1
|
Espinosa ME, Sánchez R, Otzen T, Bautista-Valarezo E, Aguiar S, Corrales-Gutierrez I, Leon-Larios F, Manterola C. Phenotypic Characterization of Patients with Polycystic Ovary Syndrome in a Population from the Ecuadorian Andes: A Cross-Sectional Study. J Clin Med 2024; 13:2376. [PMID: 38673649 PMCID: PMC11051537 DOI: 10.3390/jcm13082376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder in women of reproductive age. Diagnosis is based on the evidence-based international guideline 2018 and the Rotterdam Consensus to classify PCOS phenotypes. This study aims to characterize the biodemographic, clinical, metabolic, and reproductive variables and their relationship with PCOS phenotypes in a population from the Ecuadorian Andes. Methodology: A cross-sectional study was conducted with a non-random consecutive sample of 92 women who attended the outpatient gynecology and endocrinology clinic at the Hospital of the Technical University of Loja (UTPL)-Santa Inés, Loja, Ecuador, between January 2022 and July 2023. Descriptive statistics, mean calculations, standard deviation, parametric and nonparametric tests, odds ratios (OR), confidence intervals (CI), and p-values were employed. Results: The average age was 22 ± 3.4 years, with a predominantly mestizo, urban, single, highly educated, and medium-high socioeconomic level population. It was identified that phenotypes A + B are at a higher risk of developing oligomenorrhea and hypertriglyceridemia compared to phenotypes C + D, with statistically significant differences (p < 0.05). Furthermore, in terms of reproductive variables, phenotypes A + B exhibit a significantly higher frequency of elevated anti-Müllerian hormone (AMH) compared to phenotypes C + D, also with statistical significance (p < 0.05). Conclusions: The classical phenotypes A and B of PCOS are the most common in Ecuadorian Andean women and carry a higher risk of insulin resistance, anovulation, metabolic disorders, and elevated triglyceride levels compared to phenotypes C and D. Ethnic diversity and sociocultural habits influence the prevalence and clinical manifestations of these phenotypes.
Collapse
Affiliation(s)
- María Elena Espinosa
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Health Sciences Department, Universidad Técnica Particular de Loja, UTPL, San Cayetano alto s/n, Loja 1101608, Ecuador; (E.B.-V.); (S.A.)
| | - Raúl Sánchez
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Center of Excellence in Translational Medicine-Scientific and Technological Bioresource (CEMT-BIOREN), Temuco 4780000, Chile
| | - Tamara Otzen
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Millennium Nucleus on Sociomedicine, Santiago 7560908, Chile
| | - Estefanía Bautista-Valarezo
- Health Sciences Department, Universidad Técnica Particular de Loja, UTPL, San Cayetano alto s/n, Loja 1101608, Ecuador; (E.B.-V.); (S.A.)
| | - Stephanie Aguiar
- Health Sciences Department, Universidad Técnica Particular de Loja, UTPL, San Cayetano alto s/n, Loja 1101608, Ecuador; (E.B.-V.); (S.A.)
| | - Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, Faculty of Medicine, University of Seville, 41004 Seville, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41004 Seville, Spain;
| | - Carlos Manterola
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Millennium Nucleus on Sociomedicine, Santiago 7560908, Chile
| |
Collapse
|
2
|
Han W, Zhang M, Wang H, Yang Y, Wang L. Lipid accumulation product is an effective predictor of metabolic syndrome in non-obese women with polycystic ovary syndrome. Front Endocrinol (Lausanne) 2024; 14:1279978. [PMID: 38269246 PMCID: PMC10807289 DOI: 10.3389/fendo.2023.1279978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024] Open
Abstract
Objective To explore the correlation of lipid accumulation product (LAP) with metabolic syndrome (MS) and to assess the predictive value of LAP for MS risk in polycystic ovary syndrome (PCOS) with different body mass index (BMI). Methods A total of 242 PCOS patients and 150 controls were recruited and divided into normal-weight, overweight, and obese groups, then further divided into MS and without MS subgroups. Clinical and anthropometric variables and laboratory results were recorded. LAP was calculated from waist circumference (WC) and triglyceride using sex-specific formulae. Logistic regression analysis and receiver operating characteristic (ROC) curve were applied to determine and analyze the predictive value of LAP for MS. Results The prevalence of MS among PCOS patients was 45.04%, which was significantly higher than that of the controls (10%). Stratified by BMI, the incidence of MS in the normal-weight, overweight, and obese PCOS groups were 15.58%, 41.43%, and 71.58%, respectively. Logistic regression analysis indicated that LAP was an independent risk factor for MS in both normal-weight and overweight groups; however, the results were not significant in the obese group. ROC curve analysis showed that LAP had an outstanding discrimination index for MS in normal-weight (AUC=0.960, cut-off value=42.5) and overweight (AUC=0.937, cut-off value=47.93) PCOS patients, with a sensitivity of 0.917/0.931 (normal-weight/overweight) and a specificity of 0.969/0.854 (normal-weight/overweight), respectively. Conclusion Normal-weight and overweight PCOS patients also have a fairly high incidence of MS and should receive as much attention as obese patients. Compared to applying multiple clinical indicators, LAP is more convenient and facilitates acquiring early and accurate diagnoses of MS among non-obese PCOS patients using fewer MS markers.
