Prevalence of polycystic ovary syndrome in women with severe obesity – Effects of a structured weight loss programme

Kataoka, Josefin; Larsson, Ingrid; Björkman, Sofia; Eliasson, Björn; Schmidt, Jan Peter; Stener-Victorin, Elisabet

doi:10.1111/cen.14098

Cited by 28 publications

(31 citation statements)

References 41 publications

(57 reference statements)

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“…PCOS is the most common endocrine disorder affecting women of reproductive age, with a reported prevalence of 8-13% ( 93 – 95 ). PCOS prevalence is increased (to >25%) among severely obese women, and comorbid obesity aggravates all PCOS symptoms ( 96 ). PCOS is accompanied by substantial metabolic abnormalities, including hyperinsulinemia, insulin resistance and dyslipidemia.…”

Section: Aberrant Expression Of Gdf-8 and Female Reproductive Disordersmentioning

confidence: 99%

Regulatory Role and Potential Importance of GDF-8 in Ovarian Reproductive Activity

Zheng

Qin

et al. 2022

Front. Endocrinol.

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Growth differentiation factor-8 (GDF-8) is a member of the transforming growth factor-beta superfamily. Studies in vitro and in vivo have shown GDF-8 to be involved in the physiology and pathology of ovarian reproductive functions. In vitro experiments using a granulosa-cell model have demonstrated steroidogenesis, gonadotrophin responsiveness, glucose metabolism, cell proliferation as well as expression of lysyl oxidase and pentraxin 3 to be regulated by GDF-8 via the mothers against decapentaplegic homolog signaling pathway. Clinical data have shown that GDF-8 is expressed widely in the human ovary and has high expression in serum of obese women with polycystic ovary syndrome. GDF-8 expression in serum changes dynamically in patients undergoing controlled ovarian hyperstimulation. GDF-8 expression in serum and follicular fluid is correlated with the ovarian response and pregnancy outcome during in vitro fertilization. Blocking the GDF-8 signaling pathway is a potential therapeutic for ovarian hyperstimulation syndrome and ovulation disorders in polycystic ovary syndrome. GDF-8 has a regulatory role and potential importance in ovarian reproductive activity and may be involved in folliculogenesis, ovulation, and early embryo implantation.

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Section: Aberrant Expression Of Gdf-8 and Female Reproductive Disordersmentioning

confidence: 99%

Regulatory Role and Potential Importance of GDF-8 in Ovarian Reproductive Activity

Zheng

Qin

et al. 2022

Front. Endocrinol.

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“…Moreover, obesity aggravates all symptoms. Depending on diagnostic criteria, the prevalence of PCOS varies, and we have recently reported a prevalence of 25.6% in women with severe obesity, using the National Institutes of Health (NIH)-criteria [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Circulating Anti-Müllerian hormone in a cohort-study of women with severe obesity with and without polycystic ovary syndrome and the effect of a one-year weight loss intervention

Kataoka

Larsson

Lindgren

et al. 2022

Reprod Biol Endocrinol

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Background Women with polycystic ovary syndrome (PCOS) have high circulating anti-Müllerian hormone (AMH) levels which is correlated with antral follicle count and polycystic ovarian morphology and negatively correlated with body mass index (BMI). Moreover, diet-induced weight loss in women with PCOS and overweight or obesity, reduce or normalize AMH-levels. There is, however, no previous study investigating the circulating AMH levels in women with severe obesity and how a structured diet-induced weight loss program affects circulating AMH levels in these women. Therefore, this study aims to investigate circulating AMH levels in a population of women with severe obesity (BMI ≥ 35 kg/m2) with and without PCOS, as diagnosed by the NIH-criteria, and to investigate the effect of a one-year weight loss program with a very low-energy diet (VLED) on circulating levels of AMH. Methods In a prospective cohort-study, were 246 women with severe obesity were screened for PCOS diagnosis with the NIH-criteria, circulating AMH and anthropometry were measured at baseline and after a 12-month weight loss intervention with very low-energy diet (VLED). Results Mean BMI was 39.9 ± 4.7 (PCOS), 39.6 ± 4.3 (non-PCOS) P = 0.960. Circulating AMH was higher in women with PCOS (5.47 ± 4.89 µg/L) compared with non-PCOS (2.66 ± 3.71 µg/L) P < 0.001 and was positively correlated with circulating total testosterone in both groups. Next, we performed ROC-analyses, and show that circulating AMH could not discriminate women with PCOS and severe obesity from non-PCOS women with severe obesity. Finally, a one-year weight reduction program does not affect circulating AMH levels despite significant weight loss neither in women with PCOS, nor without PCOS and severe obesity. Conclusion Women with severe obesity and PCOS have elevated levels of circulating AMH compared to women without the syndrome. AMH-levels could not discriminate women with PCOS from non-PCOS because of low sensitivity and specificity. Significant weight loss was not associated with changes in circulating AMH levels, neither in women with, nor without PCOS and severe obesity. These results imply that in women with severe obesity, a greater weight loss may be needed to improve reproductive features, independent of PCOS diagnosis. Trial registration number: Clinical trial.gov: NCT01319162.

