Cardiometabolic Risks in Polycystic Ovary Syndrome: Non-Traditional Risk Factors and the Impact of Obesity

Chiu, Wei-Ling; Boyle, Jacqueline; Vincent, Amanda; Teede, Helena; Moran, Lisa J.

doi:10.1159/000455233

Cited by 27 publications

(22 citation statements)

References 166 publications

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“…Hyperinsulinemia and insulin resistance are common in patients with metabolic disorders, including type 2 diabetes mellitus (T2DM) [1], metabolic syndrome (MetS) [2], polycystic ovary syndrome (PCOS) [3], and cardiovascular disease (CVD) [4]. Poor glycemic control would result in long-term adverse outcomes in subjects with T2DM, such as micro-and macrovascular complications, including cardiovascular events, renal failure, blindness, and peripheral neuropathy [5].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2018

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Although several studies have evaluated the effect of folate supplementation on diabetes biomarkers among patients with metabolic diseases, findings are inconsistent. This review of randomized controlled trials (RCTs) was performed to summarize the evidence on the effects of folate supplementation on diabetes biomarkers among patients with metabolic diseases. Randomized-controlled trials (RCTs) published in PubMed, EMBASE, Web of Science and Cochrane Library databases up to 1 September 2017 were searched. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Heterogeneity was measured with a Q-test and with I statistics. Data were pooled by using the fix or random-effect model based on the heterogeneity test results and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). A total of sixteen randomized controlled trials involving 763 participants were included in the final analysis. The current meta-analysis showed folate supplementation among patients with metabolic diseases significantly decreased insulin (SMD -1.28; 95% CI, -1.99, -0.56) and homeostasis model assessment of insulin resistance (HOMA-IR) (SMD -1.28; 95% CI, -1.99, -0.56). However, folate supplementation did not affect fasting plasma glucose (FPG) (SMD -0.30; 95% CI, -0.63, 0.02) and hemoglobin A1C (HbA1c) (SMD -0.29; 95% CI, -0.61, 0.03). The results of this meta-analysis study demonstrated that folate supplementation may result in significant decreases in insulin levels and HOMA-IR score, but does not affect FPG and HbA1c levels among patients with metabolic diseases.

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Section: Introductionmentioning

confidence: 99%

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2018

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“…The inclusion criteria for this study were [1] 20 to 35 years of age and [2] Han ethnicity. The exclusion criteria were [1] hyperprolactinemia, hypo-or hyperthyroidism, or abnormal liver, kidney, or heart function; [2] gastrointestinal disease, active infections, thyroid dysfunction, hyperprolactinemia, hypertension, or diabetes mellitus; [3] oral contraceptives, glucocorticoids, antiandrogen agents, ovulation induction agents, diabetic drugs, or other steroid agents taken within 3 months; or [4] antibiotic therapy received within at least 3 months before the study.…”

Section: Study Participantsmentioning

confidence: 99%

“…Clinically, PCOS is characterized by hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology (2). The pathologic state of PCOS is a life-long condition and leads to an increased risk of hyperlipidemia, cardiovascular disease, hypertension, the metabolic syndrome, and endometrial cancer (3)(4)(5). Polycystic ovary syndrome affects not only women's physical health but also their mental health (6).…”

mentioning

confidence: 99%

Metagenomic analysis identified microbiome alterations and pathological association between intestinal microbiota and polycystic ovary syndrome

Chu

Han

et al. 2020

Fertility and Sterility

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Objective: To identify different microbial species in women with polycystic ovary syndrome (PCOS) and reveal a possible relationship between gut dysbiosis and pathological changes. Design: Cross-sectional study. Setting: Academic institution. Patient(s): Reproductive-aged women with PCOS (n ¼ 14) and controls (n ¼ 14) from the Centre for Reproductive Medicine. Intervention(s): Shotgun metagenomic sequencing on fecal samples from patients, and clinical parameters (including body mass index, endocrine hormone levels, and glycemia level) gathered for correlation analysis. Main Outcome Measure(s): Identification of different gut microbial strains and relativity between microbiota and clinical parameters. Result(s): We found several microbial strains were statistically significantly more abundant in the PCOS group, including Parabacteroides merdae, Bacteroides fragilis, and strains of Escherichia and Shigella, whereas Faecalibacterium prausnitzii was enriched in the control group. Metagenomic species (MGS) analysis revealed that the microbes of the PCOS group were negatively correlated with those of the control group. Of note, we observed a positive correlation between MGS relevant to PCOS and endocrine disorders, including body mass index and elevated levels of serum testosterone, luteinizing hormone, and antim€ ullerian hormone. Functional alterations, reflected by Kyoto Encyclopedia of Genes and Genomes orthologues, could imply potential mechanisms of microbial involvement in the developmental progress of PCOS. Conclusion(s): Our findings suggest an intimate association and potential mechanisms linking microbial dysbiosis and the pathophysiologic changes of PCOS. We address the importance of monitoring and modulating microbial composition and functional shifts in future clinical practice. (Fertil Steril Ò 2020;113:1286-98. Ó2020 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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“…While PCOS is influenced by race, BMI and age, with symptoms becoming less thunderous with increasing age and most of them disappearing after the onset of menopause, cardio-metabolic disorders can, however, continue to pose a threat to the patients’ health ( 94 , 96 – 99 ). If earlier studies regarding the higher risk of CVD in women with PCOS could not establish its absoluteness ( 100 ), more recent data confirm that the metabolic dysfunction typical of women with PCOS leads to a definite increase in CVD events ( 101 – 103 ).…”

Section: Cardiovascular Disease In Pcosmentioning

confidence: 99%

Impact of Increased Oxidative Stress on Cardiovascular Diseases in Women With Polycystic Ovary Syndrome

et al. 2021

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Polycystic ovary syndrome (PCOS) is a complex disorder that affects around 5% to 10% of women of childbearing age worldwide, making it the most common source of anovulatory infertility. PCOS is defined by increased levels of androgens, abnormal ovulation, irregular menstrual cycles, and polycystic ovarian morphology in one or both ovaries. Women suffering from this condition have also been shown to frequently associate certain cardiovascular comorbidities, including obesity, hypertension, atherosclerosis, and vascular disease. These factors gradually lead to endothelial dysfunction and coronary artery calcification, thus posing an increased risk for adverse cardiac events. Traditional markers such as C-reactive protein (CRP) and homocysteine, along with more novel ones, specifically microRNAs (miRNAs), can accurately signal the risk of cardiovascular disease (CVD) in PCOS women. Furthermore, studies have also reported that increased oxidative stress (OS) coupled with poor antioxidant status significantly add to the increased cardiovascular risk among these patients. OS additionally contributes to the modified ovarian steroidogenesis, consequently leading to hyperandrogenism and infertility. The present review is therefore aimed not only at bringing together the most significant information regarding the role of oxidative stress in promoting CVD among PCOS patients, but also at highlighting the need for determining the efficiency of antioxidant therapy in these patients.

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Cardiometabolic Risks in Polycystic Ovary Syndrome: Non-Traditional Risk Factors and the Impact of Obesity

Cited by 27 publications

References 166 publications

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Metagenomic analysis identified microbiome alterations and pathological association between intestinal microbiota and polycystic ovary syndrome

Impact of Increased Oxidative Stress on Cardiovascular Diseases in Women With Polycystic Ovary Syndrome

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