Dietary glycemic index is associated with less favorable anthropometric and metabolic profiles in polycystic ovary syndrome women with different phenotypes

Graff, Scheila Karen; Mario, Fernanda Missio; Alves, Bruna Cherubini; Spritzer, Poli Mara

doi:10.1016/j.fertnstert.2013.06.005

Cited by 65 publications

(87 citation statements)

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“…In contrast, there is no sufficient information to prescribe any pharmacologic therapies that directly oppose inflammation. Diets with low calorie intake are an integral part of the treatment, and diets with low glycemic index appear to be the best for PCOS patients (Graff et al 2013). Only few studies have assessed the impact of weight loss on circulating adipokines in women with PCOS, showing a weight lossrelated decrease on serum leptin levels both in PCOS and controls (Spanos et al 2012, Rondanelli et al 2014.…”

Section: Metabolic Repercussions Of Adipose Tissue Dysfunction In Pcosmentioning

confidence: 99%

“…Polycystic ovary syndrome (PCOS) is a complex condition that affects women of reproductive age and is characterized by ovulatory dysfunction and androgen excess (Graff et al 2013). The prevalence of PCOS is high, ranging from 9% according to NIH criteria to 18% according to Rotterdam criteria (Rotterdam ESHRE/ ASRM-Sponsored PCOS Consensus Workshop Group 2004, March et al 2010).…”

Section: Introductionmentioning

confidence: 99%

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Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome

Spritzer¹,

Lecke²,

Satler³

et al. 2015

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Polycystic ovary syndrome (PCOS), a complex condition that affects women of reproductive age, is characterized by ovulatory dysfunction and androgen excess. Women with PCOS present higher prevalence of obesity, central adiposity, and dyslipidemia, and face increased risk of type 2 diabetes. PCOS is closely linked to functional derangements in adipose tissue. Adipocytes seem to be prone to hypertrophy when exposed to androgen excess, as experienced by women with PCOS, and both adipose tissue hypertrophy and hyperandrogenism are related to insulin resistance. Hypertrophic adipocytes are more susceptible to inflammation, apoptosis, fibrosis, and release of free fatty acids. Disturbed secretion of adipokines may also impact the pathophysiology of PCOS through their influence on metabolism and on sex steroid secretion. Chronic low-grade inflammation in PCOS is also related to hyperandrogenism and to the hypertrophy of adipocytes, causing compression phenomena in the stromal vessels, leading to adipose tissue hypoperfusion and altered secretion of cytokines. Lifestyle changes are the first-line intervention for reducing metabolic risks in PCOS and the addition of an insulin-sensitizing drug might be required. Nevertheless, there is not sufficient evidence in favor of any specific pharmacologic therapies to directly oppose inflammation. Further studies are warranted to identify an adipokine that could serve as an indirect marker of adipocyte production in PCOS, representing a reliable sign of metabolic alteration in this syndrome.

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Section: Metabolic Repercussions Of Adipose Tissue Dysfunction In Pcosmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome

Spritzer¹,

Lecke²,

Satler³

et al. 2015

Reproduction

Self Cite

256

206

View full text Add to dashboard Cite

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“…Obesity is a prevalent characteristic of PCOS (9,23), ranging from 12.5% (24) to 100% (25), with a pooled estimated prevalence of 49% (26), as shown by a recent meta-analysis (27). The presence of obesity may exacerbate the metabolic and reproductive disorders Arq Bras Endocrinol Metab.…”