Collapse
Affiliation(s)
- Wenju Han
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
- School of Public Health, China Medical University, Shenyang, China
| | - Meiwei Zhang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Haiyan Wang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Yitian Yang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Lei Wang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| |
Collapse
|
3
|
Naz MSG, Rahnemaei FA, Tehrani FR, Sayehmiri F, Ghasemi V, Banaei M, Ozgoli G. Possible cognition changes in women with polycystic ovary syndrome: a narrative review. Obstet Gynecol Sci 2023; 66:347-363. [PMID: 37376796 PMCID: PMC10514592 DOI: 10.5468/ogs.22165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/15/2022] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Nowadays, polycystic ovary syndrome (PCOS) and cognitive dysfunction are major health problems among female. This narrative review aimed to investigate cognitive dysfunction in female with PCOS. English and Persian articles published in PubMed, Scopus, Web of Science, Google Scholar, PsycINFO, Scientific Information Database, and Cochrane Database of Systematic Reviews until May 2022 were searched. Sixteen studies involving 850 female with PCOS and 974 controls were assessed. In these studies, the association between biochemical factors and symptoms of PCOS and memory, attention, executive functioning, information processing speed, and visuospatial skills was evaluated. The literature review revealed the possible cognitive changes in female with PCOS. This study summarized the different aspects of cognitive function in female with PCOS due to medication, psychological problems (mood disorders caused by disease symptoms and complications), and biochemical markers, such as metabolic and sex hormone abnormalities. Considering the existing scientific gap regarding the possibility of cognitive complications in female with PCOS, further biological studies should be conducted to evaluate the potential mechanisms involved.
Collapse
Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Alsadat Rahnemaei
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht,
Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Sayehmiri
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Vida Ghasemi
- Department of Nursing, Asadabad School of Medical Sciences, Asadabad,
Iran
| | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas,
Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| |
Collapse
|
4
|
Ersak B, Özakşit G, Tugrul D, Doğanay M, Ustun Y, Kokanalı MK. Role of serum renalase levels in predicting the presence of metabolic syndrome in patients with polycystic ovary syndrome. Taiwan J Obstet Gynecol 2023; 62:417-422. [PMID: 37188446 DOI: 10.1016/j.tjog.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE This study was designed to compare the serum renalase levels of polycystic ovary syndrome (PCOS) women with and without metabolic syndrome (MS) and those of healthy non-PCOS women. MATERIALS AND METHODS Seventy-two patients diagnosed with PCOS and age-matched 72 healthy non-PCOS were included in the study. The PCOS group was divided into two groups as having metabolic syndrome or not. General gynecological and physical examination findings and laboratory results were recorded. Renalase levels in serum samples were determined using Enyzme-Linked ImmunoSorbent Assay method. RESULTS Mean serum renalase level was significantly higher in PCOS patients with MS compared with both PCOS patients without MS and healthy controls. Additionally, serum renalase correlates positively with body mass index, systolic and diastolic blood pressure, serum triglyceride and homeostasis model assessment-insulin resistance values among PCOS women. However, systolic blood pressure was found to be the only significant independent factor that can affect the serum renalase levels. A serum renalase level of 79.86 ng/L had a sensitivity of 94.7% and specificity of 46.4% in discriminating PCOS patients with metabolic syndrome from healthy women. CONCLUSIONS Serum renalase level increases in women with PCOS in the presence of metabolic syndrome. Therefore, monitoring the serum renalase level in women with PCOS can predict the metabolic syndrome that may develop.
Collapse
Affiliation(s)
- Burak Ersak
- Department of Obstetrics and Gynecology, University of Health Sciences, Zekai Tahir Burak Women Health Care, Training and Research Hospital, Ankara, Turkey.