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“…Clinically, it is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovary morphology, often accompanied by insulin resistance and obesity [3][4][5]. Moreover, prevalence rates increase to over 25% in severely obese women with PCOS [6]. The etiology of PCOS has not been clarified yet, but, in recent years, more and more attention has been paid to the role of environmental and genetic factors in the occurrence and development of PCOS [7].…”

Section: Introductionmentioning

confidence: 99%

Effects of exogenous adiponectin supplementation in early pregnant PCOS mice on the metabolic syndrome of adult female offspring

et al. 2021

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Objective PCOS is a heterogeneous endocrine disorder with both reproductive and metabolic abnormalities. At present, PCOS has been confirmed to have a certain genetic background. Compared with healthy women, the vast majority of PCOS patients have hyperandrogenemia, and this excessive androgen exposure during pregnancy may affect the development of female fetuses. The aim of the current study was to investigate the effect of adiponectin intervention during early pregnancy of obese mice with PCOS on the metabolic phenotype of adult female offspring. Methods After the PCOS model was established, C57BL/6J mice were divided into maternal-control, maternal-PCOS, and maternal-PCOS + APN groups. DHEA-induced PCOS mice were supplemented with adiponectin (10 mg/kg/day) in the early pregnancy in order to eliminate adverse hormone exposure and then traced for endocrine indicators in their adult female offspring, which were observed for metabolism syndrome or endocrine disturbance and exhibited the main effects of APN. To further explore the underlying mechanism, the relative expressions of phosphorylated AMPK, PI3K, and Akt were detected in the ovaries of offspring mice. Results The serum testosterone level of the maternal-PCOS + APN group in early pregnancy was significantly lower than that of the maternal-PCOS group (p < 0.01). The serum testosterone level in the offspring-PCOS + APN group was significantly lower than in the offspring-PCOS group (p <0.05), the diestrus time characterized by massive granulocyte aggregation in the estrus cycle was significantly shorter than in the offspring-PCOS group (p<0.05), and the phenotypes of PCOS-like reproductive disorders and metabolic disorders, such as obesity, insulin resistance, impaired glucose tolerance, and hyperlipidemia, were also significantly improved in the offspring-PCOS + APN group (p < 0.05). Compared with the control group, the expression levels of phosphorylated AMPK, PI3K, and Akt in the offspring-PCOS group were significantly decreased (p < 0.05), while those in the offspring-PCOS + APN group were significantly increased (p < 0.05). Conclusions APN intervention in early pregnancy significantly reduced the adverse effects of maternal obesity and high androgen levels during pregnancy on female offspring and corrected the PCOS-like endocrine phenotype and metabolic disorders of adult female offspring. This effect may be caused by the activation of the AMPK/PI3K-Akt signaling pathway in PCOS offspring mice.

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Prevalence of polycystic ovary syndrome in women with severe obesity – Effects of a structured weight loss programme

Cited by 28 publications

References 41 publications

Regulatory Role and Potential Importance of GDF-8 in Ovarian Reproductive Activity

Regulatory Role and Potential Importance of GDF-8 in Ovarian Reproductive Activity

Circulating Anti-Müllerian hormone in a cohort-study of women with severe obesity with and without polycystic ovary syndrome and the effect of a one-year weight loss intervention

Effects of exogenous adiponectin supplementation in early pregnant PCOS mice on the metabolic syndrome of adult female offspring

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