Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome

Livadas, Sarantis; Panidis, Dimitrios; Diamanti-Kandarakis, Evanthia

doi:10.1530/eje-13-1007

Cited by 42 publications

(38 citation statements)

References 47 publications

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“…(Boudreaux et al, 2006;Espinos-Gomez et al, 2009;Gambineri et al, 2012). Normal weight women with PCOS have been reported to be insulin resistant (Stepto et al, 2013), but it has also been reported that insulin resistance ameliorates during aging in non-obese women with PCOS, possibly due to decreasing androgen levels (Livadas et al, 2014). We do, however, acknowledge that the numbers of subjects with disturbances of glucose homoeostasis in this subgroup of PCOS women was relatively small.…”

Section: Discussionmentioning

confidence: 68%

Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

Ollila

West

Keinänen‐Kiukaanniemi

et al. 2016

Hum. Reprod.

131

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STUDY QUESTION: What are the respective roles of polycystic ovary syndrome (PCOS), long-term weight gain and obesity for the development of prediabetes or Type 2 diabetes mellitus (T2DM) by age 46 years? SUMMARY ANSWER: The risk of T2DM in women with PCOS is mainly due to overweight and obesity, although these two factors have a synergistic effect on the development of T2DM.WHAT IS KNOWN ALREADY: PCOS is associated with an increased risk of prediabetes and T2DM. However, the respective roles of PCOS per se and BMI for the development of T2DM have remained unclear.STUDY DESIGN, SIZE, DURATION: In a prospective, general population-based follow-up birth cohort 1966 (n = 5889), postal questionnaires were sent at ages 14 (95% answered), 31 (80% answered) and 46 years (72% answered). Questions about oligoamenorrhoea and hirsutism were asked at age 31 years, and a question about PCOS diagnosis at 46 years. Clinical examination and blood sampling were performed at 31 years in 3127 women, and at 46 years in 3280 women. A 2-h oral glucose tolerance test (OGTT) was performed at 46 years of age in 2780 women.PARTICIPANTS/MATERIALS, SETTING, METHODS: Women reporting both oligoamenorrhoea and hirsutism at age 31 years and/or diagnosis of PCOS by 46 years were considered as women with PCOS (n = 279). Women without any symptoms at 31 years and without PCOS diagnosis by 46 years were considered as controls (n = 1577). The level of glucose metabolism was classified according to the results of the OGTT and previous information of glucose metabolism status from the national drug and hospital discharge registers. LIMITATIONS, REASONS FOR CAUTION:The diagnosis of PCOS was based on self-reporting, and the questionnaire at 46 years did not distinguish between polycystic ovaries only in ultrasonography and the syndrome. Ovarian ultrasonography was not available to aid the diagnosis of PCOS. WIDER IMPLICATIONS OF THE FINDINGS:These results emphasize weight management already during adolescence and early adulthood to prevent the development of T2DM in women with PCOS, as the period between 14 and 31 years seems to be a crucial timewindow during which the women with PCOS who are destined to develop T2DM by 46 years of age experience a dramatic weight gain. Furthermore, our results support the view that, particularly in times of limited sources of healthcare systems, OGTT screening should be targeted to overweight/obese women with PCOS rather than to all women with PCOS.

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Section: Discussionmentioning

confidence: 68%

Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

Ollila

West

Keinänen‐Kiukaanniemi

et al. 2016

Hum. Reprod.

