate the risk of GDM in women with a history of PCOS. This was a retrospective cohort study conducted at a single center in Vietnam between January 2014 and December 2017. A total of 400 women who conceived through assisted reproductive technology (ART) were included, 200 who had been diagnosed with PCOS, and 200 without a PCOS diagnosis as controls. Multivariable logistic regression models were used to examine the association between risk of GDM and PCOS after adjusting for confounders. GDM was present in 37% of those with PCOS, compared with 26.5% in those without PCOS (RR 1.4, 95% CI 1.04–1.87, p=0.02). The prevalence of GDM did not differ significantly between PCOS phenotype groups (p=0.28). Women with PCOS undergoing ART had a higher risk of GDM after adjusting for differences in age, pre-pregnancy body mass index, type of infertility, ART indications, and type of ART (adjusted OR 2.04, 95% CI 1.06–3.92). First-trimester fasting plasma glucose (FPG) was also an independent predictor for GDM (adjusted OR 1.54, 95% CI 1.01–2.34). This study suggests that PCOS and first-trimester FPG are independent risk factors for the development of GDM.