Section: Obesity Insulin Resistance and Metabolic Comorbiditiesmentioning

confidence: 99%

Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances

Spritzer

2014

Arq Bras Endocrinol Metab

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Polycystic ovary syndrome (PCOS) is a common condition in women at reproductive age associated with reproductive and metabolic dysfunction. Proposed diagnosed criteria for PCOS include two out of three features: androgen excess, menstrual irregularity, and polycystic ovary appearance on ultrasound (PCO), after other causes of hyperandrogenism and dysovulation are excluded. Based on these diagnostic criteria, the most common phenotypes are the "classic PCOS" -hyperandrogenism and oligomenorrhea, with or without PCO; the "ovulatory phenotype" -hyperandrogenism and PCO in ovulatory women; and the "non-hyperandrogenic phenotype" , in which there is oligomenorrhea and PCO, without overt hyperandrogenism. The presence of obesity may exacerbate the metabolic and reproductive disorders associated with the syndrome. In addition, PCOS women present higher risk for type 2 diabetes and higher prevalence of cardiovascular risk factors that seems to be associated with the classic phenotype. The main interventions to minimize cardiovascular and metabolic risks in PCOS are lifestyle changes, pharmacological therapy, and bariatric surgery. Treatment with metformin has been shown to improve insulin sensitivity, lowering blood glucose and androgen levels. These effects are more potent when combined with lifestyle interventions. In conclusion, besides reproductive abnormalities, PCOS has been associated to metabolic comorbidities, most of them linked to obesity. Confounders, such as the lack of standard diagnostic criteria, heterogeneity of the clinical presentation, and presence of obesity, make management of PCOS difficult. Therefore, the approach to metabolic abnormalities should be tailored to the risks and treatment goals of each individual woman. Arq Bras Endocrinol Metab. 2014;58(2):182-7 Keywords PCOS; obesity; insulin resistance; metformin RESUMO A síndrome dos ovários policísticos (PCOS) é um distúrbio frequente em mulheres em idade reprodutiva, associado com disfunção reprodutiva e metabólica. Os critérios diagnósticos atuais para PCOS incluem pelo menos dois dos três seguintes: hiperandrogenismo, irregularidade menstrual e aparên-cia policística dos ovários à ultrassonografia (PCO), após exclusão de outras causas de hiperandrogenismo e anovulação. Com base nesses critérios diagnósticos, os fenótipos mais comuns são "PCOS clássico"-hiperandrogenismo e oligomenorreia, com ou sem PCO; o "fenótipo ovulatório" -hiperandrogenismo e PCO em mulheres ovulatórias; e o "fenótipo não hiperandrogênico"-no qual ocorrem oligomenorreia e PCO sem hiperandrogenismo evidente. A presença de obesidade pode exacerbar os distúrbios metabólicos e reprodutivos associados com a síndrome. Além disso, mulheres com PCOS apresentam maior risco para diabetes tipo 2 e maior prevalência de fatores de risco cardiovascular, que parecem estar associados com o fenótipo clássico. As principais intervenções para minimizar riscos metabólicos e cardiovasculares em PCOS são mudanças de estilo de vida, tratamento farmacológico e cirurgia bariátrica. O tr...

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“…In addition, the focus of treatment should be their clinical consequences instead of the insulin resistance per se, such as metabolic syndrome, abdominal adiposity (waist circumference higher than 88 cm) as well as impaired fasting glucose (IFG, fasting glucose between 100 and 125 mg/dL), impaired glucose tolerance (IGT, 2 h post-glucose between 140 and 199 mg/dL) and T2 diabetes (fasting glucose equal or higher than 126 and/or 2 h post-glucose equal or higher than 200 mg/dL) 2,24,25 . Lifestyle change is the first-line non-pharmacological therapy to lessen cardiovascular and metabolic risks, mainly in overweight or obese PCOS women, and should combine behavioral (reduction of psychosocial stressors), dietary, and exercise management [26][27][28] . Lifestyle modification has been already proved to be effective in reducing the incidence of diabetes in persons at high risk 29 .…”

Section: Metabolic Disturbances and Cardiovascular Risk Factors In Womentioning

confidence: 99%

Dietary glycemic index is associated with less favorable anthropometric and metabolic profiles in polycystic ovary syndrome women with different phenotypes

Cited by 65 publications

References 66 publications

Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome

Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome

Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances

Primary and secondary prevention of metabolic and cardiovascular comorbidities in women with polycystic ovary syndrome

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