Changes in Metabolic Profile in the Women with a History of PCOS—A Long-Term Follow-Up Study

Abstract

Data concerning metabolic consequences in women with polycystic ovary syndrome (PCOS) are delivered mainly by cross-sectional studies. In this research, we re-examined 31 Caucasian PCOS women after a median period of 120.9 months to evaluate the changes in metabolic syndrome components. Clinical examination, oral glucose tolerance test with estimations of glucose and insulin, lipids, sex hormone-binding globulin (SHBG) and sex hormones assessments were performed on two occasions. Additionally, the euglycaemic hyperinsulinaemic clamp technique was used at the baseline to assess insulin sensitivity (M-clamp value). In the end, the median age of participants was 35. We observed an increase in glucose concentrations, a decrease in insulin concentrations and no changes in insulin resistance markers. Final mean glucose, mean insulin, Matsuda index and body mass index (BMI) were correlated with baseline M-clamp value and SHBG (p < 0.01). During the follow-up, no one in the sample developed diabetes. The annualised incidence rate for conversion from normoglycaemia to prediabetes totalled 4.5%. Baseline BMI, free androgen index, fasting glucose and M-clamp value were identified as prediabetes predictors in young PCOS women (respectively, OR = 1.17, OR = 1.42, OR = 1.2, OR = 0.73, p < 0.05). Prediabetes appeared in 76.47% of the women with a final BMI of ≥ 25 kg/m2 and in 7.14% of the normal-weight women (p = 0.0001). In conclusion, we report a high rate of adverse change in glucose metabolism in overweight and obese participants, a deterioration in β-cell function and strong correlations between metabolic parameters assessed in the third and the fourth decade in PCOS women, emphasising the role of early intervention to prevent cardiometabolic diseases.

The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study

“…The presence of hirsutism, androgenic alopecia and acne was verified. Anthropometric and blood pressure measurements, as well as the assessment of fat mass by multi-frequency bioelectrical impedance analysis, were performed as previously described [ 52 ].…”

“…Fasting blood samples were used to assay total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), glycated hemoglobin (HbA1c), SHBG, TT, androstenedione (A4), 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), FSH, LH, AMH, estradiol (E2), prolactin, high-sensitivity C-reactive protein (hsCRP) and E-selectin. The methods used in biochemical analyses of glucose, insulin, HbA1c, TC, HDL-c, TG, SHBG, TT, A4, DHEAS and 17-OHP were described previously [ 52 ]. Serum FSH, LH and prolactin levels were determined with immunoradiometric method (DIAsource ImmunoAssays S.A., Angleur, Belgium) (MDC for FSH: 0.01 mIU/mL, for LH: 0.2 mIU/mL, for prolactin: 0.35 ng/mL; intra-assay and inter-assay CV for FSH < 2% and 4.4%, for LH < 3.9% and 8%, for prolactin < 5.2% and 9.2%, respectively).…”

“…Homeostasis model assessment score (HOMA), Matsuda index, HOMA β-cell function (HOMA-%β), plasma LDL-c and FAI were calculated as previously described [ 52 ].…”

“…Metabolic syndrome was defined according to the International Diabetes Federation (IDF) [ 57 ], and a detailed description of the applied criteria was provided previously [ 52 ]. Prediabetes referred to impaired fasting glucose (fasting plasma glucose levels: 100–125 mg/dL), impaired glucose tolerance (the 2-h plasma glucose in an OGTT: 140–199 mg/dL) and HbA1c (5.7–6.4%) [ 58 ].…”

“…Given the limited knowledge on the natural history of PCOS, we conducted a longitudinal follow-up study including 31 women with a previous diagnosis of PCOS according to the Rotterdam criteria. A detailed re-evaluation of participants’ metabolic profiles with particular emphasis on glucose tolerance has been provided recently [ 52 ]. The aim of this research was to describe the effects of aging on clinical, hormonal and ovarian characteristics in the studied cohort and to assess the predictors of change in PCOS status.…”