Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS

Abstract

Objective: Metabolic syndrome (MBS) is a common disorder and is thought to be extremely prevalent in polycystic ovary syndrome (PCOS). In the USA the prevalence of MBS in PCOS has been reported to be as high as 43 -46% using Adult Treatment Panel III (ATP-III) criteria. Because of differences in diet, lifestyle and genetic factors, we postulated that the prevalence of MBS might not be as high in Italian women. This study sought to determine the prevalence of MBS in Italian women using both the ATP-III and the World Health Organization (WHO) criteria and to determine whether the prevalence is influenced by the way in which PCOS is diagnosed. Design: Assessment of the prevalence of MBS in 282 women with PCOS, aged 18-40 years, living in western Sicily. Eighty-five age-and weight-matched normal women served as controls. Methods: Patients were divided into those with chronic anovulation and hyperandrogenism (classic PCOS; n ¼ 225) and others with hyperandrogenism and polycystic ovaries but who were ovulatory (ovulatory PCOS; n ¼ 57). A 75 g oral glucose tolerance test was carried out, as were lipid determinations; insulin resistance was assessed by the Quantitative Insulin-Sensitivity Check Index (QUICKI). We used ATP-III and WHO criteria to diagnose MBS. Results: Using ATP-III criteria, the prevalence of MBS was 8.2% and using WHO criteria it was 16% in Italian women with PCOS. In controls, the prevalence was 2.4% using both methods. In classic PCOS patients, MBS was higher (8.9% by ATP-III, 17.3% by WHO) than in ovulatory PCOS (5% and 10.6% respectively). Body weight significantly modified prevalence rates. Conclusion: MBS is substantially higher in women with PCOS than in the general population, and the prevalence is higher in those women diagnosed by classic criteria. However, the prevalence of MBS in PCOS appears to be much lower in Italy than in the USA.

Metabolic syndrome in infertile women with polycystic ovarian syndrome

“…Also, based on WHO criteria and ATP-III criteria, Carmina and cols. found the prevalence rates of MS were 16% and 8.2%, respectively, in Italian PCOS women (19). In addition to different criteria for diagnosis of PCOS and MS, the characteristics of the population studied, such as race, age, BMI, different dietary habits and lifestyle in different countries, had important roles for different prevalence rate of MS in PCOS women.…”

“…Many of the metabolic abnormalities of PCOS patients overlap with components of MS. The prevalence rates of MS in PCOS women vary among different countries and ethnicities as follows: 43-46% in America (11,12), 37.9% in India (13), 35.3% in Thailand (14), 28.4% in Brazil (15), 16.8% in China (16), 14.5% in Korea (17), 11.6% in Turkey (18) and 8.2% in Southern Italy (19). These differences in prevalence rates of MS in PCOS patients in different countries may be depended to several factors, like age, BMI, and race of patients as well as different approaches to define MS and PCOS.…”

Metabolic syndrome in women with polycystic ovary syndrome: prevalence, characteristics and predictors

“…In the USA population, its prevalence in adolescents was 37% (14), while in adult women it varied from 34.4% (16) to 47.9% (17). In Southern Italy its prevalence was 8.2% (20) and 8.4 to 16% in Turkey (19), while Czech women with polycystic ovary syndrome were rarely described, although its isolated features were relatively frequent (18).…”

“…The data regarding the prevalence of metabolic syndrome in PCOS are scarce, and limited only to the USA (13)(14)(15)(16)(17) and Europe (18)(19)(20). In the USA population, its prevalence in adolescents was 37% (14), while in adult women it varied from 34.4% (16) to 47.9% (17).…”

Manifestações clínicas, bioquímicas, ultrassonográficas e metabólicas da síndrome dos ovários policísticos em adolescentes

“…A resistência insulínica é um achado frequente nas pacientes com SOP e tem sido observada em estudos prévios 27,28 sendo diretamente relacionada à obesidade e influenciando na presença de síndrome metabólica. A prevalência de 13,6% de síndrome metabólica em nosso estudo foi inferior à encontrada no estudo de Rossi et al 28 e superior aos achados de Carmina et al 29 . Os estudos enfatizam que adolescentes identificadas com síndrome metabólica apresentam risco aumentado de diabetes mellitus e doença arterial coronoariana na vida adulta [30][31][32] .…”