Polycystic Ovary Syndrome

2014 ◽  
Author(s):  
Lubna Pal ◽  
Kimberly Keefe
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Depressive Disorders ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Oral Glucose ◽  
Ultrasound Images ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
Increased Risk

Polycystic ovary syndrome (PCOS) is a commonly encountered endocrine disorder that is characterized by a combination of hyperandrogenism, menstrual disturbances (predominantly oligomenorrhea), and a classic sonographic polycystic ovarian morphology. Additional sequelae associated with PCOS include infertility and enhanced risk of developing type 2 diabetes mellitus and cardiovascular disease. The prevalence of depressive disorders and obstructive sleep apnea is disproportionately higher in women with PCOS, and this population is at increased risk for endometrial hyperplasia and endometrial cancer. This chapter reviews the definition, epidemiology, etiology and genetics, pathophysiology, diagnosis (including history, physical examination, and laboratory tests), differential diagnosis, and management of PCOS. Syndromes and diseases associated with PCOS are discussed. Tables describe the three approaches to PCOS, conditions mimicking PCOS, diagnosis of the metabolic syndrome in women using the National Cholesterol Education Program criteria, workup for PCOS, comprehensive care for PCOS patients, and the multistep approach to treatment of PCOS-related anovulatory infertility. Figures include transvaginal ultrasound images of a normal ovary and a multifollicular ovary in a woman with PCOS, the Ferriman-Gallwey scoring system for quantifying hirsutism, acanthosis nigrans on the neck of a woman with PCOS and insulin resistance, the relationship between body mass index and basal luteinizing hormone levels, oral glucose challenge results in nonobese women with PCOS, and an algorithm for treatment decision making. This review contains 6 highly rendered figures, 6 tables, and 120 references.

scholarly journals The Polycystic Ovary Syndrome and the Metabolic Syndrome: A Possible Chronobiotic-Cytoprotective Adjuvant Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Eduardo Spinedi ◽  
Daniel P. Cardinali
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
Polycystic Ovary Syndrome ◽  
White Adipose Tissue ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
The Impact

Polycystic ovary syndrome is a highly frequent reproductive-endocrine disorder affecting up to 8–10% of women worldwide at reproductive age. Although its etiology is not fully understood, evidence suggests that insulin resistance, with or without compensatory hyperinsulinemia, and hyperandrogenism are very common features of the polycystic ovary syndrome phenotype. Dysfunctional white adipose tissue has been identified as a major contributing factor for insulin resistance in polycystic ovary syndrome. Environmental (e.g., chronodisruption) and genetic/epigenetic factors may also play relevant roles in syndrome development. Overweight and/or obesity are very common in women with polycystic ovary syndrome, thus suggesting that some polycystic ovary syndrome and metabolic syndrome female phenotypes share common characteristics. Sleep disturbances have been reported to double in women with PCOS and obstructive sleep apnea is a common feature in polycystic ovary syndrome patients. Maturation of the luteinizing hormone-releasing hormone secretion pattern in girls in puberty is closely related to changes in the sleep-wake cycle and could have relevance in the pathogenesis of polycystic ovary syndrome. This review article focuses on two main issues in the polycystic ovary syndrome-metabolic syndrome phenotype development: (a) the impact of androgen excess on white adipose tissue function and (b) the possible efficacy of adjuvant melatonin therapy to improve the chronobiologic profile in polycystic ovary syndrome-metabolic syndrome individuals. Genetic variants in melatonin receptor have been linked to increased risk of developing polycystic ovary syndrome, to impairments in insulin secretion, and to increased fasting glucose levels. Melatonin therapy may protect against several metabolic syndrome comorbidities in polycystic ovary syndrome and could be applied from the initial phases of patients’ treatment.

scholarly journals Vitamin D receptor and binding protein polymorphisms in women with polycystic ovary syndrome: a case control study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Do Kyeong Song ◽  
Hyejin Lee ◽  
Young Sun Hong ◽  
Yeon-Ah Sung
Keyword(s):  
Vitamin D ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Vitamin D Receptor ◽  
Polycystic Ovary ◽  
Binding Protein ◽  
Oral Glucose ◽  
Ovary Syndrome ◽  
Vdr Gene ◽  
Increased Risk

