Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk?

Daan, Nadine M.P.; Louwers, Yvonne V.; Koster, Maria P. H.; Eijkemans, Marinus J.C.; Rijke, Yolanda B. de; Lentjes, E G W M; Fauser, Bart C.J.M.; Laven, Joop S.E.

doi:10.1016/j.fertnstert.2014.08.001

Cited by 182 publications

(154 citation statements)

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“…Increased body weight is accepted as a major risk factor for MS. Increased body mass and androgen levels were also known to be related to inflammatory response, and proinflammatory cytokine production like TNF-α also contributes to development of insulin resistance and metabolic syndrome in PCOS [18][19][20][21][22][23][24][25]. In accordance to literature, more than half of the Turkish PCOS adolescents were overweight in the present study.…”

Section: Discussionsupporting

confidence: 87%

“…Fruzetti et al also confirmed our results in Italian adolescent PCOS patients [19]. In contrast, a multicenter study reported that low HDL-C levels were more common in hyperandrogenemic adult women with PCOS as compared to normoandrogenemic women with PCOS (40.9% vs. 18.1%; p = 0,001) [23]. However, a recent study of 624 postmenopausal women found that endogenous androgen levels did not predict dyslipidemia, whereas HOMA-IR independently predicted HDL-C [24].…”

Section: Discussionsupporting

confidence: 86%

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The incidence of metabolic syndrome in adolescents with different phenotypes of PCOS

et al. 2017

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Objectives: To evaluate the incidence of metabolic syndrome in Turkish adolescents with different phenotypes of polycystic ovary syndrome (PCOS). Material and methods:This cross-sectional study was performed on the Youth Center clinic of a tertiary referral hospital in Turkey. Adolescents with PCOS (n = 144) were classified into four phenotype groups according to the presence of oligo/anovulation (O), hyperandrogenism (H), and polycystic ovarian morphology (P) as follows: Phenotype A (O + H + P), Phenotype B (H + O), Phenotype C (H + P), Phenotype D (O + P). The adolescents gave early follicular phase blood samples for endocrine and metabolic tests. The incidence and the presence of parameters of metabolic syndrome were assessed among the four groups. Results:In total, 54.9% of the adolescents with PCOS were overweight and 25.7% had metabolic syndrome. The incidence of metabolic syndrome in Phenotypes A-D were as follows: 39.5%, 20.5%, 26.5%, and 15.2%, respectively. Although body mass index was higher in the Phenotype A group, insulin resistance was similar in all of the phenotype groups. The most common dyslipidemia was low HDL-C levels and this was present in more than half of the adolescents with PCOS. Both body mass index and total testosterone levels were significantly higher in adolescents with metabolic syndrome in comparison to those without metabolic syndrome. Conclusions:Although low HDL-C levels and insulin resistance are common PCOS findings in adolescents, the metabolic profile seems to be worse in Phenotype A than the other phenotypes. Therefore, screening programs should evaluate patients based on the known risk factors and phenotypes for adolescents with PCOS.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

The incidence of metabolic syndrome in adolescents with different phenotypes of PCOS

et al. 2017

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“…This might indicate the lack of any relationship between ovarian reserve and insulin resistance directly, or that other factors, besides BMI, are associated with both AMH level and insulin sensitivity. As described by Daan et al [36], the extent of hyperandrogenism appears to be of influence on cardio-metabolic risk in patients with PCOS. It can thus be hypothesized that this holds true for women without PCOS as well, suggesting that other hormone pathways (such as the adrenal axis) may play an additional role.…”

Section: Discussionmentioning

confidence: 77%

“…PCOS is characterized by oligomenorrhea or amenorrhea, hyperandrogenism and/or polycystic ovaries in women with WHO class 2 anovulation [35]. Women with PCOS, especially those with hyperandrogenism and/or obesity [36], more frequently have metabolic disturbances, making them more prone to developing the metabolic syndrome and type 2 diabetes [35]. In these women, AMH has been described to be elevated [21], and therefore the relationship between AMH and cardio-metabolic risk factors may also differ compared to regularly cycling women.…”

Section: Metabolic Syndrome and Amh In The Case Of Pcosmentioning

confidence: 99%

Anti-Müllerian Hormone as a marker of ovarian reserve in relation to cardio-metabolic health: A narrative review

et al. 2015

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“…Because the cardio-metabolic profile of PCOS phenotypes characterised by hyperandrogenism and chronic anovulation is poorer, the inclusion of nonhyperandrogenic phenotypes might favour the occurrence of bias in the assessment of the aetiopathogenesis of PCOS and its relationship to cardiovascular comorbidities during late stages of life (Melo et al 2011, Daan et al 2014. Moreover, most of the existing studies are multicentre cross-sectional or case-control studies in which women at different stages of life and who have a varied prevalence of comorbidities associated with PCOS were analysed (Michelmore et al 2001, Ibáñ ez et al 2008, Legro et al 2010, Chen et al 2011, Hizli et al 2012, Hwang et al 2012, Shi et al 2012, Louwers et al 2013, Shayeb et al 2014.…”

mentioning

confidence: 99%

Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause

Melo¹,

Dias²,

Cavalli³

et al. 2015

Reproduction

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Polycystic ovary syndrome (PCOS) is a multifactorial disorder that arises from interactions between genetic, environmental and intrauterine factors. Small-for-gestational-age (SGA) babies and the daughters of mothers with PCOS represent possible postnatal clinical targets for developmental programming by steroid excess. The presence of excess glucocorticoids and/or androgens during foetal organogenesis and growth might promote changes in gene expression, and these changes might be related to an increase in the risk of PCOS-like reproductive and metabolic disorders in postnatal life, such as rapid growth and weight gain during the first 2 years of life (only in SGA babies), hyperinsulinaemia, adipocyte dysfunction and childhood visceral obesity, premature pubarche and adrenarche (only in SGA babies) and PCOS. In the fourth decade of life, women who have PCOS may be at higher risk for type 2 diabetes mellitus, dyslipidaemia and systemic arterial hypertension, which suggests that these women are also at higher risk for cardiovascular disease during menopause. However, PCOS can also occur in women who were born at appropriate weight for GA or in newborns of women without PCOS, which suggests that genetic variation and environmental factors play important roles in the development and maintenance of PCOS in a population. Genome-wide association studies based on adequate population samples have shown a higher frequency of genetic polymorphisms of the LHCGR, THADA and DENND1A genes in women with PCOS. Genetic studies of PCOS have also included analyses of structural changes in the chromosome based on an assessment of telomere length in single, cross-sectional evaluations, and these studies have produced controversial results. The present narrative review assesses the multifactorial origins of PCOS (including environmental, genetic and intra-uterine factors) and the development of conditions associated with this disorder. It is concluded that although PCOS might originate in the intra-uterine environment through developmental programming by steroid excess, the interaction between genetic and environmental factors is crucial for its appearance. Follow-up studies should be conducted to assess the same populations over their entire lifespans while taking into account different aspects of the pathogenesis of PCOS.Reproduction (2015) 150 R11-R24

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Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk?

Cited by 182 publications

References 44 publications

The incidence of metabolic syndrome in adolescents with different phenotypes of PCOS

The incidence of metabolic syndrome in adolescents with different phenotypes of PCOS

Anti-Müllerian Hormone as a marker of ovarian reserve in relation to cardio-metabolic health: A narrative review

Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause

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