Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCos) is the most common endocrinopathy in women of reproductive age. PCos is not only the leading cause of anovulatory infertility but is also associated with an array of metabolic disorders, among which impaired glucose metabolism has been a topic of intense research. The aim of the present narrative review is to summarize the findings of the studies that have evaluated the prevalence and incidence of prediabetes and type 2 diabetes mellitus (T2Dm) in patients with PCos, to analyze the factors underpinning the association between T2Dm and PCos and to discuss the current strategies for screening and management of impaired glucose metabolism in this population. Both prediabetes and T2Dm are highly prevalent in patients with PCos. Accordingly, regular screening is recommended in this population for the early identification of impaired glucose metabolism, particularly in overweight or obese patients and in those with a family history of T2Dm. Prevention of T2Dm in patients with prediabetes is primarily based on lifestyle changes, while metformin might be considered in selected cases. The treatment of T2Dm is similar in patients with and without PCos but appropriate contraceptive measures should be implemented in patients receiving treatments other than insulin, metformin or glyburide.

Genome-Wide Identification of mRNAs, lncRNAs, and Proteins, and Their Relationship With Sheep Fecundity

“…It was evident that the diameter of large follicles before ovulation in Xinji fine-wool sheep is significantly larger than that in Small Tail Han sheep. That Small Tail Han sheep were found to have more large follicles (distributed on both ovaries) in the present study was consistent with the findings of Lazaridou et al (2017 ). This study found that in the natural estrus cycle of sheep, the FSH, E2, and P4 levels in Small Tail Han sheep were significantly higher than those in Xinji fine-wool sheep.…”

“…According to the present study, it was speculated that the lower expression of HSD17B1 in Small Tail Han sheep decreases E2, P4, and ACT secretion and further reduce the apoptosis of granulosa cells, which could have maintained the development of follicles. The function of regulating these sex steroids of HSD17B1 in granulosa cells had previously been reported in rats, mice, and horses ( McGee and Hsueh, 2000 ; Gangloff et al, 2001 ; Zhang et al, 2012 ; Lazaridou et al, 2017 ). This study confirmed that HSD17B1 might play a similar role in sheep.…”

Childbirth experiences in women with polycystic ovary syndrome: A cohort study

“…Women with PCOS often suffer from comorbidities related to metabolic, psychological, and reproductive factors. Compared with women without PCOS, they have higher prevalence of insulin resistance, type 2 diabetes, metabolic syndrome, non‐alcoholic fatty liver disease, obesity, hypertension, and risk for cardiovascular diseases 3–5 . Obesity exacerbates most co‐morbidities and symptoms associated with PCOS 6 .…”

Meta-Research: A Poor Research Landscape Hinders the Progression of Knowledge and Treatment of Reproductive Diseases

“…The various hormonal disturbances in PCOS predispose these individuals to multiple comorbidities, such as cardiovascular disease (CVD), diabetes, and metabolic syndrome. The metabolic disorder has been well-established, with evidence of insulin resistance and hyperinsulinemia in 60-80% of all PCOS patients (Lazaridou et al, 2017). Research in PCOS has focused on managing symptoms, rather than uncovering the underlying pathogenesis to discover more clear diagnostics and targeted treatments.…”