Relative risk of conversion from normoglycaemia to impaired glucose tolerance or non-insulin dependent diabetes mellitus in polycystic ovarian syndrome

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.

Section: Cardiometabolic Disease In Pcosmentioning

confidence: 81%

Section: Cardiometabolic Disease In Pcosmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

Glintborg

Andersen

2017

“…Several relatively small studies have shown an increase in IGT and the development of type 2 diabetes amongst PCOS patients, particularly in subjects with a positive family history (49,50,51,52,53,54). The AE-PCOS Society consensus statement (12) recommends a 2 h post-75 g oral glucose challenge to be performed in PCOS women with a BMI O30 kg/m 2 , or alternatively in lean PCOS women with advanced age (O40 years), personal history of gestational diabetes, or family history of type 2 diabetes.…”

Section: Type 2 Diabetes Risk and Pcosmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

Sathyapalan

Atkin²

2012

Polycystic ovary syndrome (PCOS) has been associated with increased cardiovascular risk (CVR) markers, but population studies have not clarified whether there is an increase in cardiovascular morbidity and mortality. Four different PCOS phenotypes resulted from the Rotterdam criteria that may differ in their CVR potential, thus introducing further complexity. This has led to studies using surrogate CVR markers including biomarkers in blood and imaging such as flow-mediated vasodilatation. In PCOS, both peripheral and central insulin resistance (IR) have been shown. Weight loss has been shown to improve IR and visceral fat, while insulin sensitizer therapies with metformin or thiazolidinediones improve IR and endothelial dysfunction. IR is also found in non-alcoholic fatty liver disease that in turn is very common in PCOS; studies have suggested that IR may be improved by treatment with metformin and omega-3 fish oils. PCOS patients have a more dyslipidemic phenotype that is worse in 'classical PCOS' associated with a higher CVR. Studies with atorvastatin and simvastatin have reported a decrease in the lipid parameters and an improvement in CVR indices including IR, but it is unclear whether this is due to their lipid-lowering action or a pleiotropic effect of the statin. In this expert opinion review, the relevant literature published during the last 2 years was considered. It focuses on some recent important data that has emerged while also exposing the gaps that remain in our knowledge that need to be addressed.

“…IR constitutes a prerequisite for diabetes mellitus (DM) and/or metabolic syndrome development, and consequently the increased incidence of these two morbidities in women with PCOS, compared with their BMI-matched peers, is expected (5,6,7,8,9). However, the available prospective studies reporting the significantly higher incidence of DM in women with PCOS compared with general population are few and DM is found mainly in obese women with the syndrome (10,11,12).…”

Section: Introductionmentioning

confidence: 99%

Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome

Livadas

Panidis

Diamanti-Kandarakis

2014

Background: Polycystic ovary syndrome (PCOS) represents a moving spectrum of hormonal to metabolic abnormalities, as women with the syndrome are aging. Hormonal abnormalities, anovulation, and hyperandrogenic signs were predominant during the early years of PCOS and fade away with the years. Metabolic abnormalities and insulin resistance (IR) remain throughout the PCOS life cycle; however, it is unclear as to how they change, as women with the syndrome are aging. Objective: To evaluate the changes in IR and its associations with clinical, biochemical, hormonal, and ultrasound findings in a large cohort of women with PCOS and controls, as they are aging. Design: A cross-sectional study was carried out to evaluate the diverse impacts of aging on IR. Setting: An outpatient clinic was chosen for the study. Participants: A total of 1345 women with PCOS (Rotterdam criteria) and 302 controls of Caucasian origin and Greek ethnicity comprised the study group. Main outcome and measures: The impact of age on IR, as calculated using homeostasis model assessment of IR (HOMA-IR) index, and several PCOS characteristics were evaluated. Results: In PCOS, age (K0.045G0.008) was negatively, and BMI positively (0.18G0.007) associated with HOMA-IR (R 2 Z0.36).