scholarly journals Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246862
Author(s):  
Roshan Dadachanji ◽  
Anushree Patil ◽  
Beena Joshi ◽  
Srabani Mukherjee
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Contributing Factors ◽  
Ovary Syndrome ◽  
Total Study Population ◽  
Study Population ◽  
Post Hoc ◽  
The Impact ◽  
Rotterdam Criteria

Polycystic ovary syndrome is a complex endocrinopathy with heterogeneous presentation and multifactorial etiology. We have undertaken this case-control study to compare metabolic and endocrine characteristics in different phenotypic subgroups of women with PCOS and the impact of obesity on them. Women with PCOS (n = 489) were classified into 4 phenotypes according to Rotterdam criteria. Comparisons of clinical, biochemical and hormonal parameters were performed across all phenotypic groups of PCOS and with controls (n = 270) by Welch’s ANOVA with subsequent Games-Howell post-hoc test. We found maximum prevalence of normoandrogenic phenotype D, which is milder form of PCOS in terms of insulin resistance, gonadotropin levels and dyslipidemia, followed by phenotype A, in our total study population. After classification of the study group into lean and obese groups, only few insulin and lipid-related traits showed marked differences between phenotypes. Further, we noted that obese women showed adverse metabolic but not androgenic traits compared to lean counterparts in the same phenotype. Metabolic syndrome frequency is increased in hyperandrogenic phenotypes with HDL-C and waist circumference being most predominant contributing factors in total, lean and obese groups. We demonstrate that in our study population there is greater occurrence of phenotype D of PCOS. Our study highlights the importance of clinicians concurrently employing Rotterdam criteria along with obesity status for ascertaining accurate PCOS status and formulating suitable therapeutic intervention.

Impact of Metformin on IVF Outcomes in Overweight and Obese Women With Polycystic Ovary Syndrome: A Randomized Double-Blind Controlled Trial

2018 ◽  
Vol 26 (10) ◽  
pp. 1336-1342 ◽  
Author(s):  
Osama S. Abdalmageed ◽  
Tarek A. Farghaly ◽  
Ahmed A. Abdelaleem ◽  
Ahmed E. Abdelmagied ◽  
Mohammed K. Ali ◽  
...  
Keyword(s):  
Placebo Group ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Controlled Study ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Double Blind ◽  
Ivf Outcomes ◽  
Metformin Group ◽  
The Impact

Objectives: To evaluate the impact of metformin on in vitro fertilization (IVF) outcomes in overweight and obese women with polycystic ovary syndrome (PCOS). Methods: This was a randomized double-blind placebo-controlled study ( ClinicalTrials.gov : NCT 02910817) carried out in a University IVF Center. The study included 102 overweight and obese women (body mass index [BMI] >24 kg/m2) with PCOS who underwent their first fresh autologous IVF-embryo transfer cycle and agreed to participate in the study. The study participants were randomized into 2 groups: metformin group received metformin (1000 mg per day) at the start of controlled ovarian stimulation (COH) until the day of the pregnancy check, and placebo group received placebo tablets in the same duration. The primary outcome measure was the total number of retrieved oocytes. Results: Both groups were homogenous in baseline demographic characteristics. Metformin group versus the placebo group demonstrated decrease in the mean number of the retrieved oocytes (9.06 ± 4.23 vs 16.86 ± 8.3, P < .01) and similar live birth rate (LBR; 25.5% vs 17.6%, P = .34). The number of fertilized oocytes was lower in the metformin group (5.65 ± 2.66 vs 9 ± 4.55, P < .01). However, the fertilization rate was similar in both groups (62.3% vs 53.4%, P = .10). There was no difference in the implantation rate (15.7% vs 11.8%, P = .32), multiple pregnancy rate (13.4% vs 3.9%, P = .08), or miscarriage rate (23.5% vs 35.7%, P = .46). No cases of ovarian hyperstimulation syndrome (OHSS) were observed in both groups. Conclusion: Short-term administration of metformin to overweight or obese women with PCOS undergoing IVF decreased number of the retrieved oocytes but did not improve the LBR. Synopsis Metformin use could decrease the number of retrieved oocytes in overweight and obese women with polycystic ovary syndrome undergoing IVF.

