Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Jacewicz-Święcka, Małgorzata; Kowalska, Irina

doi:10.1002/dmrr.3054

Cited by 33 publications

(22 citation statements)

References 174 publications

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“…It has also been observed that fat distribution is altered in PCOS patients and that this group presents greater tendency to increased VAT accumulation in comparison to the general population [17]. Moreover, it has been shown that VAT is associated with insulin resistance and increased metabolic risk in PCOS women [21], and that increased concentrations of androgens are connected with abdominal fat deposition [22]. Therefore, our results confirmed that phenotype A could be considered a phenotype with increased risk of obesity, type 2 diabetes, coronary heart disease and other metabolic disorders [23], and it may be related to significantly higher FAI in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes

Polak

Adamska

Krentowska

et al. 2020

JCM

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Insulin resistance and hyperandrogenemia observed in polycystic ovary syndrome (PCOS) are associated with metabolic disturbances and could be connected with body composition pattern. To date, several studies defining the parameters of body composition using dual energy X-ray absorptiometry (DXA) method in the group of PCOS patients have been published, however, without the analysis in different phenotypes. The aim of the present study was to investigate the relationships between serum androgens concentration, insulin resistance and distribution of fat mass using DXA method in various PCOS phenotypes according to the Rotterdam criteria. We examined 146 women: 34 (38%) had PCOS phenotype A, 20 (23%) phenotype B, 20 (23%) phenotype C and 15 (16%) phenotype D (with mean age of each phenotype 25 years), and 57 control subjects (mean age of 25.5 years). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum concentrations of testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S) were assessed and free androgen index (FAI) was calculated. In phenotypes A, B and C, we observed higher FAI in comparison to the control group (all p < 0.01). Serum concentrations of androstenedione and DHEA-S were higher in phenotypes A and C in comparison to the control group (all p < 0.01). However, only in phenotype A we found higher visceral adipose tissue (VAT) mass and android/gynoid ratio (A/G ratio) in comparison to the control group (all p < 0.01). In phenotype A, we observed connection of VAT with FAI (r = 0.58, p < 0.01). Accordingly, A/G ratio was related with FAI in all phenotypes (all p < 0.05). Additionally, in phenotype C, A/G ratio was related to serum concentrations of DHEA-S and androstenedione (r = 0.46, p = 0.03; r = 0.53, p = 0.01, respectively). We also found connections of HOMA-IR with VAT and A/G ratio in all phenotypes (all p < 0.05). Women with phenotype A had higher amount of VAT and A/G ratio in comparison to the control group. Serum concentration of androgens and insulin resistance are connected with VAT and A/G ratio in normoandrogenic and hyperandrogenic PCOS phenotypes.

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Section: Discussionmentioning

confidence: 99%

Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes

Polak

Adamska

Krentowska

et al. 2020

JCM

Self Cite

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“…Women with PCOS are also at an increased risk for the development of both T2DM and CVD risk factors with their higher rates of overweight/obesity including central obesity and dyslipidemia. Although predicted, a higher risk for CVD mortality has not so far been reported due to the paucity of population-based long-term studies [66,67].…”

Section: Women With Gestational Diabetes: a Special Female Populationmentioning

confidence: 99%

Do Women with Diabetes Need More Intensive Action for Cardiovascular Reduction than Men with Diabetes?

et al. 2020

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Purpose of Review This narrative review makes the case for greater efforts to reduce cardiovascular disease (CVD) risk in women with diabetes. Recent Findings In a recent meta-analysis including five CVOTs of diabetes medications with 46,606 subjects, women (vs men) with type 2 diabetes had a higher relative risk for stroke (RR 1.28; 95% CI 1.09, 1.50) and heart failure (1.30; 1.21, 1.40). Prior studies found higher “within-gender” RR for CVD mortality in women with diabetes although men have an absolute higher risk. Women with prior gestational diabetes mellitus (GDM) have a 2-fold higher CVD risk than the background population. Worse CVD and CVD risk factor management in women, as well as lower female therapy adherence, contribute further to these disparities. Summary The mechanism behind this excess risk includes biological, hormonal, socioeconomic, clinical, and behavioral factors that still require further investigation. The need for more intensive CVD reduction in women now includes more attention to screening for both incident diabetes and CVD risk factors among high-risk women.

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“…Consequently, the prevalence of metabolic syndrome (MetS) is found to be at least threefold higher in women with PCOS compared to general population [ 32 ] and is estimated at 33% to 47% [ 18 , 33 ]. Interestingly, although PCOS patients have a proven increased prevalence of cardiovascular disease risk factors, the risk of cardiovascular morbidity and mortality is still equivocal [ 34 , 35 ]. To explain this phenomenon, longitudinal studies with PCOS women should be conducted.…”

Section: Introductionmentioning

confidence: 99%

“…Although a lot of reports concerning metabolic consequences in PCOS have been published, almost all of them were designed as cross-sectional studies. There is a paucity of studies with long-term follow-up in which the detailed metabolic profile in women with PCOS was re-evaluated [ 35 ] and therefore, the course and development of metabolic disorders as well as the factors which impact on the subsequent complications in women with PCOS are poorly explored. The main aim of the present study was to determine the impact of ageing on glucose metabolism, insulin sensitivity, anthropometric parameters, lipid profile and values of blood pressure (BP) in a cohort of 31 women with previously diagnosed PCOS according to the Rotterdam criteria.…”

Section: Introductionmentioning

confidence: 99%

Changes in Metabolic Profile in the Women with a History of PCOS—A Long-Term Follow-Up Study

Jacewicz-Święcka

Kowalska

2020

JCM

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Data concerning metabolic consequences in women with polycystic ovary syndrome (PCOS) are delivered mainly by cross-sectional studies. In this research, we re-examined 31 Caucasian PCOS women after a median period of 120.9 months to evaluate the changes in metabolic syndrome components. Clinical examination, oral glucose tolerance test with estimations of glucose and insulin, lipids, sex hormone-binding globulin (SHBG) and sex hormones assessments were performed on two occasions. Additionally, the euglycaemic hyperinsulinaemic clamp technique was used at the baseline to assess insulin sensitivity (M-clamp value). In the end, the median age of participants was 35. We observed an increase in glucose concentrations, a decrease in insulin concentrations and no changes in insulin resistance markers. Final mean glucose, mean insulin, Matsuda index and body mass index (BMI) were correlated with baseline M-clamp value and SHBG (p < 0.01). During the follow-up, no one in the sample developed diabetes. The annualised incidence rate for conversion from normoglycaemia to prediabetes totalled 4.5%. Baseline BMI, free androgen index, fasting glucose and M-clamp value were identified as prediabetes predictors in young PCOS women (respectively, OR = 1.17, OR = 1.42, OR = 1.2, OR = 0.73, p < 0.05). Prediabetes appeared in 76.47% of the women with a final BMI of ≥ 25 kg/m2 and in 7.14% of the normal-weight women (p = 0.0001). In conclusion, we report a high rate of adverse change in glucose metabolism in overweight and obese participants, a deterioration in β-cell function and strong correlations between metabolic parameters assessed in the third and the fourth decade in PCOS women, emphasising the role of early intervention to prevent cardiometabolic diseases.

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Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Cited by 33 publications

References 174 publications

Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes

Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes

Do Women with Diabetes Need More Intensive Action for Cardiovascular Reduction than Men with Diabetes?

Changes in Metabolic Profile in the Women with a History of PCOS—A Long-Term Follow-Up Study

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