Abstract Background Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, characterized by hyperandrogenism, oligomenorrhea, polycystic ovary morphology, and insulin resistance. Vitamin D deficiency and vitamin D receptor (VDR)/vitamin D binding protein (VDBP) gene variants could play an important role in susceptibility to PCOS and contribute to metabolic disturbances and menstrual dysfunction. We aimed to investigate the associations of VDR gene and VDBP gene polymorphisms with PCOS susceptibility and to elucidate the impacts of these polymorphisms on the hormonal and metabolic parameters of PCOS. Methods We recruited 432 women with PCOS and 927 controls. Polymorphisms in the VDR gene (VDR Fok-I, Cdx2, Apa-I, and Bsm-I) and VDBP gene (VDBP rs4588, rs7041, and rs22822679) were genotyped. A 75-g oral glucose tolerance test was performed. Results The distributions of genotypes and allele frequencies in VDR and VDBP genes did not differ between PCOS and control. In women with PCOS, compared to the VDR Fok-I GG genotype, the VDR Fok-I AG genotype was significantly associated with increased levels of total testosterone (β = 5.537, P = 0.005). Compared to the VDR Cdx2 AC genotype, the VDR Cdx2 CC genotype was associated with increased levels of fasting insulin and HOMA-IR in women with PCOS, however, the associations were not statistically significant. Conclusions This finding indicates that genetic variations in VDR and VDBP were not associated with increased risk for PCOS. In contrast, the VDR Fok-I polymorphism was associated with testosterone level and the Cdx2 polymorphism with insulin sensitivity in PCOS. However, the Cdx2 polymorphism was not significantly associated with increased insulin and insulin sensitivity in women with PCOS after multiple linear regression.

scholarly journals Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population-based cohort study

2019 ◽  
Vol 180 (4) ◽  
pp. 265-272 ◽  
Author(s):  
Balachandran Kumarendran ◽  
Dana Sumilo ◽  
Michael W O’Reilly ◽  
Konstantinos A Toulis ◽  
Krishna M Gokhale ◽  
...  
Keyword(s):  
Cohort Study ◽  
Polycystic Ovary Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Polycystic Ovary ◽  
Population Based ◽  
Sleep Apnoea ◽  
Ovary Syndrome ◽  
Obstructive Sleep ◽  
Increased Risk

Objective Obesity is very common in patients with obstructive sleep apnoea (OSA) and polycystic ovary syndrome (PCOS). Longitudinal studies assessing OSA risk in PCOS and examining the role of obesity are lacking. Our objective was to assess the risk of OSA in women with vs without PCOS and to examine the role of obesity in the observed findings. Design Population-based retrospective cohort study utilizing The Health Improvement Network (THIN), UK. Methods 76 978 women with PCOS and 143 077 age-, BMI- and location-matched women without PCOS between January 2000 and May 2017 were identified. Hazard ratio (HR) for OSA among women with and without PCOS were calculated after controlling for confounding variables using multivariate Cox models. Results Median patient age was 30 (IQR: 25–35) years; median follow-up was 3.5 (IQR: 1.4–7.1) years. We found 298 OSA cases in PCOS women vs 222 in controls, with incidence rates for OSA of 8.1 and 3.3 per 10 000 person years, respectively. Women with PCOS were at increased risk of developing OSA (adjusted HR = 2.26, 95% CI: 1.89–2.69, P < 0.001), with similar HRs for normal weight, overweight and obese PCOS women. Conclusions Women with PCOS are at increased risk of developing OSA compared to control women irrespective of obesity. Considering the significant metabolic morbidity associated with OSA, clinicians should have a low threshold to test for OSA in women with PCOS. Whether OSA treatment has an impact on PCOS symptoms and outcomes needs to be examined.

