Characterization of polycystic ovary syndrome among Flo app users around the world

Abstract Background Polycystic ovary syndrome (PCOS) is a complex and multi-faceted endocrine disorder that affects 5–20% of women. Literature is limited regarding potentially differing PCOS phenotypes among women around the world. Objective To use Flo app technology to understand the multifaceted characteristics of PCOS across several countries and identify contributing risk factors to the development of this condition. Study design Flo is a widely used female health and wellbeing app with period tracking functionality that provides a globally representative and medically unbiased perspective on PCOS symptomatology. A chatbot dialog on PCOS was subsequently administered on the Flo application (app) to users from 142 countries (with at least 100 respondents) who have the app running in English during September–October 2019. Results For analyses, we selected the five countries with the greatest number of respondents: US (n = 243,238), UK (n = 68,325), India (n = 40,092), Philippines (n = 35,131), and Australia (n = 29,926). Bloating was the most frequently reported symptom among PCOS-positive women and appeared to be the main predictor of PCOS in our model (odds ratio 3·76 [95% CI 3·60–3·94]; p < 0·0001). Additional top predictors of PCOS are high blood cholesterol and glucose levels. As BMI increased, the percentage of women who reported a physician-confirmed PCOS diagnosis also increased. However, women in India did not follow this trend. Conclusion Our findings are based on the largest known PCOS dataset and indicate that symptoms are more complex than previously understood. The most frequently reported symptoms (bloating, facial hirsutism, irregular cycles, hyperpigmentation, and baldness) are broader than those included in the Rotterdam criteria. Future work should reevaluate and refine the criteria utilized in PCOS diagnosis.

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Characterization of Polycystic Ovary Syndrome Among Flo App Users Around the World

10.21203/rs.3.rs-131934/v1 ◽

2020 ◽

Author(s):

Tarun Jain ◽

Olivia Negris ◽

Dannielle Brown ◽

Isabel Galic ◽

Rodion Salimgariev ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Blood Cholesterol ◽

Ovary Syndrome ◽

Glucose Levels ◽

Health And Wellbeing ◽

The World ◽

Women Literature ◽

Future Work ◽

Women In India

Abstract Background: Polycystic ovary syndrome (PCOS) is a complex and multi-faceted endocrine disorder that affects 5-20% of women. Literature is limited regarding potentially differing PCOS phenotypes among women around the world. Therefore, we used Flo app technology to understand the multifaceted characteristics of PCOS across several countries and identify contributing risk factors to the development of this condition.Methods: Flo is a widely used female health and wellbeing app with period tracking functionality that provides a globally representative and medically unbiased perspective on PCOS symptomatology. A chatbot dialog on PCOS was subsequently administered on the Flo application (app) to users from 142 countries (with at least 100 respondents) who have the app running in English during September-October 2019.Results: For analyses, we selected the five countries with the greatest number of respondents: US (n=243,238), UK (n=68,325), India (n=40,092), Philippines (n=35,131), and Australia (n=29,926). Bloating was the most frequently reported symptom among PCOS-positive women and appeared to be the main predictor of PCOS in our model (odds ratio 3·76 [95% CI 3·60-3·94]; p<0·0001). Additional top predictors of PCOS are high blood cholesterol and glucose levels. As BMI increased, the percentage of women who reported a physician-confirmed PCOS diagnosis also increased. However, women in India did not follow this trend.Conclusions: Our findings are based on the largest known PCOS dataset and indicate that symptoms are more complex than previously understood. The most frequently reported symptoms (bloating, facial hirsutism, irregular cycles, hyperpigmentation, and baldness) are broader than those included in the Rotterdam criteria. Future work should reevaluate and refine the criteria utilized in PCOS diagnosis.

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Use of fasting blood glucose levels to detect the presence of glucose intolerance in polycystic ovary syndrome (PCOS)

Fertility and Sterility ◽

10.1016/j.fertnstert.2010.07.277 ◽

2010 ◽

Vol 94 (4) ◽

pp. S71

Author(s):

J. Mehta ◽

A. Ketefian ◽

M. Pall ◽

U. Ezeh ◽

R. Azziz

Keyword(s):

Blood Glucose ◽

Polycystic Ovary Syndrome ◽

Glucose Intolerance ◽

Polycystic Ovary ◽

Fasting Blood Glucose ◽

Ovary Syndrome ◽

Glucose Levels ◽

Blood Glucose Levels

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Relationship of Insulin Receptor Substrate-1 and -2 Genotypes to Phenotypic Features of Polycystic Ovary Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2002-020216 ◽

