Risk of metabolic complications in the new PCOS phenotypes based on the Rotterdam criteria

Shroff, Rupal; Syrop, Craig H.; Davis, William A.; Voorhis, Bradley J. Van; Dokras, Anuja

doi:10.1016/j.fertnstert.2007.01.032

Cited by 179 publications

(161 citation statements)

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“…The prevalence of metabolic syndrome was 30-40 % in the study conducted by Shroff et al [20] and 35.07 % in Kar et al [15]. It is also observed that the prevalence of metabolic syndrome was higher in phenotype A in other studies [15,17,21]. Strongest positive association of metabolic syndrome was observed for systolic and diastolic blood pressure followed by waist circumference, triglyceride level, HDL level and lowest with fasting glucose levels.…”

Section: Discussionmentioning

confidence: 81%

Endocrine and Metabolic Profile of Different Phenotypes of Polycystic Ovarian Syndrome

Saxena

Shivani

Bhattacharjee

2016

J Obstet Gynecol India

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Background Polycystic ovarian syndrome (PCOS) is a common endocrinopathy associated with wide heterogeneity and serious clinical implications. Prevalence and characteristics of different phenotypes are not well defined. Therefore, this study was planned to determine the prevalence of four phenotypes of PCOS and to evaluate their endocrine and metabolic parameters including insulin resistance and metabolic syndrome with respect to controls. Methods This observational, case-control study was conducted in the gynecology outpatient department of a tertiary care center where 161 PCOS and 50 non-PCOS women were recruited and investigated.Results All phenotypes of PCOS had higher BMI with respect to controls (P \ 0.000). Overweight women were maximum in phenotype H ? O followed by phenotype H ? P. Significantly higher levels of luteinizing hormone (P \ 0.01), testosterone (P \ 0.0001), were observed in all phenotypes of PCOS as compared to controls. Serum cholesterol (P \ 0.026) and triglycerides (P \ 0.05) were significantly higher in all PCOS phenotypes compared to controls. Levels of fasting (P \ 0.000) and post-prandial

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Section: Discussionmentioning

confidence: 81%

Endocrine and Metabolic Profile of Different Phenotypes of Polycystic Ovarian Syndrome

Saxena

Shivani

Bhattacharjee

2016

J Obstet Gynecol India

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“…In turn, hyperinsulinemia stimulates androgens www. journals.viamedica.pl/ginekologia_polska synthesis in ovaries, closing the vicious circle [5]. Therefore, we have aimed at analyzing whether (TT/DHT) may be helpful in predicting metabolic risk not only in PCOS patients but also in healthy women not meeting PCOS criteria.…”

Section: Introductionmentioning

confidence: 99%

Total testosterone to dihydrotestosterone ratio assessed by LC-MS/MS predicts a worse metabolic profile not only in PCOS patients

et al. 2017

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Objectives: Total testosterone/dihydrotestosterone ratio (TT/DHT) was found to determine metabolic risk in polycystic ovary syndrome (PCOS). The aim of this study was to analyze whether (TT/DHT) may be helpful in predicting metabolic risk not only in PCOS patients but also in healthy women. Material and methods:Total testosterone (TT), dihydrotestosterone (DHT), androstendione and dehydroepiandrosterone sulphate (DHEA-S) were measured by LC-MS/MS in 36 women with PCOS and in 29 age-matched controls without clinical hyperandrogenism. In all participants, anthropometric data, lipids, adipose tissue percent (%fat), HOMA-IR were also assessed. Results:The studied groups were not different in terms of age, BMI, waist circumference, %fat and HOMA-IR. In the patients group, mean TT and androstendione levels were significantly higher as compared to controls (1.4 nmol/L vs. 1.0 nmol/L, P < 0.001) and (6.6 nmol/L vs. 4.9 nmol/L, P < 0.01), respectively. In the patients group, mean TT/DHT ratio was significantly higher compared to controls (3.6 vs. 2.7, P < 0.01) and correlated with BMI (r = 0.37, P < 0.05), waist circumference (r = 0.44, P < 0.01), %fat (r = 0.30, P < 0.05), as well as with insulin levels (r = 0.38, P < 0.05) and HOMA-IR (r = 0.44, P < 0.05). The association between TT/DHT ratio and unfavorable metabolic parameters was also seen in controls. Conclusion:Total testosterone/dihydrotestosterone ratio assessed by LC-MS/MS correlates with a worse metabolic profile not only in PCOS patients, but also in healthy women.