scholarly journals Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome

2009 ◽  
Vol 161 (4) ◽  
pp. 575-582 ◽  
Author(s):  
E Wehr ◽  
S Pilz ◽  
N Schweighofer ◽  
A Giuliani ◽  
D Kopera ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Oral Glucose ◽  
Model Assessment ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Glucose Response ◽  
The Metabolic Syndrome

ObjectivesWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances, in particular from insulin resistance. Accumulating evidence suggests that vitamin D deficiency may contribute to the development of the metabolic syndrome (MS). Hence, the aim of our study was to investigate the association of 25(OH)D levels and the components of the MS in PCOS women.Methods25(OH)D levels were measured by means of ELISA in 206 women affected by PCOS. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.ResultsThe prevalence of insufficient 25(OH)D levels (<30 ng/ml) was 72.8% in women with PCOS. PCOS women with the MS had lower 25(OH)D levels than PCOS women without these features (17.3 vs 25.8 ng/ml respectively; P<0.05). In multivariate regression analysis including 25(OH)D, season, body mass index (BMI), and age, 25(OH)D and BMI were independent predictors of homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI; P<0.05 for all). In binary logistic regression analyses, 25(OH)D (OR 0.86, P=0.019) and BMI (OR 1.28, P<0.001) were independent predictors of the MS in PCOS women. We found significantly negative correlations of 25(OH)D levels with BMI, waist circumference, waist-to-hip ratio, systolic and diastolic blood pressure, fasting and stimulated glucose, area under the glucose response curve, fasting insulin, HOMA-IR, HOMA-β, triglycerides, and quotient total cholesterol/high-density lipoprotein (HDL) and positive correlations of 25(OH)D levels with QUICKI and HDL (P<0.05 for all).ConclusionWe demonstrate that low 25(OH)D levels are associated with features of the MS in PCOS women. Large intervention trials are warranted to evaluate the effect of vitamin D supplementation on metabolic disturbances in PCOS women.

Increased risk of depressive disorders in women with polycystic ovary syndrome

2007 ◽  
Vol 87 (6) ◽  
pp. 1369-1376 ◽  
Author(s):  
Elizabeth Hollinrake ◽  
Alison Abreu ◽  
Michelle Maifeld ◽  
Bradley J. Van Voorhis ◽  
Anuja Dokras
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Depressive Disorders ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Increased Risk

scholarly journals Metabolic syndrome and polycystic ovary syndrome... and vice versa

2009 ◽  
Vol 53 (2) ◽  
pp. 227-237 ◽  
Author(s):  
Eleni Kandaraki ◽  
Charikleia Christakou ◽  
Evanthia Diamanti-Kandarakis
Keyword(s):  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Clinical Observations ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
The Relationship ◽  
Endocrine Features

The metabolic syndrome (MS) and the polycystic ovary syndrome (PCOS) appear to be interrelated, although they are distinct entities. Women with PCOS appear to be commonly affected by MS, while women with MS may display reproductive or endocrine features of PCOS. These clinical observations appear to be only partly attributable to the association of both syndromes with obesity and imply a reciprocal pathophysiologic relationship between PCOS and MS with potentially significant clinical sequelae. Adult women with MS are at a greater risk of developing cardiovascular disease; women with PCOS also appear to carry such an increased risk in their postmenopausal life. Conversely, women with MS may experience reproductive disturbances, reminiscent of PCOS, more commonly than their counterparts from the general population. This review presented the current epidemiology of MS in adults and adolescents with PCOS, as well as the limited amount of data on the prevalence of features of PCOS among women with MS or MS features. We also discuss the potential pathophysiologic mechanisms underlying the relationship between these interweaving, but distinct, syndromes.

scholarly journals Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

2006 ◽  
Vol 155 (2) ◽  
pp. 337-345 ◽  
Author(s):  
Dorte Glintborg ◽  
Marianne Andersen ◽  
Claus Hagen ◽  
Jan Frystyk ◽  
Veronica Hulstrøm ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Body Composition ◽  
Polycystic Ovary Syndrome ◽  
Fat Mass ◽  
Polycystic Ovary ◽  
Geometric Mean ◽  
Whole Body ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Increased Risk