scholarly journals “The whole package deal”: experiences of overweight/obese women living with polycystic ovary syndrome

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Carolyn Ee ◽  
Caroline Smith ◽  
Lisa Moran ◽  
Freya MacMillan ◽  
Michael Costello ◽  
...  
Keyword(s):  
Social Media ◽  
Polycystic Ovary Syndrome ◽  
Focus Groups ◽  
Polycystic Ovary ◽  
Delayed Diagnosis ◽  
Significant Degree ◽  
Obese Women ◽  
Structured Interviews ◽  
Ovary Syndrome ◽  
The Impact

Abstract Background Polycystic Ovary Syndrome (PCOS) is a common female reproductive disorder with multiple manifestations. There are relatively few qualitative studies exploring the nature of living with PCOS despite its high prevalence. Qualitative research can enhance clinical practice via the provision of patient insights into the experience of living with their condition. Methods We conducted two focus groups and three semi-structured interviews of Australian overweight/obese women with PCOS aged 18–46 years between March and April 2017 who were recruited through social media advertising. Interviews and focus groups were audio recorded and transcribed verbatim. Thematic analysis was applied to the data, using the method of constant comparison. Results Ten women contributed data from two focus groups and two semi-structured interviews. Five themes emerged from the data: complexity of the condition with its multiple manifestations, difficulties with delayed diagnosis and lack of information provided after diagnosis, negative experiences on social media and online forums and the need for support, frustration over lack of a “cure”; and the impact of symptoms and concern about long-term sequelae. Conclusions Living with PCOS appears to generate a significant degree of anxiety about the future, dissatisfaction with current treatment models, and loss of feminine identity. Gaps in timely diagnosis, information and support provision need to be addressed. This includes supporting weight management as a fundamental concern for women with PCOS.

scholarly journals Impact of weight loss on plasma ghrelin level, clinical, and metabolic features of obese women with or without polycystic ovary syndrome

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Nearmeen M. Rashad ◽  
Yasser S. Saraya ◽  
Samir A. Afifi ◽  
Ayman E. Ali ◽  
Radwa M. Al-sayed
Keyword(s):  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ghrelin Level ◽  
Enzyme Linked Immunosorbent Assay ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Plasma Ghrelin Level ◽  
Co Morbidity ◽  
The Impact

Abstract Background Polycystic ovary syndrome (PCOS) is a common reproductive endocrine co-morbidity of obesity. Ghrelin is a peptide which regulates food intake and body weight. The aim of this study was to measure ghrelin levels in obesity and PCOS and to evaluate the impact of weight loss on plasma ghrelin level, metabolic, and phenotypic features of PCOS. This prospective comparative study enrolled obese women without PCOS (N = 60) and obese PCOS women (n = 50) and 85 control groups. Body compositions including fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DEXA). Plasma ghrelin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Results Our results revealed that plasma ghrelin levels were lower in PCOS patients compared to obese (9.49 ± 5.59 ng/ml) and controls (48.21 ± 21.09 ng/ml). Moreover, it was negatively correlated to anthropometric measures, glycemic, lipid profile, and the phenotype characteristics of PCOS. Interestingly, after 12 weeks of following the Mediterranean diet (MD)-based weight loss program, ghrelin levels were increased in both obese groups. Conclusion Successful weight loss leads to increase ghrelin levels in both obese and PCOS groups.

scholarly journals Metabolomic biomarkers of polycystic ovary syndrome related-obesity: a review of the literature

2020 ◽  
Vol 28 (3) ◽  
pp. 241-255
Author(s):  
Camelia Larisa Vonica ◽  
Anca Daniela Farcas ◽  
Gabriela Roman ◽  
Andrada Alina Muresan ◽  
Adriana Fodor ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Amino Acid ◽  
Polycystic Ovary Syndrome ◽  
Predictive Accuracy ◽  
Polycystic Ovary ◽  
Visceral Obesity ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Eligibility Criteria ◽  
The Impact