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“…Por otro lado, se desconoce si este grupo de individuos posee los mismos riesgos cardiovasculares y reproductivos que las pacientes SOP según los criterios del NIH (7). En efecto, en un estudio retrospectivo cuyo objetivo eran determinar el riesgo relativo del SM en pacientes con SOP según los criterios de Rotterdam, se encontró que el fenotipo no androgénico de ovarios poliquísticos y oligoamneorrea (fenotipo D) presentaba el mismo riesgo que las pacientes controles sanas no SOP, incluso en las mujeres obesas (16). De esta forma, frente a la controversia de aumentar la heterogeneidad del SOP y con la débil evidencia disponible sobre los nuevos fenotipos, algunos grupos consideran muy prematuro adoptar los nuevos criterios de Rotterdam, ya que podrían significar efectos negativos a nivel de la práctica clínica, investigación científica y calidad de vida de las pacientes (14).…”

Section: Discussionunclassified

“…Desde este punto de vista, surge la interrogante sobre la validez de los dos nuevos fenotipos incorporados al síndrome, ovarios poliquísticos con oligoamenorrea y ovarios poliquísticos con hiperandrogenismo (fenotipos D y C). No está claro aún que estos últimos fenotipos, no así con los fenotipos NIH, posean igualmente mal pronóstico reproductivo o representen factores de riesgo cardiovascular a largo plazo, sobretodo con la ausencia de hiperandrogenismo (13,14,15,16).…”

Section: Discussionunclassified

“…En efecto, es sabido que el SOP representa un factor de riesgo para abortos espontáneos, abortos recurrentes, restricción del crecimiento intrauterino (RCIU), diabetes gestacional y preeclampsia, pero no se sabe si ocurren en igual medida con cada uno de estos nuevos fenotipos (8,19,20). Del mismo modo, el SOP representa un importante factor de riesgo cardiovascular, con mayor prevalencia de SM, insulino resistencia y diabetes mellitus, desconociéndose si todos los fenotipos son igualmente riesgosos (16).…”

Section: Discussionunclassified

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Espectro Fenotípico Del Síndrome De Ovario Poliquístico

2010

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: El síndrome de ovario poliquístico (SOP) es la endocrinopatía más frecuente en la mujer de edad reproductiva, de etiología incierta y presentación clínica heterogénea. Su diagnóstico y definición es aún controversial. La introducción de los criterios del Consenso de Rotterdam generó nuevos fenotipos al incorporar la ecografía transvaginal como elemento diagnóstico, aumentando aún más la heterogeneidad del síndrome. Objetivo: Determinar en una cohorte consecutiva de 102 pacientes con diagnóstico de SOP, su frecuencia, las características clínicas, hormonales y metabólicas, de los cuatro fenotipos posibles según Rotterdam. Resultados: Fenotipo A 62%, Fenotipo B 21%, Fenotipo C 9% y Fenotipo D 8%. El síndrome metabólico se presentó en 29% de las pacientes, siendo mayor en los fenotipos A (30%) y B (43%) que en los fenotipos C (11%) y D (13%). El 82% presentaba sobrepeso, siendo significativamente mayor en los fenotipos A (88%) y B (90%). Hubo diferencias significativas al comparar las variables puntaje de hirsutismo, SHBG, testosterona total, IAL, volumen ovárico, colesterol total, colesterol HDL, colesterol LDL y glicemia en ayuno. No existieron diferencias significativas entre los grupos al comparar las variables edad, IMC, DHEA-SO4 y triglicéridos. Conclusión: El consenso de Rotterdam agruparía a diferentes fenotipos en un mismo síndrome, que podrían representar distintos grados de severidad de una misma enfermedad. Se desconoce si estos fenotipos poseen los mismos riesgos a largo plazo y sería apresurado tratarlos como una misma entidad.PALABRAS CLAVE: Síndrome ovario poliquístico, síndrome metabólico, hirsutismo, hiperandrogenismo, obesidad, riesgo cardiovascular SUMMARYBackground: Policystic ovary syndrome (PCOS) is a very common endocrine disease in women of reproductive age, of uncertain etiology and heterogeneous clinical presentation. The introduction of the Rotterdams Consensus criteria generated new phenotypes by incorporating transvaginal ultrasound, thus increasing the heterogenity of PCOS. Objectives: To determine in a cohort of 102 patients with the diagnosis of PCOS the prevalence, clinical, hormonal and metabolic profile according to Rotterdam. Results: It was determined the Phenotype A 62% Phenotype B 21%, Phenotype C 9% and Phenotype D 8% of the patients. The metabolic syndrome was present in 29% of the PCOS patients, being it more frequent in the phenotypes A (30%) and B (43%) than C (11%) and D (13%). The 82% of the patients were overweigth, especially in the phenotypes A (88%) and B (90%). Also, statistically significant differences were observed when comparing the variables score of hirsutism, free androgen index, total testosterone, HDL cholesterol SHBG, ovarian volume, total cholesterol, glycemia and LDL cholesterol. There were no significant differences between the groups to compare variables such as age, BMI, DHEA and triglycerides. Conclusion: These findings indicate that the

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Risk of metabolic complications in the new PCOS phenotypes based on the Rotterdam criteria

Cited by 179 publications

References 26 publications

Endocrine and Metabolic Profile of Different Phenotypes of Polycystic Ovarian Syndrome

Endocrine and Metabolic Profile of Different Phenotypes of Polycystic Ovarian Syndrome

Total testosterone to dihydrotestosterone ratio assessed by LC-MS/MS predicts a worse metabolic profile not only in PCOS patients

Espectro Fenotípico Del Síndrome De Ovario Poliquístico

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