Phenotypes and body mass in women with polycystic ovary syndrome identified in referral versus unselected populations: systematic review and meta-analysis

Lizneva, Daria; Kirubakaran, Richard; Mykhalchenko, Kateryna; Suturina, Larisa; Chernukha, Chernukha G.E.; Diamond, Michael P.; Azziz, Ricardo

doi:10.1016/j.fertnstert.2016.07.1121

Cited by 127 publications

(96 citation statements)

References 61 publications

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“…[9][10][11][12][13][14][15][16][17] For some women, such as those with severe hyperandrogenism, early diagnosis and management of PCOS could arguably slow progression of comorbidities and prevent long term harms by prompting early intervention. A PCOS label might, for example, help women undergo regular screening for comorbidities and make dietary and lifestyle changes, such as losing weight and reducing risk of diabetes or cardiovascular disease (table 3⇓).…”

Section: Rationale For Changementioning

confidence: 99%

Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome?

Copp

Jansen

Doust

et al. 2017

BMJ

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Section: Rationale For Changementioning

confidence: 99%

Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome?

Copp

Jansen

Doust

et al. 2017

BMJ

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“…It has been shown that PCOS patients from referral population have a greater mean BMI and higher prevalence of obesity compared to women with PCOS diagnosed in the medically unselected population. [7][8][9][10][11][12] The evidence that obesity is associated with higher prevalence of PCOS is conflicting too. Data from some retrospective and longitudinal observational studies have suggested the higher incidence of PCOS among obese women, but it was not supported by data obtained in other studies.…”

Section: Introductionmentioning

confidence: 99%

“…10 At the same time some authors reported that the prevalence of metabolic syndrome does not differ in obese vs non-obese women with PCOS. This may be explained by the heterogeneity of the groups of infertile women due to different causes of infertility, PCOS phenotype and racial differences.…”

mentioning

confidence: 99%

Overweight and Obesity Prevalence in Referral Population of Infertile Women with Polycystic Ovary Syndrome

2017

AOWMC

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Background: Obesity and polycystic ovary syndrome are commonly associated, but data regarding overweight and obesity prevalence in PCOS patients remains controversial and depends on study population (referral or unselected) and PCOS phenotype. There are few studies which present ethnic differences in prevalence of overweight and obese women with PCOS.Objective: To test the hypothesis that overweight and obesity prevalence is not similar in infertile women with PCOS and without PCOS and depends on ethnicity of patients. Subjects and methods:A prospective study was performed in a referral (clinical) population, included 397 infertile women (134 with PCOS, aged 28.2±4.7years (Group A) and 263 without PCOS, aged 29.4±5.4years (Group B); 363 Caucasians and 34 Asians), who were referred for the evaluation of infertility at clinical research centers in Irkutsk and Ulan-Ude (Eastern Siberia) between 2007 and 2015, and agreed to participate in the prospective study. 53 fertile women aged 27.6±7.3years were recruited as controls. A complete medical history, physical examination with BMI calculation, laparoscopy, pelvic ultrasound and hormonal immunoassay analysis were performed in all patients. Results:The mean BMI and obesity prevalence was significantly higher in both groups of infertile patients compared to controls without significant difference between women with PCOS and without PCOS. However, lower rate of subjects with normal BMI was demonstrated predominantly in the PCOS group. The increase of mean BMI vs controls was more significant in Asian infertile women with PCOS than in Caucasians. Conclusion:Our study results suggest that the mean BMI and obesity prevalence are comparable in the referral population of infertile women with and without PCOS. Nevertheless, the lower number of patients with normal BMI, compared to fertile controls, have been found only in the group of PCOS infertile women. These findings may be explained by phenotype and ethnic heterogeneity of PCOS women. Asian infertile women with PCOS are more likely to have increased BMI than Caucasians. Due to study limitations more data is needed in referral as well as in unselected populations of PCOS women from Asian and Caucasian ethnic groups.

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“…Although it is most clinically apparent among women of reproductive age, PCOS can be symptomatic in pre-adolescent and menopausal women, and potentially even in men. 3,4 PCOS is also associated with an increased risk of endometrial and possibly ovarian carcinoma. In addition to hyperandrogenic dermatologic symptoms (acne, alopecia, and hirsutism), PCOS is associated with impaired reproduction and obstetric outcomes.…”

mentioning

confidence: 99%

“…In 1990, the relatively strict US National Institutes of Health (NIH) criterion categorized two phenotypes of PCOS: phenotype A, comprising oligo-anovulation, hyperandrogenism, and PCOM; and phenotype B, comprising oligo-anovulation and hyperandrogenism. 4 Consequently, to gain the most accurate understanding of the prevalence of PCOS, epidemiologic studies of unselected or unbiased populations must be undertaken. 10 There is strong evidence that the features of PCOS identified among clinically referred patients are more severe than the phenotypes of PCOS identified in studies of medically unbiased (unselected) populations.…”

mentioning

confidence: 99%

Why we need epidemiologic studies of polycystic ovary syndrome in Africa

Maya

Guure

Adanu

et al. 2018

Intl J Gynecology & Obste

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The primary objective of the Ghana Polycystic Ovary Syndrome Epidemiology and Phenotype (Ghana-PEP) study will be to assess the relevance and phenotypic distribution of polycystic ovarian syndrome (PCOS) in a medically unbiased population of reproductive-aged women. In addition, the study will also attempt to identify sociodemographic, environmental, and psychological factors that may play a role in the development of PCOS phenotype. The study aims to recruit 990 randomly selected women aged 18-45 years living in Nsawam, the district capital of the Nsawam-Adoagyiri Municipality, in the Eastern region of Ghana. Participants will complete a questionnaire with the aid of trained personnel, undergo a physical examination, and undergo ultrasonography and biochemical evaluations relevant to PCOS. It is anticipated that the study will provide the population prevalence and phenotypes, and distribution of PCOS.

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Phenotypes and body mass in women with polycystic ovary syndrome identified in referral versus unselected populations: systematic review and meta-analysis

Abstract: The prevalence of more complete phenotypes in PCOS and mean BMI were higher in subjects identified in referral versus unselected populations, suggesting the presence of significant referral bias.

Cited by 127 publications

References 61 publications

Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome?

Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome?

Overweight and Obesity Prevalence in Referral Population of Infertile Women with Polycystic Ovary Syndrome

Why we need epidemiologic studies of polycystic ovary syndrome in Africa

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