2002 ◽

Vol 87 (9) ◽

pp. 4297-4300 ◽

Cited By ~ 72

Author(s):

David A. Ehrmann ◽

Xu Tang ◽

Issei Yoshiuchi ◽

Nancy J. Cox ◽

Graeme I. Bell

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

African American ◽

African Americans ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Insulin Receptor Substrate ◽

Ovary Syndrome ◽

Glucose Levels

Insulin resistance is a key component in the pathogenesis of polycystic ovary syndrome (PCOS) and type 2 diabetes. Polymorphisms in the genes encoding the insulin receptor substrate (IRS) proteins, IRS-1 (Gly972Arg) and IRS-2 (Gly1057Asp), influence susceptibility to type 2 diabetes. This study was undertaken to assess the influence of these polymorphisms on insulin resistance, glucose tolerance, and androgen levels in nondiabetic PCOS women. We studied 227 PCOS subjects including 126 and 48 nondiabetic white and African-American subjects, respectively. The IRS-1 Gly972Arg allele frequencies were identical in whites and African-Americans [0.95 (Gly) and 0.05 (Arg)]. The IRS-2 Gly1057Asp allele frequencies were 0.85 (Gly) and 0.15 (Asp) in African-Americans and 0.59 (Gly) and 0.41 (Asp) in whites. There was no association of IRS-1 genotype with any clinical or hormonal measure in nondiabetic white or African-American PCOS subjects. However, nondiabetic subjects with the IRS-2 Gly/Gly genotype had significantly higher 2-h oral glucose tolerance test glucose levels compared with those with Gly/Asp and Asp/Asp genotypes in whites or Gly/Asp genotype in African-Americans (there were no Asp/Asp subjects in our modest size African-American sample). These results suggest that the IRS-2 Gly1057Asp polymorphism influences blood glucose levels in nondiabetic white and African-American women with PCOS. Thus, individuals with the common IRS-2 Gly/Gly genotype may be at increased risk of developing type 2 diabetes.

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Bifidobacterium is enriched in gut microbiome of Kashmiri women with polycystic ovary syndrome

10.1101/718510 ◽

2019 ◽

Author(s):

Saqib Hassan ◽

Marika A Kaakinen ◽

Harmen Draisma ◽

Mohd Ashraf Ganie ◽

Aafia Rashid ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Relative Abundance ◽

Gut Microbiome ◽

Multiple Testing ◽

Polycystic Ovary ◽

Fasting Blood Glucose ◽

Reproductive Age ◽

Ovary Syndrome ◽

Microbiome Composition ◽

Glucose Levels

AbstractPolycystic ovary syndrome (PCOS) is a common endocrine condition in women of reproductive age understudied in non-European populations. In India, PCOS affects the life of up to 19.4 million women of age 14-25 years. Gut microbiome composition might contribute to PCOS susceptibility. We profiled the microbiome in DNA isolated from faecal samples by 16S rRNA sequencing in 19/20 women with/without PCOS from Kashmir, India. We assigned genera to sequenced species with an average 121k reads depth and included bacteria detected in at least 1/3 of the subjects or with average relative abundance ≥0.1%. We compared the relative abundances of 40/58 operational taxonomic units in family/genus level between cases and controls, and in relation to 33 hormonal and metabolic factors, by multivariate analyses adjusted for confounders, and corrected for multiple testing. Seven genera were significantly enriched in PCOS cases: Sarcina, Alkalibacterium and Megasphaera, and previously reported for PCOS Bifidobacterium, Collinsella, Paraprevotella and Lactobacillus. We identified significantly increased relative abundance of Bifidobacteriaceae (median 6.07% vs. 2.77%) and Aerococcaceae (0.03% vs. 0.004%), whereas we detected lower relative abundance Peptococcaceae (0.16% vs. 0.25%) in PCOS cases. For the first time, we identified a significant direct association between butyrate producing Eubacterium and follicle-stimulating hormone levels. We observed increased relative abundance of Collinsella and Paraprevotella with higher fasting blood glucose levels, and Paraprevotella and Alkalibacterium with larger hip and waist circumference, and weight. We show a relationship between gut microbiome composition and PCOS linking it to specific reproductive health metabolic and hormonal predictors in Indian women.

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The Treatment with Complementary and Alternative Traditional Chinese Medicine for Menstrual Disorders with Polycystic Ovary Syndrome

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6678398 ◽

2021 ◽

Vol 2021 ◽

pp. 1-19

Author(s):

Yuehui Zhang ◽

Xiaozhu Guo ◽

Shuting Ma ◽

Haoyue Ma ◽

Hang Li ◽

...

