Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma?

Belosi, C.; Selvaggi, Luigi; Apa, Rosanna; Guido, Maurizio; Romualdi, Daniela; Fulghesu, Anna Maria; Lanzone, Antonio

doi:10.1093/humrep/del306

Cited by 76 publications

(56 citation statements)

References 33 publications

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“…Preadipocytes are known to have androgen receptors and high androgen levels have been shown to induce selective IR in cultured adipocytes (Belosi et al, 2006). Also, long term androgen administration in female-to-male transsexuals has been shown to induce the development of abdominal obesity and IR (Elbers et al, 2003).…”

Section: Pcos and Obesitymentioning

confidence: 99%

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Rachoń

Teede

2010

Molecular and Cellular Endocrinology

136

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Insulin resistance (IR) is a consequence of obesity, and in women it is often inextricably linked with ovarian function leading to clinical reproductive manifestations such as early menarche onset, subfertility and polycystic ovary syndrome (PCOS). Likewise, the dramatic fall in oestrogen production after menopause may contribute to weight gain and changes in adipose tissue distribution.Overall, women who are obese, especially those with reproductive complications including PCOS, have been identified as specific high risk subgroups for further progression through to prediabetes, type 2 diabetes mellitus (T2DM) and potentially cardiovascular disease (CVD). This review focuses on the interrelationship between the ovarian function and obesity as well as its treatment strategies.

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Section: Pcos and Obesitymentioning

confidence: 99%

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Rachoń

Teede

2010

Molecular and Cellular Endocrinology

136

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“…27 However, in research settings, subdividing PCOS into more discrete categories is imperative if we are to clearly define incidence, degree of symptomology and health risks among all variants of PCOS (Table 3). [28][29][30][31][32] In the most comprehensive study aimed at evaluating the phenotypic spectrum of PCOS, DiamantiKandarakis et al showed hyperandrogenic and anovulatory phenotypes of PCOS to be the most insulin resistant-irrespective of BMI or central adiposity. 33 Their approach to elucidating differences among PCOS phenotypes involved a number of physicians and ultrasonographers working cooperatively to diagnose and evaluate a large study population.…”

Section: Elucidating the Phenotypic Spectrum Of Polycystic Ovary Syndmentioning

confidence: 99%

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

Lujan

Chizen

Pierson

2008

Journal of Obstetrics and Gynaecology Canada

148

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It is estimated that as many as 1.4 million Canadian women may be afflicted with polycystic ovary syndrome (PCOS). Although PCOS is heralded as one of the most common endocrine disorders occurring in women, its diagnosis, management, and associated long-term health risks remain controversial. Historically, the combination of androgen excess and anovulation has been considered the hallmark of PCOS. To date, while these symptoms remain the most prevalent among PCOS patients, neither is considered an absolute requisite for the syndrome. Inclusion of ultrasonographic evidence of polycystic ovaries as a diagnostic marker has substantially broadened the phenotypic spectrum of PCOS, yet much debate surrounds the validity of these newly identified milder variants of the syndrome. Difficulty in resolving the spectrum of PCOS stems from the continued use of inconsistent and inaccurate methods of evaluating androgen excess, anovulation, and polycystic ovaries on ultrasound. At present, there is no clear-cut definition of biochemical hyperandrogenemia, particularly since we depend on poor laboratory standards for measuring androgens in women. Clinical signs of hyperandrogenism are ill-defined in women with PCOS, and the diagnosis of both hirsutism and polycystic ovarian morphology remains alarmingly subjective. Lastly, there is an inappropriate tendency to assign ovulatory status solely on the basis of menstrual cycle history or poorly timed endocrine measurements. In this review, we elaborate on these limitations and propose possible resolutions for clinical and research settings. By stimulating awareness of these limitations, we hope to generate a dialogue aimed at solidifying the evaluation of PCOS in Canadian women.

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“…However, Asian women with PCOS are less likely to have metabolic dysfunction, IR, and obesity compared with Caucasian women with PCOS (15)(16)(17). There is little data on omentin levels within the context of PCOS (18,19).…”

Section: Introductionmentioning

confidence: 99%

Plasma omentin-1 levels are reduced in non-obese women with normal glucose tolerance and polycystic ovary syndrome

Choi¹,

Rhee²,

Kim³

et al. 2011

European Journal of Endocrinology

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Objective: Omentin-1 is a novel adipokine that increases insulin sensitivity and is expressed in visceral adipose tissue. The aim of this study was to determine the metabolic parameters that influence plasma omentin-1 levels in women with polycystic ovary syndrome (PCOS). Design and methods: A cross-sectional study was performed in 87 women with PCOS and 53 body mass index (BMI)-matched healthy controls including 39 non-obese, normal-weight (NW) PCOS women with normal glucose tolerance (NGT) and 44 BMI-and homeostasis model assessment (HOMA)-matched controls. Indices of insulin sensitivity, metabolic variables, circulating androgen levels, serum adiponectin, and omentin-1 levels were measured. A 75 g oral glucose tolerance test was performed in all participants. Results: Plasma omentin-1 levels were significantly lower in women with PCOS compared with those in BMI-matched controls (P!0.001). A significantly lower level of plasma omentin-1 was observed in non-obese women with PCOS and NGT compared with that in BMI-and HOMA-matched controls (P!0.001). Omentin-1 level was negatively correlated with BMI, indices of insulin sensitivity, and circulating androgens and was associated with greater 2 h postprandial glucose, C-peptide, and insulin levels compared with fasting values. Within the NW and NGT groups, omentin-1 levels remained negatively correlated with BMI, 2 h postprandial C-peptide, and circulating androgens and demonstrated a negative linear trend according to quartile of free testosterone (PZ0.028). Conclusions: Plasma levels of omentin-1 were reduced in non-obese women with PCOS and NGT. Postprandial hyperinsulinemia and hyperglycemia contributed more to lower omentin-1 levels than did fasting values in the setting of PCOS. Increased androgen levels contributed to decreased omentin-1 levels in women with PCOS.

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Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma?

Abstract: In the grey area between NIH and ESHRE/ASRM classifications, UCSC criteria could identify a subgroup of women, missed by NIH criteria, with more pronounced stigmas than those identified by ESHRE/ASRM criteria alone, and who may profit more from a targeted therapy.

Cited by 76 publications

References 33 publications

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

Plasma omentin-1 levels are reduced in non-obese women with normal glucose tolerance and polycystic ovary syndrome

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