Objective: Polycystic ovary syndrome (PCOS) patients are abdominally obese and are at increased risk of developing the metabolic syndrome. Low adiponectin and ghrelin levels in PCOS patients could be caused by insulin resistance as well as high testosterone levels. Design: Adiponectin and ghrelin levels were evaluated in 51 hirsute PCOS patients referred to the outpatient clinic of an academic, tertiary care medical centre and in 63 weight-matched female controls. Relationships between adiponectin, ghrelin, leptin, body composition, testosterone and insulin were examined. Methods: Measurements of body composition including waist-hip-ratio (WHR), body mass index (BMI) and whole body dual-energy X-ray absorptiometry scan measures of body fat mass. Measurements of fasting levels of adiponectin, ghrelin, leptin, androgen status, oestradiol, lipid variables and insulin during follicular phase. Results: Adiponectin levels were significantly decreased in obese PCOS patients compared with weight-matched controls (geometric mean (−2 to 2 s.d.) 5.3 (2.5–11.1) vs 7.3 (3.0–17.4) mg/l, P<0.05). Mean ghrelin was significantly lower in hirsute PCOS patients than in controls (0.6 (0.3 to 1.4) vs 0.8 (0.4 to 1.7) μg/l, P<0.001) and this remained significant after subdividing subjects according to waist circumference and BMI. During multiple regression analysis, testosterone correlated positively with adiponectin and negatively with ghrelin independent of BMI, WHR and total fat mass. Conclusion: Obese hirsute PCOS patients demonstrated significantly lower adiponectin levels than weight-matched controls suggesting a very high risk for the metabolic syndrome. Furthermore, ghrelin levels were decreased in hirsute PCOS patients and showed a significant, negative correlation with testosterone independent of body composition.

scholarly journals Glycemic Status in Patients with Polycystic Ovary Syndrome and Dyslipidemia Before and After Three Months Treatment with Atorvastatin

2013 ◽  
Vol 20 (2) ◽  
pp. 123-126
Author(s):  
Ana Raluca Memu ◽  
Ioana Zosin ◽  
Gabriela Negrişanu
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Glucose Tolerance ◽  
Carbohydrate Metabolism ◽  
Polycystic Ovary ◽  
Normal Weight ◽  
Total Testosterone ◽  
Oral Glucose ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Before And After

AbstractBackground and Aims. Polycystic ovary syndrome (PCOS) is associated with disturbances in carbohydrate and lipid metabolism. Statins appear to have beneficial effects in PCOS, although some meta-analyzes showed an increased risk of developing diabetes mellitus. The aim of this study was to evaluate the effect of treatment with 20 mg of atorvastatin daily for three months on glucose tolerance in a group of 8 normal weight patients with PCOS and dyslipidemia. Material andMethods. We evaluated 8 patients aged between 29 and 40 years, with normal weight, diagnosed with PCOS and dyslipidemia. The carbohydrate metabolism was assessed by oral glucose tolerance test (OGTT) before and after 3 months of therapy with 20 mg of atorvastatin daily. Results. Treatment with atorvastatin resulted in a statistically significant reduction in total cholesterol (p = 0.001), LDL cholesterol (p = 0.001), triglycerides (p = 0.01) and statistically significant increase in HDL cholesterol (p = 0.003). Fasting plasma glucose (p = 0.59) and the 2-hour OGTT glycemia (p = 0.54) were not significantly changed. Total testosterone decreased significantly ( p= 0.04). Conclusions. At baseline, all patients included in our study showed unaffected carbohydrate metabolism. Even after 3 months of therapy with atorvastatin 20 mg daily no changes in glucose homeostasis were noted.

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

2005 ◽  
Vol 90 (4) ◽  
pp. 1929-1935 ◽  
Author(s):  
Teimuraz Apridonidze ◽  
Paulina A. Essah ◽  
Maria J. Iuorno ◽  
John E. Nestler
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
General Population ◽  
Polycystic Ovary Syndrome ◽  
Acanthosis Nigricans ◽  
Polycystic Ovary ◽  
Total Testosterone ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Increased Risk

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.

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