Keyword(s):

Chinese Medicine ◽

Polycystic Ovary Syndrome ◽

Alternative Medicine ◽

Traditional Medicine ◽

Polycystic Ovary ◽

World Health ◽

Menstrual Disorders ◽

Ovary Syndrome ◽

The World ◽

Complementary And Alternative

Polycystic ovary syndrome (PCOS) is a frequent gynecological female endocrinopathy, characterized by chronic anovulation, hyperandrogenism, and insulin resistance (IR). Menstrual disorders are one of the main clinical manifestations of PCOS. Other symptoms include hirsutism and/acne. At present, the treatment of PCOS with irregular menstruation is mainly based on oral contraceptives, but there are some side effects and adverse reactions. In recent years, more and more attention has been paid to the complementary and alternative medicine (CAM), which has been widely used in clinical practice. Modern Western medicine is called “conventional medicine” or “orthodox medicine,” and the complementary and alternative medicine is called “unconventional medicine” or “unorthodox medicine.” CAM includes traditional medicine and folk therapy around the world. Around 65–80% of world health management business is classified into traditional medicine by the World Health Organization, which is used as alternative medicine in Western countries. In our country, Chinese medicine, acupuncture, and other therapies are commonly used due to their significant efficacy and higher safety. Therefore, this review aims to summarize and evaluate the mechanisms and the effect of current complementary replacement therapy in the treatment of menstrual disorders caused by PCOS, so as to provide guidance for the following basic and clinical research.

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The influence of obesity, androgenism and fertility status on the psychosocial health and wellbeing of women with polycystic ovary syndrome.

Fertility and Sterility ◽

10.1016/s0015-0282(01)02105-7 ◽

2001 ◽

Vol 76 (3) ◽

pp. S29 ◽

Cited By ~ 1

Author(s):

J.G McCook

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Psychosocial Health ◽

Ovary Syndrome ◽

Health And Wellbeing ◽

Fertility Status

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Association between the serum estrone-to-estradiol ratio and parameters related to glucose metabolism and insulin resistance in women with polycystic ovary syndrome

Clinical and Experimental Reproductive Medicine ◽

10.5653/cerm.2021.04553 ◽

2021 ◽

Vol 48 (4) ◽

pp. 374-379

Author(s):

Nayoung Kim ◽

Sungwook Chun

Keyword(s):

Insulin Resistance ◽

Glucose Metabolism ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Postprandial Glucose ◽

Serum Glucose ◽

Clinical Variable ◽

Fasting Insulin ◽

Ovary Syndrome ◽

Glucose Levels

Objective: We aimed to evaluate associations between the ratio of serum estrone (E1) to estradiol (E2) and parameters related to serum glucose metabolism and insulin resistance in women with polycystic ovary syndrome (PCOS). Methods: In total, 133 women between the ages of 18 and 33 diagnosed with PCOS were enrolled in this study. All participants with PCOS underwent blood tests to determine hormonal and biochemical metabolic parameters and a standard 2-hour 75-g oral glucose tolerance test. They were divided into two groups according to the serum E1-to-E2 ratio: group 1 (E1/E2 ratio <2.0) and group 2 (E1/E2 ratio ≥2.0). Results: In the comparative analysis, the waist-to-hip ratio (WHR) was the only clinical variable that was significantly different between the two groups. Patients with a higher E1/E2 ratio showed higher fasting insulin levels, homeostasis model for insulin resistance, and postprandial glucose levels at 2 hours (PPG2). In a correlation analysis, only PPG2 was significantly related to the serum E1/E2 ratio. However, after controlling for the confounding effects of body mass index (BMI) and WHR, fasting glucose was also significantly correlated with the serum E1/E2 ratio. Conclusion: Women with PCOS with a higher serum E1/E2 ratio were found to be more likely to show higher fasting insulin and postprandial glucose levels. Significant correlations were found between the serum E1/E2 ratio and both fasting and postprandial serum glucose levels after adjusting for BMI and WHR in women with PCOS.

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The prevalence of polycystic ovary syndrome in adolescents: A systematic review and meta-analysis

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v17i8.4818 ◽

2019 ◽

Cited By ~ 2

Author(s):

Marzieh Saei Ghare Naz ◽

Fahimeh Ramezani Tehrani ◽

Hamid Alavi Majd ◽

Fazlollah Ahmadi ◽

Giti Ozgoli ◽

...

