Changes in clinical and biochemical characteristics of polycystic ovary syndrome with advancing age

Abstract

Objective To verify whether aging can modify the clinical and biochemical characteristics of women with polycystic ovary syndrome (PCOS). Material and methods This observational cross-sectional study was conducted at the reproductive endocrinology clinics of Julio Muller University Hospital and Tropical Institute of Reproductive Medicine in Cuiabá, MT, Brazil, between 2003 and 2017. Both, 796 PCOS and 444 non-PCOS normal cycling women underwent the same examination. PCOS was diagnosed using the Rotterdam criteria as recommended for adolescent and adult subjects. Anthropometric, metabolic, and endocrinological modifications with aging were initially examined in the two groups: control and PCOS. Further analyses were performed after a 5-year age stratification of data throughout the reproductive period. All participants signed a consent form approved by the local ethical committee. Results Biomarkers of adiposity were more remarkable in African descendant PCOS women. Body weight, waist/hip ratio, fat mass, and BMI were higher in PCOS women and tended to increase at all 5 age-strata, between ≤19 and 35 years of age. Serum androgen levels decreased with aging, markedly in PCOS subjects (P < 0.01 for all age-strata comparisons), but remained elevated when compared with the levels found in controls. Carbohydrate markers, triglycerides, and total cholesterol tended to increase over time in PCOS (P < 0.01 for all age-strata comparisons). Total cholesterol also tended to increase with age in non-PCOS women (P = 0.041). Conclusion The present study has shown that the advancing age influences many features of PCOS women. Biochemical hyperandrogenism, the core criterion recommended in the current systems to define the syndrome, showed statistically significant tendencies to decrease with aging progression but did not normalize. The use of age-adjusted features for the diagnosis of PCOS are recommended.

Differential Effects of Various Androgens on Polycystic Ovary Syndrome

“…To perform logistic regression analyses all these cut-off values were ≥ 90th percentile of 425 normal cyclings, normal weight, non-PCOS women (Supplemental table 1S). Because of inconsistent results due to ethnicity and inter-rater evaluation, hirsutism was not scored; rather, it was registered as a dichotomous variable according to the patient's complaints and the presence or the lack of hirsutism in the upper lip, chin, chest, upper or lower back, upper or lower abdomen, upper arms and thighs in the medical examination [23][24][25].…”

“…LDL-C was calculated as TC -(HDL-C + TG/5) [29]. All hormone measures, their sensitivities, coefficients of intra-and inter-assay variations were recently shown [25]. In short, sex-hormone-binding globulin (SHBG), total testosterone (T), and DHEA were measured with an electrochemiluminescence assay (Elecsys 1010, Roche Diagnostics GmbH, Mannheim, Germany).…”

Serum free testosterone levels in polycystic ovarian syndrome patients and its correlation with clinical hyperandrogenism in Pakistan

“…[19][20][21] Differences in published results indicate that hyperandrogenism not only reflects circulating androgen levels, but is also influenced by the peripheral metabolism of androgens and aging . 22,23 A recent study showed that androgen excess in polycystic ovarian syndrome patients also contributes to insulin resistance and obesity like metabolic complications. 24 Clinical evidence of hyperandrogenism is not always present, especially in patients of Asian descent, and biochemical hyperandrogenemia may be present in the absence of clinical evidence.…”

The connection of alpha‐1 acid glycoprotein inflammatory marker with anthropometric, hormonal, and metabolic characteristic of women with polycystic ovary syndrome

“…3β-hydroxysteroid dehydrogenase II (3β-HSDII), and 11β-hydroxylase deficiencies were excluded in the cases of 17-hydroxyprogesterone (17-OHP4) levels ≤5 ng/ml (≤15 nmol/L), 17-hydroxypregnenolone (17-OHPE) ≤ 0.42 ng/ml (≤13.5 nmol/L), and compound S ≤ 0.8 ng/ml (≤23 nmol/L). Overt hypothyroidism was excluded by a thyroid-stimulating hormone (TSH) level of ≥10 μUI/ml and free thyroxin (FT4) level of ≤9.0 pmol/ L. 32,33 Hyperprolactinemia was excluded when prolactin (PRL) levels were ≤1.086 nmol/L. Both, controls and PCOS patients who had used sex steroids or insulinsensitizing drugs over the past 6 months or those who did not fulfill the Rotterdam criteria were excluded.…”

“…Because of inconsistent results due to ethnicity and inter-rater evaluation, hirsutism was not scored; rather, it was registered as a dichotomous variable according to the patient's complaints and the presence or the lack of hirsutism in the upper lip, chin, chest, upper or lower back, upper or lower abdomen, upper arms, and thighs in the medical examination. 33,34…”