131

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“…We have also showed that circulatory concentrations of TC, TAG, HDL-C, LDL-C, E 2 , SHBG, insulin and HOMA-IR index did not differ between healthy subjects and women with PCOS. It is plausible that age and BMI are the main players in determining the aforementioned biochemical and hormonal features; therefore, differences in the mean age or BMI of patients (in different studies) may lead to inconsistent results, as seen for insulin resistance which is higher in overweight and obese women than in lean individuals (Livadas et al 2014, Moran et al 2015.…”

Section: Discussionmentioning

confidence: 99%

Matrix metalloproteinases 2 and 9 and MMP9/NGAL complex activity in women with PCOS

et al. 2016

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It is believed that matrix metalloproteinases (MMPs) play important roles in follicular development and pathogenesis of polycystic ovary syndrome (PCOS). However, conflicting results are available about the alteration of MMP2 and MMP9 concentrations or activities in PCOS. In fact, there is no study entirely investigating both concentration and activity of these MMPs and serum levels of their tissue inhibitors TIMP2 and TIMP1, as well as lipocalin-bound form of MMP9 (MMP9/NGAL). Therefore, the thoroughness of previous studies is questionable. This study was conducted to determine circulatory concentration of MMP2, MMP9, MMP9/NGAL complex, TIMP1 and TIMP2 as well as gelatinase activities of MMP2, MMP9 and MMP9/NGAL complex in women with PCOS and controls. Mean age and BMI as well as serum levels of total cholesterol, triacylglycerol, HDL-C, LDL-C, fasting blood sugar (FBS), insulin, estradiol and sex hormone-binding globulin did not differ between groups, whereas a marked decrease in FSH and significant increases in LH, LH/FSH ratio, testosterone and free androgen index were observed. Women with PCOS and controls showed closed concentrations of MMP2, MMP9, MMP9/NGAL, TIMP1 and TIMP2. Gelatinase activity of MMP9 was found significantly higher in PCOS than in controls (64.53G15.32 vs 44.61G18.95 respectively) while patients and healthy subjects showed similar activities of MMP2 and MMP9/NGAL complex. Additionally, PCOS patients showed a higher MMP9/TIMP1 ratio compared with control women. Direct correlations were also observed between circulatory MMP9 level and the concentration and activity of MMP9/NGAL complex. In conclusion, based on the results of present study, we believe that MMP9 may be involved in the pathogenesis of PCOS.Reproduction (2016) 151 305-311

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“…The mean age and serum testosterone of Sarantis Livadas et al study was 32.21 ± 14.40 and 1.36 ± 0.47 nmol/L respectively. (5) Hypoandrogenaemia in men and hyperandrogenaemia in women are associated with increased risk of CAD, but also with visceral obesity, IR, low HDL-C and elevated TG and LDL-C. (17) High testosterone levels are associated with higher risk of type 2 diabetes in women, but with lower risk in men. (18) Therefore, at physiological levels, T and E2 are thought to be involved in maintaining normal insulin sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…(2) In a normal population also the aging process is associated with a gradual increase in obesity, IR and β-cell decompensation leading to DM development. (5) Few studies have prospectively examined endogenous sex hormones as predictors of type 2 diabetes in women. (6) Therefore, the relationship of sex hormones producing metabolic and endocrine imbalances associated with lipid profile and IR will contribute to more awareness in terms of sex-and genderspecific risk factors.…”

mentioning

confidence: 99%

A Study of Association of Sex Hormones With Insulin Resistance and Obesity for Diabetes Mellitus Risk in Adult Women

Suganthy¹,

Mohanty²,

Jeyakumar³

et al. 2017

jemds

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BACKGROUNDSex hormones have a great impact on energy metabolism, body composition, vascular function and inflammatory responses and insulin resistance. Ovarian hormones influence insulin sensitivity across the lifespan of women. DM prevalence also affects women's health across the life stages causing the second highest mortality in South Asians. DM has polyfactorial aetiological differences between males and females. There is need of search of sex/gender specific risk factors of DM in middle aged women. Therefore, this study is undertaken to analyse the association of sex hormones with insulin resistance, obesity and lipid profile thereby to assess the DM risk.

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Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome

Cited by 42 publications

References 47 publications

Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

Matrix metalloproteinases 2 and 9 and MMP9/NGAL complex activity in women with PCOS

A Study of Association of Sex Hormones With Insulin Resistance and Obesity for Diabetes Mellitus Risk in Adult Women

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