AbstractBackground and objectives: Polycystic ovary syndrome (PCOS) displays a phenotype-dependent cardio-metabolic risk. By performing a systematic search of the literature, we aimed to summarize metabolomic signatures associated with obesity in PCOS women.Data sources and study eligibility criteria: We conducted a comprehensive search including: Embase, PubMed, and Web of Science until 31st of May 2019. We used the terms: metabolomics and polycystic ovary syndrome. We excluded the following papers: animal studies, studies that included only lean PCOS women, reviews, meta-analyses, results of interventional studies, those that did not apply metabolomic techniques.Results: The lipid signature in obese women with PCOS showed increased levels of free fatty acids (carnitine, adipic acid, linoleic acid, oleic acid) and lower levels of lysophosphatidylcholines and glycerolphosphocholine compared with non-obese PCOS women. Regarding carbohydrate metabolism, a decrease in citric and lactic acid levels characterized obese PCOS women. Decreased lactic acid in obese PCOS women suggests augmented insulin stimulated glucose muscle use in lean, but not in obese women. Considering amino acid metabolomic markers, valine, glycine, serine, threonine, isoleucine and lysine were higher in obese PCOS women. Patients with visceral obesity presented a diminished uptake of essential amino acids, BCAA, leucine and serine in the skeletal muscle. α-ketoglutarate was significantly higher in obese women with PCOS in comparison with lean women with PCOS, distinguishing these 2 subgroups of PCOS with high ‘predictive accuracy’.Limitations: Overall, a small number of studies have focused on the impact of obesity on the metabolic fingerprints of PCOS women. There is need for properly controlled, high-quality studies.Conclusions: There is compelling evidence of significant alterations in carbohydrate, lipid, and amino acid metabolism in women with PCOS and obesity. Metabolomics may identify new metabolic pathways involved in PCOS and improve our understanding of the complex relation between PCOS and obesity in order to personalize PCOS therapy.

The impact of hyperandrogenism in female obesity and cardiometabolic diseases associated with polycystic ovary syndrome

2013 ◽  
Vol 15 (3) ◽  
Author(s):  
Thomas M. Barber ◽  
Petra Vojtechova ◽  
Stephen Franks
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Cardiometabolic Risk ◽  
Polycystic Ovary ◽  
Fat Distribution ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Per Se ◽  
The Impact

AbstractPolycystic ovary syndrome (PCOS) is a common condition characterized by reproductive and hyperandrogenic features and is often associated with obesity and metabolic dysfunction. Overall, women with PCOS have a substantially greater prevalence of metabolic syndrome than women from the general population. Furthermore, PCOS per se (independent of its frequent association with obesity) often confers cardiometabolic risk (including insulin resistance), and its concurrence with obesity often represents a metabolic “double-whammy” from the adverse effects of PCOS and obesity. The introduction of the Rotterdam diagnostic criteria for PCOS in 2003 has broadened the scope of this condition. The Rotterdam diagnostic criteria have also introduced two new phenotypic subgroups (including normoandrogenemic women with PCOS) that have provided novel insights into a potential role for hyperandrogenism in the development of adverse cardiometabolic risk in women with PCOS. Based on evidence from cross-sectional and interventional studies, hyperandrogenism, obesity, and cardiometabolic risk in women appear to be linked through complex and multidirectional pathways. Furthermore, data from obese women without a formal diagnosis of PCOS also suggest that these interrelationships often exist in female obesity per se (in milder forms than occurs in PCOS). Data from female-to-male transsexuals are particularly informative because these show direct effects of hyperandrogenism (induced through exogenous use of androgenic therapies) on fat distribution and cardiometabolic risk in women. A challenge for the future will be to disentangle and improve our understanding of this complex pathogenic web, thereby facilitating novel and targeted therapies for the hyperandrogenic and adverse cardiometabolic manifestations of PCOS.

scholarly journals Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome

2014 ◽  
Vol 171 (3) ◽  
pp. 301-309 ◽  
Author(s):  
Sarantis Livadas ◽  
Anastasios Kollias ◽  
Dimitrios Panidis ◽  
Evanthia Diamanti-Kandarakis
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Early Years ◽  
Model Assessment ◽  
Metabolic Abnormalities ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
The Impact

