State of the Art Review: Emerging Therapies: The Use of Insulin Sensitizers in the Treatment of Adolescents with Polycystic Ovary Syndrome (PCOS)

Geller, David H.; Pacaud, Danièle; Gordon, Catherine M.; Misra, Madhusmita

doi:10.1186/1687-9856-2011-9

Cited by 58 publications

(52 citation statements)

References 254 publications

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“…The prevalence rate of insulin resistant in females with PCOS varies across studies. Some authors advocate that insulin resistance is always present in these females [18] whereas others estimated the prevalence rate of insulin resistance to vary between 40% to 70% [19]. These results vary due to the diagnostic methods used [12] [20] [21].…”

Section: Discussionmentioning

confidence: 98%

Insulin Sensitivity and Gynaecological Features of Infertile Cameroonian Females with Polycystic Ovary Syndrome: A Cross-Sectional Study

Dohbit¹,

Sobngwi²,

Kemfang³

et al. 2017

OJOG

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Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary (PCO), hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It is an intriguing pathology that involves the perpetuation of a vicious circle with reproductive, endocrine and metabolic components. We aimed to assess the reproductive features and insulin sensitivity (IS) in infertile women with or without PCOS. Materials and Methods: We carried out a cross-sectional analytic study at the outpatient Obstetrics and Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital, Cameroon from September 1 st 2012 to March 31 st 2013 giving total study duration of 07 months.Laboratory analyses were carried out at the National Obesity Centre (NOC) of the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam consensus meeting of 2003 and 21 non PCOS subjects as control.PCOS women were younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2 years; p = 0.0004). The majority of the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic findings were typical of PCOS. Hirsutism score was higher in the PCOS group with a median of 9 (7 -13).Insulin sensitivity was impaired in two-thirds of the study population, with 12 women found to be insulin resistant (6 PCOS, 6 non PCOS), 12 patients had Apart from blood glucose levels (p = 0.007), all other anthropometric and biological parameters were not significant. Spearman's correlation identified fasting plasma glucose and total cholesterol as factors associated with insulin sensitivity in females with PCOS. Impaired fasting glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common findings in PCOS. Furthermore, our findings suggest that PCOS may be more of systemic metabolic disease than solely a purely gynecologic disorder as described hitherto. Despite normal fasting plasma glucose levels, a good proportion of these women has impaired insulin sensitivity and it is associated with a metabolic syndrome.

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Section: Discussionmentioning

confidence: 98%

Insulin Sensitivity and Gynaecological Features of Infertile Cameroonian Females with Polycystic Ovary Syndrome: A Cross-Sectional Study

Dohbit¹,

Sobngwi²,

Kemfang³

et al. 2017

OJOG

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“…Данный метод терапии может уменьшить уровень инсулина и увеличить чувствительность к нему тканей организма, что приведет к снижению уровней лютеини-зирующего гормона (ЛГ) и андрогенов в крови [69].…”

Section: волшебная рыбкаunclassified

“…Медикаментозная терапия СПКЯ, как правило, назна-чается детскими гинекологами [69]. Следует знать, что перед назначением оральных контрацептивов лечащий врач должен проанализировать семейный анамнез для выявления семейной коагулопатии, особенно повышен-ной свертываемости крови или других факторов риска тромбообразования и инсульта (например, гиперлипиде-мии).…”

Section: волшебная рыбкаunclassified

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Metabolic syndrome in children and adolescents. Principles of treatment

et al. 2017

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“…19,80,81 Lifestyle modification with calorie restriction and increased exercise is paramount, but sustained weight loss is difficult to achieve. Insulinlowering treatments, whether weight reduction or drug treatment, have an ∼50% probability of improving menstrual cyclicity but a negligible effect on hirsutism.…”

Section: Principles Of Treatment Of Adolescent Pcosmentioning

confidence: 99%

The Diagnosis of Polycystic Ovary Syndrome in Adolescents

2015

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Consensus has recently been reached by international pediatric subspecialty societies that otherwise unexplained persistent hyperandrogenic anovulation using age-and stage-appropriate standards are appropriate diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescents. The purpose of this review is to summarize these recommendations and discuss their basis and implications. Anovulation is indicated by abnormal uterine bleeding, which exists when menstrual cycle length is outside the normal range or bleeding is excessive: cycles outside 19 to 90 days are always abnormal, and most are 21 to 45 days even during the first postmenarcheal year. Continued menstrual abnormality in a hyperandrogenic adolescent for 1 year prognosticates at least 50% risk of persistence. Hyperandrogenism is best indicated by persistent elevation of serum testosterone above adult norms as determined in a reliable reference laboratory. Because hyperandrogenemia documentation can be problematic, moderate-severe hirsutism constitutes clinical evidence of hyperandrogenism. Moderate-severe inflammatory acne vulgaris unresponsive to topical treatment is an indication to test for hyperandrogenemia. Treatment of PCOS is symptom-directed. Cyclic estrogenprogestin oral contraceptives are ordinarily the preferred first-line medical treatment because they reliably improve both the menstrual abnormality and hyperandrogenism. First-line treatment of the comorbidities of obesity and insulin resistance is lifestyle modification with calorie restriction and increased exercise. Metformin in conjunction with behavior modification is indicated for glucose intolerance. Although persistence of hyperandrogenic anovulation for $2 years ensures the distinction of PCOS from physiologic anovulation, early workup is advisable to make a provisional diagnosis so that combined oral contraceptive treatment, which will mask diagnosis by suppressing hyperandrogenemia, is not unnecessarily delayed.Polycystic ovary syndrome (PCOS) is the most common cause of chronic hyperandrogenic anovulation and the single most common cause of infertility in young women. 1 It is also a risk factor for metabolic syndrome-related comorbidities and for impaired wellbeing and mortality. 2 Considerable evidence suggests that PCOS has diverse causes, arising as a complex trait with contributions from both heritable and environmental factors that affect ovarian steroidogenesis. 3,4 Insulinresistant hyperinsulinism, in part related to coexistent obesity, is the most common nonsteroidogenic factor. The complex interactions generally mimic an autosomal dominant trait with variable penetrance: the disorder is correlated in identical twins 5 ; about half of sisters are hyperandrogenic, and half of these also have oligo-amenorrhea and thus PCOS 6,7 ; and polycystic ovaries appear to be inherited as an autosomal dominant trait. 7,8 Three percent to 35% of mothers have PCOS, 9,10 and metabolic syndrome prevalence is high in parents and siblings. 11-13 The syndrome was first described...

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State of the Art Review: Emerging Therapies: The Use of Insulin Sensitizers in the Treatment of Adolescents with Polycystic Ovary Syndrome (PCOS)

Cited by 58 publications

References 254 publications

Insulin Sensitivity and Gynaecological Features of Infertile Cameroonian Females with Polycystic Ovary Syndrome: A Cross-Sectional Study

Insulin Sensitivity and Gynaecological Features of Infertile Cameroonian Females with Polycystic Ovary Syndrome: A Cross-Sectional Study

Metabolic syndrome in children and adolescents. Principles of treatment

The Diagnosis of Polycystic Ovary Syndrome in Adolescents

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