Augmentation of cortical bone mineral density in women with polycystic ovary syndrome: a peripheral quantitative computed tomography (pQCT) study

Kassanos, Dimitrios; Trakakis, E; Baltas, Christos; Papakonstantinou, Olympia; Simeonidis, G.; Salamalekis, George; Grammatikakis, Ioannis; Basios, Georgios; Labos, G.; Skarantavos, G.; Balanika, Alexia

doi:10.1093/humrep/deq149

Cited by 46 publications

(44 citation statements)

References 39 publications

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“…Conversely, other studies report higher BMD in PCOS [13] consistent with testosterone inhibiting bone resorption in vivo [4] or through peripheral conversion to 17b-estradiol and estrone, effects of elevated insulin on osteoblast proliferation [14] or the higher prevalence of overweight and obesity in PCOS. It is possible that the effects of contraception on BMD may be worsened in the hyperandrogenic state of PCOS given that steroidal contraceptives reduce bioavailable androgens.…”

Section: Discussionmentioning

confidence: 91%

Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

et al. 2015

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Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with features including hyperandrogenism and menstrual irregularity frequently treated with hormonal steroidal contraceptives. Women with PCOS appear to have lower bone mineral density (BMD). While steroidal contraceptives may positively affect bone health, their effect on BMD in PCOS is not known. The aim of this study was to assess BMD in women with PCOS according to recent contraceptive use. A cross-sectional analysis of 95 pre-menopausal overweight or obese sedentary women with PCOS [age 29.4 ± 6.4 years, body mass index (BMI) 36.1 ± 5.3 kg/m(2)] who either recently took steroidal contraceptives (ceased 3 months prior) or were not taking steroidal contraceptives was conducted. Clinical outcomes included BMD, anthropometry, insulin, glucose, reproductive hormones, dietary intake and vitamin use. BMD was significantly lower for women who used contraceptives compared to those who did not (mean difference 0.06 g/cm(2) 95 % confidence interval -0.11, -0.02, p = 0.005). In regression models, lower BMD was independently associated with contraceptive use (β = -0.05, 95 % CI -0.094, -0.002, p = 0.042), higher testosterone (β = -0.03, 95 % CI -0.05, -0.0008, p = 0.043) and lower BMI (β = 0.006, 95 % CI 0.002, 0.01, p = 0.007) (r (2) = 0.22, p = 0.001 for entire model). We report for the first time that overweight and obese women with PCOS with recent steroidal contraceptive use had lower BMD in comparison to non-users independent of factors known to contribute to BMD. Whether this observation is directly related to steroidal contraceptive use or other factors requires further investigation.

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Section: Discussionmentioning

confidence: 91%

Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

et al. 2015

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“…Our study showed that lean women with PCOS had greater mean skeletal mass than control women. Peripheral quantitative computerised tomography established significantly higher distal-tibial cortical density in lean PCOS than that in lean control women, although trabecular bone density did not differ (Kassanos et al 2010). Good et al (1999) reported higher BMD in the left and right arms and left ribs of a lean PCOS group compared to control values.…”

Section: Discussionmentioning

confidence: 79%

“…In recent years, attention has centred on determining body composition in PCOS women with different body mass index, quantity and quality of bone mass and (Zborowski et al, 2000;Kirchengast et Huber 2001;Faulds 2003;Puder et al 2005;To and Wong 2005;Toscani et al 2007;Barber et al 2008;Cosar et al 2008;Moran and Teede 2009;Kassanos et al 2010;March et al 2010;Manneras-Holm et al 2011;Villa et al 2011 andFranks 2013). Our study presents analytic results of investigations into body composition and somatotype in lean PCOS women.…”

Section: Discussionmentioning

confidence: 99%

Body composition of lean women with polycystic ovary syndrome

Zabulienė

Urbonienė

Tutkuvienė

2013

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Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine and metabolic disorders in reproductive age women, and it is related to changes in body size, shape and composition. Anthropometric somatotype is a quantitative description of the individual's body shape and composition classified as endomorphy, mesomorphy or ectomorphy. Since PCOS somatotype has never previously been studied, here we evaluate body shape and composition phenomena in lean women with polycystic ovary syndrome and assess relationships with metabolic parameters. The study of 20-35 year-old women was carried out at the Department of Anatomy, Histology and Anthropology at Vilnius University. Standard anthropometric instruments and methods were used, and J. Matiegka's equations calculated skeletal mass, skin and subcutaneous adipose tissue and muscles and internal organs. In addition, Heath -Carter's somatotypes were computed, and the participants' glucose, insulin, testosterone, sex hormone-binding globulin and lipid levels were established. We analysed data from 120 women with a mean age of 27.30 ± 3.68 years. Lean women with PCOS had greater skeletal mass by 0.47 kg (p<0.05, Cohen's d=1.14), greater skin and subcutaneous adipose tissue mass by 2.79 kg (p<0.05, Cohen's d=6.07) and lower muscle mass by 1.47 kg (p<0.05, Cohen's d=2.84) compared to control women (p<0.05). The mean PCOS somatotype ratio was 4.96-4.38-3.00 (SD 1.50-1.26-1.11). This classified women with PCOS as mesomorphic endomorphs, in contrast to healthy women who were endomorphic mesomorphs. The PCOS subjects' skin and subcutaneous adipose tissue and endomorphy/mesomorphy somatotype positively correlated with insulin levels and the HOMA-IR. It was established that lean women with polycystic ovary syndrome had a mesomorphic endomorph somatotype and higher skin and subcutaneous adipose tissue mass, but less muscle mass than healthy lean women. In addition, skin and subcutaneous adipose tissue positively correlated with insulin level and HOMA-IR in lean PCOS women.

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“…4,5 The static levels of estradiol, with the absence of estradiol peak associated with ovulation in PCOS women, may negatively affect bone density and geometry. 6,7 Although conflicting results have been reported so far bone mass and density in PCOS women appear to be maintained at a level comparable to normal ovulatory women or even higher. 8e10 A higher bone mass might be related to a higher body mass index (BMI), higher estrogen and androgen levels and hyperinsulinemia.…”

Section: Introductionmentioning

confidence: 99%

“…11 In peripheral quantitative computed tomography (pQCT) studies a trend for higher cortical and total bone cross-sectional area (CSA) was found in lean and obese PCOS women. 7 At present there is no approved therapy for PCOS in adolescents. Ib añez et al described a treatment combination of low-dose flutamide, metformin and etinylestradioldrosperinone (oral contraception with antiandrogen effect).…”

Section: Introductionmentioning

confidence: 99%

Effect of Antiandrogen Treatment on Bone Density and Bone Geometry in Adolescents with Polycystic Ovary Syndrome

Bechtold

Pozza

Putzker

et al. 2012

Journal of Pediatric and Adolescent Gynecology

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Augmentation of cortical bone mineral density in women with polycystic ovary syndrome: a peripheral quantitative computed tomography (pQCT) study

Cited by 46 publications

References 39 publications

Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

Body composition of lean women with polycystic ovary syndrome

Effect of Antiandrogen Treatment on Bone Density and Bone Geometry in Adolescents with Polycystic Ovary Syndrome

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