Body fat distribution has weight-independent effects on clinical, hormonal, and metabolic features of women with polycystic ovary syndrome

Pasquali, Renato; Casimirri, Francesco; Venturoli, Stefano; Antônio, Maria Ângela Reis de Góes Monteiro; Morselli, Labate; Reho, S.; Pezzoli, A.; Paradisi, Roberto

doi:10.1016/0026-0495(94)90118-x

Cited by 110 publications

(69 citation statements)

References 37 publications

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“…Abdominal obesity may also further worsen the hyperandrogenic state in PCOS women. 46,47 This is not an unexpected finding, since the increase of body weight and fat tissue in women is associated with several abnormalities of sex steroid balance. Such changes involve androgens and SHBG, their main carrier protein.…”

Section: Shbgmentioning

confidence: 73%

“…We have repeatedly demonstrated that the androgen profile and insulin basal levels as well as the insulin response to a glucose load are significantly higher in the subgroup with abdominal body fat distribution than in the group with the peripheral type, regardless of BMI. 46,47 This has been confirmed in studies using dual-energy X-ray absorptiometry (DEXA) to define different obesity phenotypes. 90 Holte et al 91 found a significant association between abdominal fat mass and insulin resistance evaluated by the euglycemic hyperinsulinemic clamp technique.…”

Section: The Impact Of Body Fat Distributionmentioning

confidence: 86%

“…91 Moreover, this subgroup of PCOS women may have a more unfavorable lipid profile, namely higher triglyceride and very-low-density lipoprotein (VLDL) and lower HDL cholesterol concentrations. 47 In addition, PCOS women with the abdominal phenotype present a higher prevalence of menses abnormalities and acanthosis nigricans (a cutaneous marker of insulin resistance) and a tendency towards worsened hirsutism. 47 As discussed above, abdominal obesity is associated with profound alterations of both production and metabolic clearance rates of major androgens and reduced SHBG blood levels.…”

Section: The Impact Of Body Fat Distributionmentioning

confidence: 99%

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Obesity and the polycystic ovary syndrome

et al. 2002

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The polycystic ovary syndrome (PCOS) is a condition characterized by hyperandrogenism and chronic oligo-anovulation. However, many features of the metabolic syndrome are inconsistently present in the majority of women with PCOS. Approximately 50% of PCOS women are overweight or obese and most of them have the abdominal phenotype. Obesity may play a pathogenetic role in the development of the syndrome in susceptible individuals. In fact, insulin possesses true gonadotrophic function and an increased insulin availability at the level of ovarian tissue may favour excess androgen synthesis. Obesity, particularly the abdominal phenotype, may be partly responsible for insulin resistance and associated hyperinsulinemia in women with PCOS. Therefore, obesity-related hyperinsulinemia may play a key role in favouring hyperandrogenism in these women. Other factors such as increased estrogen production rate, increased activity of the opioid system and of the hypothalamic-pituitary-adrenal axis, decreased sex hormone binding globulin synthesis and, possibly, high dietary lipid intake, may be additional mechanisms by which obesity favours the development of hyperandrogenism in PCOS. Irrespective of the pathogenetic mechanism involved, obese PCOS women have more severe hyperandrogenism and related clinical features (such as hirsutism, menstrual abnormalities and anovulation) than normal-weight PCOS women. This picture tends to be more pronounced in obese PCOS women with the abdominal phenotype.Body weight loss is associated with beneficial effects on hormones, metabolism and clinical features. A further clinical and endocrinological improvement can also be achieved by adding insulin-sensitizing agents and=or antiandrogens to weight reduction programmes. These obviously emphasize the role of obesity in the pathophysiology of PCOS.

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Section: Shbgmentioning

confidence: 73%

Section: The Impact Of Body Fat Distributionmentioning

confidence: 86%

Section: The Impact Of Body Fat Distributionmentioning

confidence: 99%

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Obesity and the polycystic ovary syndrome

et al. 2002

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“…In addition, many PCOS patients demonstrate central fat accumulation, 12 which is associated with more severe insulin resistance and hyperinsulinemia than peripheral body fat distribution. 13 Dietary intervention studies have demonstrated that weight loss via restricted energy intake results in improved clinical status in PCOS patients. 14,15 Weight loss in hyperandrogenic obese anovulatory women has been shown to result in a normalization of insulin sensitivity, 16,17 androgen levels, 15,[18][19][20] and SHBG level.…”

Section: Introductionmentioning

confidence: 99%

Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome

et al. 2004

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OBJECTIVE: To determine whether dietary intake and physical activity contribute to obesity in women with polycystic ovary syndrome (PCOS). DESIGN: Case-control study. SUBJECTS: A total of 84 cases and 79 neighborhood controls of similar age. MEASUREMENTS: Fasting insulin, body mass index (BMI, kg/m 2 ), waist/hip ratio, Block Food Frequency Questionnaire, Paffenbarger Physical Activity Questionnaire. RESULTS: Although women with PCOS had a higher BMI than control women, an overall comparison of women with and without PCOS showed no significant difference in dietary intake. However, stratification by BMI revealed that lean women with PCOS reported significantly lower energy intake than lean women without PCOS. CONCLUSION: Differences in dietary intake and physical activity alone are not sufficient to explain differences in weight between women with and without PCOS. Further research is necessary to determine the relative contributions of lifestyle factors and metabolism to obesity in PCOS.

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“…Women with PCOS demonstrate a high level of central adiposity even in those who are not obese 7 . The increased visceral fat is correlated to increased menstrual irregularities, Acanthosis nigricans and severe hirsutism 8 . The amount of visceral fat is shown to be related to the level of androgen 9 .…”

Section: Introductionmentioning

confidence: 99%

Useeffect of Body Mass Index on in Vitro Fertilization/Intra-Cytoplasmic Sperm Injection Outcome in Egyptian Women with Polycystic Ovary Syndrome

Mahran

2017

Evidence Based Women's Health Journal

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Objectives: To investigate the effect of body mass index (BMI) on outcome of IVF/ICSI in Egyptian women with PCOS.Study design: Retrospective cohort study. Patients And Methods: The study included including 253 women with PCOS (study group) and 253 women with tubal or unexplained infertility (control group) that underwent IVF/ICSI treatment at Minia IVF Center in Egypt in the period between January 2013 and December 2015. Results: The number of retrieved oocytes and the total number of embryos were significantly higher in women with PCOS compared to the control group (P=0.003 and 0.002 respectively). There was no significant difference between the two groups as regards the clinical pregnancy rate (CPR), live birth rate and miscarriage rate. More cases of ovarian hyperstimulation syndrome (OHSS) were diagnosed in the PCOS group (24 vs. 5. P=0.3). When stratified for BMI, lean PCOS women (BMI< 25) had higher CPR (35% vs. 28.2, P=0.01), live birth rate (32% vs. 26.1%, P =0.01). There were more cases of OHSS in lean as compared with overweight and obese PCOS women (19% vs. 3.3%, P = 0.05). Conclusion: Lean PCOS women achieved higher CPR and live birth rate in IVF/ICSI compared to overweight and obese PCOS women in Egyptian population.

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Body fat distribution has weight-independent effects on clinical, hormonal, and metabolic features of women with polycystic ovary syndrome

Cited by 110 publications

References 37 publications

Obesity and the polycystic ovary syndrome

Obesity and the polycystic ovary syndrome

Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome

Useeffect of Body Mass Index on in Vitro Fertilization/Intra-Cytoplasmic Sperm Injection Outcome in Egyptian Women with Polycystic Ovary Syndrome

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