Association of polycystic ovary syndrome with metabolic syndrome and gestational diabetes: Aggravated complication of pregnancy

Abstract

Polycystic ovary syndrome (PCOS) affects 5–20% of the reproductive age women globally. PCOS is diagnosed by the presence of hyperandrogenism, oligo-anovulation, and polycystic morphology of at least one ovary. Insulin resistance (IR), hyperinsulinemia and associated metabolic abnormalities including metabolic syndrome play a significant role in the development of PCOS. The chances of developing MS in PCOS women was shown to increase by almost 14-fold in patients with increasing body mass index. Even in the absence of overt obesity, a preferential deposition of intra-abdominal fat is noted in PCOS women and this intra-abdominal fat leads to impaired insulin action and functional IR and hyperandrogenism. Functional ovarian hyperandrogenism of ovaries was suggested to be a consequence of IR, which activates androgen synthesizing enzyme, cytochrome p450-c17α-hydroxylase, in ovarian theca cells and causes elevated oxidative stress accompanied by lower antioxidant status in ovaries, which contribute to PCOS pathogenesis. The elevated levels of luteinizing hormone that accompany the early stages of hyperandrogenemia, accelerate ovarian functional deterioration, which is further aggravated by hyperinsulinemia, in PCOS women. The risk of developing gestational diabetes in PCOS women is approximately three times greater, as compared to non-PCOS women, due to IR and hyperinsulinemia. Typical insulin-sensitizing drugs such as metformin, have been used to curtail IR and hyperinsulinemia in pregnant PCOS women, with varying results indicating the complexity of the disease and the need for better controlled studies and additional efforts for PCOS-specific drug discovery.

Correlation Between Fecal Metabolomics and Gut Microbiota in Obesity and Polycystic Ovary Syndrome

“…Excessive fatty acids affect liver glucose metabolism and inhibit the inactivation of insulin by the liver, resulting in increased blood insulin levels (21,22). PCOS itself and hyperinsulinemia could increase the risk of gestational diabetes in women with PCOS by approximately three times compared with women without PCOS (23).…”

<p>Polycystic Ovary Syndrome and Pelvic Floor Dysfunction: A Narrative Review</p>

“…72,76 Nonetheless, PCOS (endocrine-metabolic disorder) is associated with increasing risk of cardiovascular disease 77 and MetS. 78 Moreover, this review highlights knowledge gaps about protective effect of hyperandrogenism on pelvic floor dysfunction as well as destructive effect of metabolic changes on pelvic floor dysfunction in women with PCOS. Further cohort and prospective studies are recommended in women with PCOS.…”

Pathophysiological changes in experimental polycystic ovary syndrome in female albino rats: Using either hemin or L‐arginine

“…The IR is usually associated with hyperinsulinemia as a compensatory response, as detected in the present study and by (Ambiger, Patil, Rekha, & Dhananjaya (). This hyperinsulinemia activates cytochrome p‐450‐c17α‐hydroxylase, the androgen synthesizing enzyme in ovarian theca cells, and decreases sex‐hormone‐binding globulin production by the liver (Yao et al, ). Moreover, insulin may increase adrenal androgen secretion in PCOS via enhancing adrenal sensitivity to adrenocorticotrophic hormone (Panigrahy, Singh, Pattnaik, & Misra, ).…”