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovarian Syndrome ◽

Polycystic Ovary ◽

Meta Analysis ◽

Qualitative Assessment ◽

Ovary Syndrome ◽

The World ◽

Ovarian Syndrome ◽

Different Parts

Background: Polycystic ovarian syndrome is an endocrine disorder with many complications. This syndrome is a growing concern among adolescents around the world, with varying reports of its prevalence in different parts of the world. Objective: This study aimed to determine the prevalence of polycystic ovary syndrome in adolescents by a systematic review and meta-analysis. Materials and Methods: In this study, a search for published articles with an English language limitation and without a time limit was done in different databases (Scopus, PubMed, and Web of Science, Emabse and Cochrane) in January 2019. The 12 studies that met the criteria for entering a qualitative assessment scale of 5 and higher were subjected to systematic review and meta-analysis. Egger and Begg’s tests were used to check the publication bias. Data were analyzed with STATA software, version 11.1. Results: Twelve studies were included for meta-analysis. The total number of participants in the study was 149,477. The average quality score of all studies was 8.67 (range: 5–10). The prevalence of polycystic ovarian syndrome in adolescents based on the Rotterdam criteria was 11.04% (95% CI: 6.84–16.09%), based on the National Institute of Health criteria, it was 3.39% (95% CI: 0.28–9.54%), and based on Androgen Excess and Polycystic Ovary Syndrome Society, it was 8.03% (95% CI: 6.24–10.01%). Conclusion: The result of this study showed that there is a variation in the prevalence of PCOS in adolescents based on different criteria; we suggest more community-based studies among adolescences in different parts of the world.

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Effect of Whey Protein on Insulin Sensitivity and Glucose Metabolism in Women with and Without Polycystic Ovary Syndrome (PCOS)

Current Developments in Nutrition ◽

10.1093/cdn/nzaa049_053 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 660-660

Author(s):

Lily Sebastian ◽

Shenavia Balcom-Luker ◽

Kayleigh Kaiser ◽

Irene Low ◽

Emily Zumbro ◽

...

Keyword(s):

Gene Expression ◽

Insulin Sensitivity ◽

Glucose Metabolism ◽

Polycystic Ovary Syndrome ◽

Whey Protein ◽

Fasting Glucose ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Glucose Levels ◽

Before And After

Abstract Objectives This study focuses on the metabolic effects of whey protein isolate (WPI) supplementation glucose and insulin metabolism in women with and without Polycystic Ovary Syndrome (PCOS). Affecting up to 20% of post-puberty aged females around the world, PCOS is identified by three main symptoms: increased levels of androgens, irregular cycles, and the presence of ovarian cysts. Women with PCOS tend to be insulin resistant and have faulty insulin signaling. We hypothesize that because WPI has been seen to increase insulin sensitivity in type 2 diabetic populations, it will attenuate blood glucose and insulin levels and in women with PCOS. Methods 15 women with PCOS and 14 women without PCOS (CON) underwent four 150-min oral glucose tolerance tests (OGTT): (i) baseline (no protein), (ii) Day 20 (iii) and Day 40 of WPI preload. Daily, participants consumed 35 g WPI 30 min before glucose load on test days. Plasma levels of glucose and insulin were assessed using a Biolis 24i chemistry analyzer. Additionally, variations in gene expression levels of glucose metabolism regulators, e.g., GLUT-4, were analyzed in 3T3-L1 cells under normal and PCOS-simulated conditions using qt-PCR before and after WPI supplementation. Results At baseline, both PCOS and CON women had similar fasting glucose levels (107.2 ± 19.54 and 101.14 ± 11.03 respectively). After 20 days of WPI supplementation, fasting glucose increased (103.75 ± 0.5 and 117.25 ± 9.60) but was attenuated by Day 40 (91.5 ± 0.71 and 94.5 ± 0.71). Furthermore, the baseline levels of GLUT-4 expression between women with PCOS (2.698 ± 0.145) and CON (2.188, ± 0.062) were not statistically different. Levels of gene expression post-supplementation with WPI are in the process of being measured. And lastly, plasma insulin levels are in the progress of being measured for both populations before and after supplementation. Conclusions Preliminary analysis indicates that upon WPI supplementation, both groups glucose levels increased after 20 days, but was then attenuated by Day 40, with a slightly greater effect in the PCOS group compared to CON. Overall, our data indicates that WPI may be a potential dietary approach to better managing the symptoms of PCOS. Funding Sources Glanbia Nutritionals, Human Nutrition Research Funds, and Texas Woman's University.

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