Pathophysiology and types of dyslipidemia in PCOS

Diamanti-Kandarakis, Evanthia; Papavassiliou, Athanasios G.; Kandarakis, Stylianos; Chrousos, George P.

doi:10.1016/j.tem.2007.07.004

Cited by 237 publications

(174 citation statements)

References 61 publications

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“…This is consistent with observations that, PCOS patients often display other indices of cardiovascular risk such as dyslipidaemia, high serum homocysteine and inflammatory markers (i.e. serum TNF and IL-6) (Diamanti-Kandarakis et al, 2007b;Guzelmeric et al, 2007;Atamer et al, 2008). They also present clinical features of premature atherosclerosis such as impaired pulse wave velocity (PWV), increased carotid intima media wall thickness (IMT), presence of carotid plaque, and increased coronary artery calcification (Carmina et al, 2008;.…”

Section: Pcos and Obesitysupporting

confidence: 90%

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Rachoń

Teede

2010

Molecular and Cellular Endocrinology

128

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Insulin resistance (IR) is a consequence of obesity, and in women it is often inextricably linked with ovarian function leading to clinical reproductive manifestations such as early menarche onset, subfertility and polycystic ovary syndrome (PCOS). Likewise, the dramatic fall in oestrogen production after menopause may contribute to weight gain and changes in adipose tissue distribution.Overall, women who are obese, especially those with reproductive complications including PCOS, have been identified as specific high risk subgroups for further progression through to prediabetes, type 2 diabetes mellitus (T2DM) and potentially cardiovascular disease (CVD). This review focuses on the interrelationship between the ovarian function and obesity as well as its treatment strategies.

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Section: Pcos and Obesitysupporting

confidence: 90%

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Rachoń

Teede

2010

Molecular and Cellular Endocrinology

128

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“…Whether HbA1c is superior to OGTT regarding long-term metabolic and cardiovascular risk in PCOS must be established in prospective studies. It was estimated that 70% newly diagnosed women with PCOS had borderline or high lipid levels (33), including increased total cholesterol, TG, LDL or decreased HDL levels (34,35). In a Danish study population with median BMI 27 kg/m 2 , 41% patients with PCOS had HDL <1.29 mmol/L and 21% patients had TG >1.68 mmol/L (36).…”

Section: Cardiometabolic Disease In Pcosmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

Glintborg

Andersen

2017

European Journal of Endocrinology

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Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition in premenopausal women. The syndrome is characterized by hyperandrogenism, irregular menses and polycystic ovaries when other etiologies are excluded. Obesity, insulin resistance and low vitamin D levels are present in more than 50% patients with PCOS, these factors along with hyperandrogenism could have adverse effects on long-term health. Hyperinflammation and impaired epithelial function were reported to a larger extent in women with PCOS and could particularly be associated with hyperandrogenism, obesity and insulin resistance. Available data from register-based and data linkage studies support that metabolic-vascular and thyroid diseases, asthma, migraine, depression and cancer are diagnosed more frequently in PCOS, whereas fracture risk is decreased. Drug prescriptions are significantly more common in PCOS than controls within all diagnose categories including antibiotics. The causal relationship between PCOS and autoimmune disease represents an interesting new area of research. PCOS is a lifelong condition and long-term morbidity could be worsened by obesity, sedentary way of life, Western-style diet and smoking, whereas lifestyle intervention including weight loss may partly or fully resolve the symptoms of PCOS and could improve the long-term prognosis. In this review, the possible implications of increased morbidity for the clinical and biochemical evaluation of patients with PCOS at diagnosis and follow-up is further discussed along with possible modifying effects of medical treatment.

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“…2 Women with PCOS commonly display a clustering of metabolic abnormalities, including impaired glucose tolerance, 3 insulin resistance, 2 dyslipidemia, 4 increased prevalence of obesity, 5,6 lowgrade chronic inflammation 7 and increased oxidative stress. 8,9 Insulin resistance has been demonstrated in both obese and non-obese women with PCOS.…”

Section: Introductionmentioning

confidence: 99%

In overweight/obese but not in normal-weight women, polycystic ovary syndrome is associated with elevated liver enzymes compared to controls

Economou¹,

Xyrafis²,

Livadas³

et al. 2009

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OBJECTIVE: To investigate liver enzymes in a cohort of women with Polycystic Ovary Syndrome (PCOS) and controls divided according to body mass index (BMI) and their association with features of the syndrome. DESIGN: Eighty-three PCOS women and 64 healthy women were studied. Patients and controls were subdivided into two groups, a lean subgroup (BMI <25kg/ m 2 ) and an overweight/obese subgroup (BMI >25kg/m 2 ). Clinical history, height and weight were obtained and metabolic and hormonal parameters were determined. RESULTS: Serum fasting insulin, fasting glucose, HOMA-IR, triglycerides and total cholesterol were significantly higher (p<0.05) in women with PCOS compared to controls. No significant difference in serum liver enzymes levels between PCOS women and controls was detected. However, serum levels of alanine aminotransferase (ALT) (17.7 vs. 14.1 U/L, p<0.05) and γ-glutamyl transpeptidase (γGT) (17.9 vs. 13.4 U/L, p<0.05) were significantly higher in overweight/obese PCOS women compared with overweight/obese controls. In overweight/obese PCOS patients and controls, ALT levels were positively correlated with free androgen index (FAI) (r=0.25 p<0.05) and total testosterone levels (r=0.33 p<0.01). CONCLUSIONS: The finding of elevated liver enzymes in overweight/obese PCOS women raises the question of screening for non-alcoholic fatty liver disease in this group.Key words: Body Mass Index, Insulin resistance, Liver enzymes, Non-alcoholic fatty liver disease, Polycystic Ovary Syndrome Research paper HORMONES 2009, 8(3):199-206 22,24 A significant elevation of aminotransferase levels (ALT and/or AST above 60 U/L) is highly likely to concur with the imaging finding of fatty infiltration in obese women with PCOS.22 Ultrasonographic evidence is more prevalent than the biochemical evidence of NAFLD in lean, overweight and obese PCOS women, 25 but the use of a lower cutoff for ALT may significantly increase the sensitivity of this marker in identifying mild NAFLD. 26Overall, existing evidence of NAFLD in PCOS women is still scarce and presents certain limitations. Of the available studies, only one included a control group. 24 Moreover, only one study included both lean and obese patients, 25 while the others either included only overweight/obese patients or did not subdivide patients according to BMI. 21,22 Additionally, serum levels of γGT were determined only in one of the available four studies. 25The aim of the present study was to investigate liver enzymes in a cohort of women with PCOS and controls divided according to BMI in order to explore a possible independent effect of PCOS and obesity on liver function and to uncover potential associations of serum liver enzymes with hormonal parameters and indices of insulin resistance.

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Pathophysiology and types of dyslipidemia in PCOS

Cited by 237 publications

References 61 publications

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

In overweight/obese but not in normal-weight women, polycystic ovary syndrome is associated with elevated liver enzymes compared to controls

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