Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis

Wild, Robert A.; Rizzo, Manfredi; Clifton, Shari; Carmina, Enrico

doi:10.1016/j.fertnstert.2010.12.027

Cited by 342 publications

(264 citation statements)

References 49 publications

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“…In a recent metaanalysis, dyslipidemia was found to be common in women with PCOS. Beyond known alterations in triglycerides and HDL-cholesterol, women with PCOS have higher LDL-cholesterol and non-HDL-cholesterol, regardless of BMI, and it is recommended that all women with PCOS be screened for dyslipidemia, including LDL-cholesterol and non-HDL-cholesterol determinations, for effective CVR prevention (62).…”

Section: Dyslipidemia In Pcosmentioning

confidence: 99%

“…Liver fat content measured by liver MRI decreased significantly, as did serum triglycerides and systolic and diastolic blood pressure, although there were no effects on BMI, non-esterified fatty acids, IR, hs-CRP, or androgen status. Metformin treatment for 6-12 months also improved hepatic parameters by reducing biochemical markers of NAFLD (62,63). Further studies, perhaps using GLP-1 analogues or thiazolidinediones that have been used in NAFLD studies, need to be performed in patients with concomitant PCOS to determine the optimal treatment.…”

Section: Nafld In Pcosmentioning

confidence: 99%

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MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

Sathyapalan

Atkin²

2012

European Journal of Endocrinology

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Polycystic ovary syndrome (PCOS) has been associated with increased cardiovascular risk (CVR) markers, but population studies have not clarified whether there is an increase in cardiovascular morbidity and mortality. Four different PCOS phenotypes resulted from the Rotterdam criteria that may differ in their CVR potential, thus introducing further complexity. This has led to studies using surrogate CVR markers including biomarkers in blood and imaging such as flow-mediated vasodilatation. In PCOS, both peripheral and central insulin resistance (IR) have been shown. Weight loss has been shown to improve IR and visceral fat, while insulin sensitizer therapies with metformin or thiazolidinediones improve IR and endothelial dysfunction. IR is also found in non-alcoholic fatty liver disease that in turn is very common in PCOS; studies have suggested that IR may be improved by treatment with metformin and omega-3 fish oils. PCOS patients have a more dyslipidemic phenotype that is worse in 'classical PCOS' associated with a higher CVR. Studies with atorvastatin and simvastatin have reported a decrease in the lipid parameters and an improvement in CVR indices including IR, but it is unclear whether this is due to their lipid-lowering action or a pleiotropic effect of the statin. In this expert opinion review, the relevant literature published during the last 2 years was considered. It focuses on some recent important data that has emerged while also exposing the gaps that remain in our knowledge that need to be addressed.

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Section: Dyslipidemia In Pcosmentioning

confidence: 99%

Section: Nafld In Pcosmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

Sathyapalan

Atkin²

2012

European Journal of Endocrinology

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“…Women with PCOS present higher prevalence of obesity, central adiposity, and dyslipidemia (Toscani et al 2007, Wiltgen & Spritzer 2010, Wild et al 2011, Lim et al 2012, and are at higher risk for type 2 diabetes compared with normal women of the same age (Legro et al 1999). Data of 240 patients fulfilling the Rotterdam criteria for PCOS show an increased prevalence of obesity, insulin resistance, metabolic syndrome, and diabetes in comparison with control groups ( Fig.…”

Section: Introductionmentioning

confidence: 99%

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

Spritzer¹,

Lecke²,

Satler³

et al. 2015

Reproduction

255

206

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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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“…PCOS is characterized by the following: i) ovulatory dysfunction resulting in oligo-and/or anovulation, ii) hyperandrogenism and/or hirsutism, and iii) the presence of polycystic ovarian morphology (1). PCOS is by far the most common cause of anovulatory infertility and has been reported to be associated with insulin resistance (IR), hyperinsulinemia, dyslipidemia, and central obesity (2, 3,4), which are all risk factors for the metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Metabolic disturbances are common in women suffering from PCOS: 30-40% have impaired glucose tolerance and IR with compensatory hyperinsulinemia, and as many as 10% will have type 2 diabetes mellitus by their fourth decade (5,6,7).…”

Section: Introductionmentioning

confidence: 99%

“…Metabolic disturbances are common in women suffering from PCOS: 30-40% have impaired glucose tolerance and IR with compensatory hyperinsulinemia, and as many as 10% will have type 2 diabetes mellitus by their fourth decade (5,6,7). A recent meta-analysis has revealed that dyslipidemia occurs more frequently in PCOS women than in control women: women with PCOS had higher LDL-cholesterol and non-HDL-cholesterol levels, regardless of BMI (4).…”

Section: Introductionmentioning

confidence: 99%

The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review

Krul-Poel

Snackey

Louwers

et al. 2013

European Journal of Endocrinology

114

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Context: Metabolic disturbances, in particular, insulin resistance (IR) and dyslipidemia, are common in women suffering from polycystic ovary syndrome (PCOS). Evidence is accumulating that vitamin D status may contribute to the development of metabolic disturbances in PCOS. Objective: The aim of this study was to carry out a systematic review addressing the association between vitamin D status, vitamin D receptor polymorphisms, and/or polymorphisms related to vitamin D metabolism and metabolic disturbances in women with PCOS. Design and methods: A systematic search of electronic databases was carried out up to January 2013 for observational studies and clinical trials in women suffering from PCOS with outcome measures that were related to vitamin D status. We conducted univariate and multivariate regression analyses of the weighted means to gain insights into the association between vitamin D, BMI, and IR based on existing literature. Results: We found 29 eligible trials with inconsistency in their results. One well-designed randomized controlled trial has been carried out until now. Univariate regression analyses of the weighted means revealed vitamin D to be a significant and independent predictor of IR in both PCOS and control women. The significance disappeared after adjustment for BMI in PCOS women. Conclusions: Current evidence suggests an inverse association between vitamin D status and metabolic disturbances in PCOS. Owing to the heterogeneity of the studies, it is hard to draw a definite conclusion. The causal relationship between vitamin D status and metabolic disturbances in PCOS remains to be determined in well-designed placebo-controlled randomized clinical trials.

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Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis

Cited by 342 publications

References 49 publications

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

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

The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review

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