Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-age women. Important factors in its pathogenesis are hyperinsulinaemia and insulin resistance, which lead to higher risk of metabolic syndrome (MetS) and its complications. With the implementation of the Rotterdam diagnostic criteria in 2003, the group of PCOS patients became highly heterogeneous, with varying metabolic risk reported for different phenotypes of the syndrome. The aim of the present review is to assess the prevalence and severity of MetS and its components in patients with the four phenotypes of PCOS. A comprehensive search of Pubmed database was performed to identify studies comparing metabolic characteristics between PCOS patients with different phenotypes of the syndrome. The results of 60 studies published between 2004 and 2020 were retrieved and analysed. More adverse metabolic profile was observed in PCOS patients with hyperandrogenic phenotypes in comparison to normoandrogenic patients, as well as in classic phenotypes, defined by National Institutes of Health criteria, in comparison to newer phenotypes introduced by the Rotterdam criteria. In the majority of observations, normoandrogenic PCOS patients did not differ significantly from controls in terms of metabolic characteristics, although some East Asian studies reported more adverse metabolic profile in normoandrogenic phenotype in comparison to healthy women. In conclusion, metabolic abnormalities in PCOS seem to be associated with joint effects of hyperandrogenism, insulin resistance and visceral obesity. The differences observed between the four phenotypes of PCOS underline the need for individualised diagnostic and therapeutic approach.

Waist Circumference Is an Essential Factor in Predicting Insulin Resistance and Early Detection of Metabolic Syndrome in Adults

“…Met-S multiplies the risk of type 2 diabetes by five [ 2 , 3 ] and that of other cardiovascular diseases by three [ 2 , 4 ]. Similarly, people with Met-S also have a greater predisposition for polycystic ovaries in women [ 5 ]; nonalcoholic fatty liver, especially in men [ 6 ]; asthmatic symptoms [ 7 ]; sleep problems [ 8 ]; certain oncological processes [ 9 , 10 ]; and, in recent years, its relationship with sarcopenia has been evidenced [ 10 ].…”

Association between serum total testosterone levels and metabolic syndrome among adult women in the United States, NHANES 2011–2016

“…Although previous studies have reported that sex hormones are related to an increased cardiometabolic risk and mortality, including MetS, type 2 diabetes mellitus (T2DM), and hypertension (6)(7)(8), the roles of these hormones among women are poorly understood. Existing literature has indicated that testosterone deficiency or low serum total testosterone (TT) levels are correlated with an increased risk of MetS or its components in the male population (9)(10)(11), and an association between metabolic abnormalities and hyperandrogenism in young women with polycystic ovarian syndrome (PCOS) (12)(13)(14). However, the relationships between TT and MetS are inconsistent in the previous studies of women due to different research subjects under certain conditions (such as different ethnic, age group, patientbased samples, post-menopausal women, and small sample sizes) or different research types (7,(15)(16)(17)(18)(19)(20).…”

Serum Claudin-5 Level As A Predictor Of Changes In The Microvascular Endothelium In Young Women With Polycystic Ovary Syndrome

“…Claudins also regulate barrier function and pericellular permeability (Li et al, 2019) .An earlier research performed on women with PCOS demonstrated a relationship between DBP and hyperandrogenemia even after age and BMI adjustments, as well as an interaction between hyperandrogenemia and hypertension (Naghshband and Malini, 2022) Since metabolic syndrome includes high blood pressure, PCOS sufferers are more likely to develop atherosclerotic heart disease. Regardless of insulin resistance, higher blood pressure may be linked to hyperandrogenemia due to increased vascular stiffness and endothelial dysfunction (Krentowska and Kowalska, 2022).…”