Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism

Armanini, Decio; Boscaro, Marco; Bordin, Luciana; Sabbadin, Chiara

doi:10.3390/ijms23084110

Cited by 110 publications

(83 citation statements)

References 81 publications

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“…The classifications of underweight, normal weight, overweight, and obese were not consistent among these studies. World Health Organization (WHO) classification for nutritional status is defined by underweight as <18.5 kg/m 2 , normal weight as 18.5–24.9 kg/m 2 , overweight as 25.0–29.9 kg/m², and obese as BMI ≥ 30 kg/m 2 [ 2 , 33 ], and most of studies adopted this classification [ 13 , 15 , 16 , 17 , 18 , 19 , 34 , 35 , 36 ]. However, some studies used 24 kg/m 2 and 28 kg/m 2 as cut-off points for overweightness and obesity [ 37 ], respectively, especially studies conducted in China [ 12 , 14 , 20 , 21 , 38 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…Polycystic ovary syndrome (PCOS) affects 4–18% of women of reproductive age, which is characterized by hyperandrogenism, chronic anovulation, and a picture of multiple small follicular cysts in the ovary [ 1 , 2 , 3 , 4 , 5 ]. PCOS is closely linked to metabolic and reproductive disorders, such as obesity, insulin resistance (IR), anovulation-related infertility and a thickened endometrium [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Yang

Liu

et al. 2022

IJERPH

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Polycystic ovary syndrome (PCOS) is a common metabolic problem in women of reproductive age. Evidence suggests pregnant women with PCOS may have a higher risk of the development of adverse pregnancy outcomes; however, the relationship between pre-pregnancy overweight/obesity and pregnancy outcomes in women with PCOS remains uncertain. We try to clarify the relationship between pre-pregnancy overweight/obesity and subsequent pregnancy outcomes. Therefore, we conducted this systematic review and meta-analysis. We used the databases obtained from the PubMed, Embase, Web of Science, and Cochrane databases, plus hand-searching, to examine the association between pre-pregnancy overweightness/obesity and pregnancy outcomes in women with PCOS from inception to 4 February 2022. A total of 16 cohort studies, including 14 retrospective cohort studies (n = 10,496) and another two prospective cohort studies (n = 818), contributed to a total of 11,314 women for analysis. The meta-analysis showed significantly increased odds of miscarriage rate in PCOS women whose pre-pregnancy body mass index (BMI) is above overweight (OR 1.71 [95% CI 1.38–2.11]) or obese (OR 2.00 [95% CI 1.38–2.90]) under a random effect model. The tests for subgroup difference indicated the increased risk was consistent, regardless which body mass index cut-off for overweight (24 or 25 kg/m2) or obesity (28 and 30 kg/m2) was used. With the same strategies, we found that pregnant women in the control group significantly increased live birth rate compared with those pregnant women with PCOS as well as pre-pregnancy overweight/obesity (OR 0.79 [95% CI 0.71–0.89], OR 0.78 [95% CI 0.67–0.91]). By contrast, we did not find any association between PCOS women with pre-pregnancy overweight/obesity and preterm birth. Based on the aforementioned findings, the main critical factor contributing to a worse pregnancy outcome may be an early fetal loss in these PCOS women with pre-pregnancy overweight/obesity. Since PCOS women with pre-pregnancy overweightness/obesity were associated with worse pregnancy outcomes, we supposed that weight reduction before attempting pregnancy in the PCOS women with pre-pregnancy overweightness/obesity may improve the subsequent pregnancy outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Yang

Liu

et al. 2022

IJERPH

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“…A meta-analysis provided evidence regarding the correlation of VD receptor polymorphisms and PCOS, identifying some susceptibility markers as well. To date, the use of metformin in PCOS patients represents a milestone in therapy for these patients [ 9 , 10 ]. Supplementation with natural molecules, such as VD, may help overcome PCOS-related symptoms [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment

Morgante

Darino

Spanò

et al. 2022

JCM

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Recent literature has stressed the importance of vitamin D (VD) in polycystic ovary syndrome (PCOS). Women with PCOS are deficient in VD, particularly those with a higher weight. Hypovitaminosis is a risk factor for glucose intolerance, and reduced levels of VD is associated with insulin resistance and increased diabetes risk. Since women with PCOS and hirsutism seem to have lower levels of VD than women with PCOS without hirsutism, a correlation between VD deficiency and hyperandrogenism may be suggested. Interestingly, VD is crucial for many human physiological functions, including to counteract inflammation and oxidative stress. Some studies evaluated effects of VD supplementation on glucose homeostasis variables, hormonal status, lipid concentrations, and biomarkers of inflammation and oxidative stress among VD-deficient women. Moreover, VD has been shown to play a role in egg quality and fertility. This review aims to show the relationship between VD and the endocrine and metabolic profile of PCOS patients, as well as its implications for their fertility. The supplement of VD to the common therapy can lead to an improvement of the insulin resistance and lipid metabolism, a reduction of circulating androgens, as well as a better response to the induction of ovulation in PCOS women.

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“…PCOS among adolescents and young girls is generally undiagnosed and underreported. Moreover, untreated patients develop complications such as infertility, pregnancy-related issues, metabolic disorders, and cardiovascular diseases [9,10]. PCOS patients have an increased chance of developing impaired glucose tolerance and suffer from T2DM.…”

Section: Introductionmentioning

confidence: 99%

Polycystic Ovarian Syndrome: Prevalence, Predisposing Factors, and Awareness Among Adolescent and Young Girls of South India

Jabeen¹,

Yamini²,

Amberina³

et al. 2022

Cureus

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IntroductionPolycystic ovarian syndrome (PCOS) is a leading cause of infertility among women throughout the world. PCOS is an endocrine abnormality that presents as hyperandrogenemia, anovulation, and/or polycystic ovaries. The exact causes of PCOS are not entirely understood. However, PCOS may be hereditary and associated with abnormalities such as high body mass index (BMI) and obesity, among others. This study is carried out to assess the prevalence and awareness among adolescents and young girls belonging to South India. MethodsThis was a prospective study that included 250 adolescent and young girls aged between 13 and 25 years. Demographic details including age, educational status, and family income were collected from all the participants after obtaining informed consent. BMI was measured in all the participants. A pre-test was conducted to assess the level of awareness followed by a 30-minute informative briefing on PCOS. All participants were asked to fill up a post-briefing questionnaire. The data collected were processed using statistical software SPSS 11.0, and the chi-square test was applied to find out the significance of the results. ResultsOf the total 250 participants included, the mean age was 16.96 years and most participants (78%) belonged to the age group of 13 to 19 years. Most (78%) of the study participants had normal BMI (18-24.9 kg/m 2 ), 17.6% were underweight (BMI < 18), and 4.4% were overweight (BMI > 25). A PCOS prevalence rate of 6.8% was noted among the study participants. A majority (78.4%) of the study participants were unaware of PCOS, and 6.8% were being treated for PCOS. The source of knowledge of PCOS was majorly teachers (37%), followed by doctors (31.5%), the internet (11%), and friends (7.5%). Lack of information and publicity (63%) were found to be the most significant reason for low levels of awareness. ConclusionPCOS is a common health problem among adolescents and young girls. Most study participants were unaware of the symptoms and management of the condition. Therefore, the disease burden noted in this study does not necessarily depict the real prevalence. Increasing awareness programs will facilitate improved understanding, increased diagnoses, and effective management of PCOS.

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Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism

Cited by 110 publications

References 81 publications

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment

Polycystic Ovarian Syndrome: Prevalence, Predisposing Factors, and Awareness Among Adolescent and Young Girls of South India

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