BackgroundPolycystic ovary syndrome (PCOS) represents a moving spectrum of hormonal to metabolic abnormalities, as women with the syndrome are aging. Hormonal abnormalities, anovulation, and hyperandrogenic signs were predominant during the early years of PCOS and fade away with the years. Metabolic abnormalities and insulin resistance (IR) remain throughout the PCOS life cycle; however, it is unclear as to how they change, as women with the syndrome are aging.ObjectiveTo evaluate the changes in IR and its associations with clinical, biochemical, hormonal, and ultrasound findings in a large cohort of women with PCOS and controls, as they are aging.DesignA cross-sectional study was carried out to evaluate the diverse impacts of aging on IR.SettingAn outpatient clinic was chosen for the study.ParticipantsA total of 1345 women with PCOS (Rotterdam criteria) and 302 controls of Caucasian origin and Greek ethnicity comprised the study group.Main outcome and measuresThe impact of age on IR, as calculated using homeostasis model assessment of IR (HOMA-IR) index, and several PCOS characteristics were evaluated.ResultsIn PCOS, age (−0.045±0.008) was negatively, and BMI positively (0.18±0.007) associated with HOMA-IR (R2=0.36). When data were stratified with regard to the BMI status, a negative association of age with HOMA-IR was found in lean, normal, and overweight patients (r: −0.266, −0.233, −0.192, P<0.001), which was neutralized in obese patients (r: −0.009, P: NS). Free androgen index and BMI were positively associated with HOMA-IR in all age quartiles. When mean HOMA-IR values were plotted according to BMI subgroups at different age quartiles, a significant gradual decrease in HOMA-IR was observed in normal (P<0.001) and overweight (P: 0.004), but not obese, women (P: 0.202) across age quartiles.ConclusionsAging increases IR in obese but not in lean and overweight women with PCOS. As BMI and androgens are positively associated with HOMA-IR and androgens decline through time, it appears that if women with PCOS do not become obese they may exhibit a better metabolic profile during their reproductive years.

scholarly journals Heterogeneity in the responsiveness to long-term lifestyle intervention and predictability in obese women with polycystic ovary syndrome

2011 ◽  
Vol 164 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Renato Pasquali ◽  
Alessandra Gambineri ◽  
Carla Cavazza ◽  
Daniela Ibarra Gasparini ◽  
Walter Ciampaglia ◽  
...  
Keyword(s):  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Lifestyle Intervention ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Partial Group ◽  
The Impact

BackgroundTreatment of obesity improves all features of the polycystic ovary syndrome (PCOS). There is, however, a heterogeneous response to weight loss, and predictive factors are unknown.ObjectiveThis follow-up study aimed to investigate obese women with PCOS treated with a long-term lifestyle program to evaluate responsiveness and predictability.MethodsOne hundred PCOS women meeting the criteria for selection were invited to participate and 65 of them agreed. Lifestyle intervention had consisted of a 1200–1400 kcal/day diet for 6 months, followed by mild calorie restriction and physical activity. The protocol, which was similar at baseline and follow-up, included anthropometry, clinical evaluation, pelvic ultrasound, and laboratory investigations. The mean follow-up period was 20.4±12.5 months.ResultsAfter the follow-up period, women were reclassified into three groups according to the persistence (group 1, 15.4%), partial (group 2, 47.7%), or complete (group 3, 36.9%) disappearance of the categorical features of PCOS (hyperandrogenism, menses, and ovulatory dysfunctions). Duration of the follow-up and extent of weight loss were similar among the three groups, as were fasting and glucose-stimulated insulin and indices of insulin resistance. Baseline waist circumference, waist to hip ratio (WHR), and androstenedione blood levels were negatively correlated with a better outcome in the univariate analysis. However, only basal androstenedione values persisted to a highly significant extent (P<0.001) in the multivariate analysis.ConclusionsResponsiveness to weight loss in overweight/obese PCOS women varies considerably and more than one third of women may achieve full recovery. These findings add new perspectives to the impact of obesity on the pathophysiology of PCOS.

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