The prevalence of obstructive sleep apnoea in women with polycystic ovary syndrome: a systematic review and meta-analysis

Kahal, Hassan; Kyrou, Ioannis; Uthman, Olalekan A.; Brown, Anna; Johnson, Samantha; Wall, Peter; Metcalfe, Andrew; Parr, David; Tahrani, Abd; Randeva, Harpal S.

doi:10.1007/s11325-019-01835-1

Cited by 53 publications

(32 citation statements)

References 73 publications

(94 reference statements)

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“…It is one of the earliest symptoms of obstructive sleep apnea (OSA), which is a complex disorder characterized by repetitive collapse of the pharyngeal airway during sleep [24]. Previous studies have reported that PCOS is associated with a reduction in REM sleep stage time and increased risk for OSA [25][26][27]. Alerted reproductive hormone secretion (i.e.…”

Section: Discussionmentioning

confidence: 99%

Lifestyle and environmental contributions to ovulatory dysfunction in women of polycystic ovary syndrome

et al. 2020

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Background: Polycystic ovary syndrome (PCOS) is the most common reason of anovulatory infertility. Environmental factor is one of the main causes of PCOS, but its contribution to ovulatory dysfunction in PCOS remains unknown. Methods: A total of 2217 infertile women diagnosed as PCOS according to Rotterdam criteria were recruited, including 1979 women with oligo-anovulation (OA group) and 238 women with normal-anovulation (non OA group). Besides, 279 healthy control women of reproductive age were enrolled as controls. Results: Frequencies of snoring (PCOS-OA group, PCOS-non-OA group, control group: 29.30% vs 18.10% vs 11.50%, P < 0.01), smoking (37.70% vs 28.10% vs 12.20%, P < 0.01), plastic tableware usage (38.30% vs 28.10% vs 25.40%, P < 0.01) and indoor decoration (32.10% vs 24.80% vs 16.80%, P < 0.01) were highest in PCOS-OA group. After adjusted for multivariable, difference remained significant between PCOS-OA group and the other two groups. PCOS-OA women preferred a meat favorable diet compared to PCOS-non-OA group (54.60% vs 41.30%, P < 0.01). There was no difference between three groups in exercise, frequency of insomnia, and alcohol consumption. Conclusions: Smoking, snoring, hyper-caloric diet, plastic tableware usage and indoor decoration were found to be associated with an increased risk for ovulatory dysfunction in women suffering from PCOS.

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Section: Discussionmentioning

confidence: 99%

Lifestyle and environmental contributions to ovulatory dysfunction in women of polycystic ovary syndrome

et al. 2020

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“…57 Furthermore, total white cell count, due to a higher mean neutrophil count, has been found to be significantly greater in women with PCOS when compared to control subjects, despite matching for BMI and insulin resistance. 58,59 Also, as women with obesity and PCOS are at increased risk of developing obstructive sleep apnea (OSA), 60,61 this could be considered a contributing factor. However, while there are multiple studies that have shown a positive association between OSA and the neutrophil to lymphocyte ratio, [62][63][64][65] a value sensitive to physiologic stress, few studies have independently associated OSA with leukocytosis, though it has been noted.…”

Section: Sex Differencesmentioning

confidence: 99%

The hematologic consequences of obesity

Purdy

Shatzel

2020

European J of Haematology

117

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The prevalence of obesity is increasing and progressively influencing physician‐patient interactions. While there is a sizable amount of data demonstrating that obesity is a state of low‐grade inflammation, to our knowledge, there is no single review summarizing its effects on hematologic parameters and thrombotic risk. We performed a literature search which largely surfaced observational studies, with a few systematic reviews and meta‐analyses of these studies. We took care to review the mechanisms driving an inflammatory state and obesity's effect on white blood cells, red blood cells, platelets, and thrombotic risk. There is an observed relative, and sometimes absolute leukocytosis driven by this inflammatory state. Obesity is also associated with increased platelet counts and an increased risk for venous thromboembolism (VTE). Lastly, the association between obesity, iron deficiency (ID), and red blood cell counts may be present but remains uncertain. Recognizing the above associations may provide clinicians with reassurance regarding otherwise unexplained hematologic abnormalities in obese individuals. We hope this review will prompt future studies to further understand the underlying mechanisms driving these abnormalities and identify modifiable risk factors and potential therapeutic targets to prevent the development of probable obesity‐associated conditions with significant morbidity and mortality, such as ID and VTE.

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“…Insulin resistance could be a mediator of metabolic risk in women with PCOS ( 36 ) and this hypothesis should be further evaluated in future studies. Obstructive sleep apnea is associated with higher risk of metabolic disease including HT ( 37 ). The risk of obstructive sleep apnea in normal weight women with PCOS and HT should be further investigated in future studies.…”

Section: Discussionmentioning

confidence: 99%

Higher blood pressure in normal weight women with PCOS compared to controls

Mellembakken

Mahmoudan

Mørkrid

et al. 2021

Endocrine Connections

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Objective: Obesity is considered to be the strongest predictive factor for cardio-metabolic risk in women with polycystic ovary syndrome (PCOS). The aim of the study was to compare blood pressure (BP) in normal weight women with PCOS and controls matched for age and BMI? Methods: From a Nordic cross-sectional base of 2,615 individuals of Nordic ethnicity, we studied a sub cohort of 793 normal weight women with BMI<25 kg/m2 (512 women with PCOS according to Rotterdam criteria and 281 age and BMI-matched controls). Participants underwent measurements of BP and body composition (BMI, waist-hip ratio), lipid status, and fasting BG. Data were presented as median (quartiles). Results: The median age for women with PCOS were 28 (25; 32) years, and median BMI was 22.2 (20.7; 23.4) kg/m2. Systolic BP was 118 (109; 128) mmHg in women with PCOS compared to 110 (105; 120) mmHg in controls, and diastolic BP was 74 (67; 81) vs. 70 (64; 75) mmHg, both p<0.001. The prevalence of women with BP ≥140/90 mmHg was 11.1% (57/512) in women with PCOS vs. 1.8% (5/281) in controls, p<0.001. In women ≥ 35 years the prevalence of BP ≥140/90 mmHg was comparable in women with PCOS and controls (12.7% vs. 9.8%, p=0.6). Using multiple regression analyses, the strongest association with BP was found for waist circumference, fasting BG and total cholesterol in women with PCOS. Conclusions: Normal weight women with PCOS have higher BP than controls. BP and metabolic screening are relevant also in young normal weight women with PCOS.

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The prevalence of obstructive sleep apnoea in women with polycystic ovary syndrome: a systematic review and meta-analysis

Cited by 53 publications

References 73 publications

Lifestyle and environmental contributions to ovulatory dysfunction in women of polycystic ovary syndrome

Lifestyle and environmental contributions to ovulatory dysfunction in women of polycystic ovary syndrome

The hematologic consequences of obesity

Higher blood pressure in normal weight women with PCOS compared to controls

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