Polycystic Ovary Syndrome in Asian Women

Yamamoto

et al. 2020

Endocrine Connections

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.

Section: Discussionmentioning

confidence: 70%

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

Yamamoto

et al. 2020

Endocrine Connections

“…Distinct features in women with PCOS, insulin resistance and compensatory hyperinsulinemia, lead to hyperandrogenemia due to increased ovarian androgen production and decreased production of sex hormone binding globulin [42,43]. Since hyperinsulinemia has been implicated as a significant cause of anovulation, many investigators hypothesized that a reduction of systemic insulin serum levels would result in an improvement of ovulatory function and overall fecundity in PCOS women.…”

Section: Discussionmentioning

confidence: 99%

Metformin therapy in a hyperandrogenic anovulatory mutant murine model with polycystic ovarian syndrome characteristics improves oocyte maturity during superovulation

et al. 2011

BackgroundMetformin, an oral biguanide traditionally used for the treatment of type 2 diabetes, is widely used for the management of polycystic ovary syndrome (PCOS)-related anovulation. Because of the significant prevalence of insulin resistance and glucose intolerance in PCOS patients, and their putative role in ovulatory dysfunction, the use of metformin was touted as a means to improve ovulatory function and reproductive outcomes in PCOS patients. To date, there has been inconsistent evidence to demonstrate a favorable effect of metformin on oocyte quality and competence in women with PCOS. Given the heterogeneous nature of this disorder, we hypothesized that metformin may be beneficial in mice with aberrant metabolic characteristics similar to a significant number of PCOS patients. The aim of this study was to gain insight into the in vitro and in vivo effects of metformin on oocyte development and ovulatory function.MethodsWe utilized metformin treatment in the transgenic ob/ob and db/db mutant murine models which demonstrate metabolic and reproductive characteristics similar to women with PCOS. Results: Metformin did not improve in vitro oocyte maturation nor did it have an appreciable effect on in vitro granulosa cell luteinization (progesterone production) in any genotype studied. Although both mutant strains have evidence of hyperandrogenemia, anovulation, and hyperinsulinemia, only db/db mice treated with metformin had a greater number of mature oocytes and total overall oocytes compared to control. There was no observed impact on body mass, or serum glucose and androgens in any genotype.ConclusionsOur data provide evidence to suggest that metformin may optimize ovulatory performance in mice with a specific reproductive and metabolic phenotype shared by women with PCOS. The only obvious difference between the mutant murine models is that the db/db mice have elevated leptin levels raising the questions of whether their response to metformin is related to elevated leptin levels and/or if a subset of PCOS women with hyperleptinemia may be responsive to metformin therapy. Further study is needed to better define a subset of women with PCOS that may be responsive to metformin.

J of Obstet and Gynaecol

“…There are very few studies on the association of metabolic parameters with subcutaneous fat in patients with PCOS. Moreover, Asian women with PCOS are leaner than those from Western countries, therefore fat distribution may be different compared with Western women . Several investigations in Western countries shows that visceral fat in PCOS patients is higher than in the control group, and that the PCOS group has an android pattern of fat distribution, but there are few studies on Asian women with PCOS.…”

Section: Introductionmentioning

confidence: 99%

Body fat distribution and its associated factors in Korean women with polycystic ovary syndrome

Jin

Yuk

Choi³

et al. 2015