| | - Gülnur Özakşit
- Department of Obstetrics and Gynecology, University of Health Sciences, Zekai Tahir Burak Women Health Care, Training and Research Hospital, Ankara, Turkey
| | - Duygu Tugrul
- Department of Obstetrics and Gynecology, University of Health Sciences, Zekai Tahir Burak Women Health Care, Training and Research Hospital, Ankara, Turkey
| | - Melike Doğanay
- Department of Obstetrics and Gynecology, University of Health Sciences, Zekai Tahir Burak Women Health Care, Training and Research Hospital, Ankara, Turkey
| | - Yaprak Ustun
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health and Research Hospital, Ankara, Turkey
| | - Mahmut Kuntay Kokanalı
- Department of Obstetrics and Gynecology, University of Health Sciences, Zekai Tahir Burak Women Health Care, Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
5
|
Moini A, Rezaee T, Aleyasin A, Arabipoor A, Moayed ME. The effect of metabolic syndrome on controlled ovarian stimulation outcome in infertile women with polycystic ovary syndrome undergoing assisted reproductive technology cycles. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:111-118. [PMID: 36155124 PMCID: PMC9983795 DOI: 10.20945/2359-3997000000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective To evaluate the effect of metabolic syndrome (MetS) diagnosis on oocyte quality and pregnancy outcomes in infertile women with polycystic ovary syndrome (PCOS) who undergoing antagonist-controlled ovarian stimulation (COS) and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Methods This prospective cohort study was conducted from November 2019 to November 2020 across two university-affiliated infertility centers in Iran. The PCOS diagnosis was defined according to the Rotterdam criteria. The patients prior to IVF/ICSI cycles were evaluated for MetS diagnosis. MetS was detected according to the National Cholesterol Education Program/Adult Treatment Panel III with the presence of at least three or more of the specific clinical criteria. The cycle outcomes were compared between MetS and non-MetS groups. Results Overall, 68 eligible infertile PCOS patients with MetS diagnosis and 126 without MetS participated. The MetS diagnosis was associated with the increased requirement of gonadotropins and the COS duration significantly (P = 0.001). Although the total numbers of retrieved and MII oocytes, obtained and topquality embryos as well as clinical pregnancy and live birth rates in the MetS group were lower than those of in the non-MetS group, the differences were not statistically significant (P > 0.05). In followup of the obstetrics complications, the rate of preeclampsia was significantly higher in patients with MetS (P = 0.02). Conclusion MetS diagnosis in PCOS patients was associated with non-significant poor COS and pregnancy outcome. Further studies with larger sample sizes are recommended to clarify the risk of MetS in patients undergoing ART cycles.
Collapse
Affiliation(s)
- Ashraf Moini
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran.,Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Tawoos Rezaee
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran, .,Infertility Ward, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Aleyasin
- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Arabipoor
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marzieh Eslami Moayed
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Krentowska A, Kowalska I. Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome. Diabetes Metab Res Rev 2022; 38:e3464. [PMID: 33988288 DOI: 10.1002/dmrr.3464] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/03/2021] [Indexed: 01/22/2023]
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.
Collapse
Affiliation(s)
- Anna Krentowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
| |
Collapse
|
7
|
Spritzer PM, Ramos RB, Marchesan LB, de Oliveira M, Carmina E. Metabolic profile of women with PCOS in Brazil: a systematic review and meta-analysis. Diabetol Metab Syndr 2021; 13:18. [PMID: 33593439 PMCID: PMC7885437 DOI: 10.1186/s13098-021-00636-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disease affecting women of reproductive age and associated with reproductive and metabolic dysfunction. Few studies are available regarding metabolic traits in Brazilian women with PCOS. The aim of this systematic review and meta-analysis was to summarize the available evidence regarding metabolic traits and comorbidities in Brazilian women with polycystic ovary syndrome (PCOS). METHODS We systematically searched PubMed, Cochrane Central Register of Controlled Trials, and Embase for cross-sectional, case-control, or cohort studies focusing on populations of different regions from Brazil, published until July 31, 2019. Studies were selected if they reported PCOS diagnostic criteria. Studies without a control group were included if they presented relevant metabolic data. RESULTS Of 4856 studies initially identified, 27 were included in the systematic review and 12 were included in the meta-analysis, for a total of 995 women with PCOS defined by Rotterdam criteria and 2275 controls from different regions of Brazil. Obesity, metabolic syndrome and IGT were prevalent, and standard mean differences for BMI (SMD 0.67, 95% CI, 0.29, 1.05), waist circumference (SMD 0.22, 95% CI 0.02, 0.41), systolic (SMD 0.66, 95% CI 0.30, 1.01) and diastolic blood pressure (SMD 0.55, 95% CI 0.24, 0.87), glucose (SMD 0.21, 95% CI 0.04, 0.38) and HOMA (SMD 0.78, 95% CI 0.52, 1.04) were significantly higher in Brazilian women with PCOS compared to controls. Lipid profile was more adverse in PCOS vs. non-PCOS women. Between-study heterogeneities were low/moderate for glucose and HOMA and moderate/high for the other variables. CONCLUSIONS The data of this systematic review and meta-analysis indicate that Brazilian women with PCOS have a worse metabolic profile than women without PCOS with no important regional differences. The prevalence of metabolic changes is intermediate in Brazil vs. other countries.
Collapse
Affiliation(s)
- Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Department of Physiology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-003, Brazil.
| | - Ramon Bossardi Ramos
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA
| | - Lucas Bandeira Marchesan
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Monica de Oliveira
- Instituto de Medicina Integral Professor Fernando Figueira Hospital, Recife, Pernambuco, Brazil
| | - Enrico Carmina
- University of Palermo School of Medicine, Palermo, Italy
| |
Collapse
|
8
|
Marchesan LB, Ramos RB, Spritzer PM. Metabolic Features of Women With Polycystic Ovary Syndrome in Latin America: A Systematic Review. Front Endocrinol (Lausanne) 2021; 12:759835. [PMID: 34737723 PMCID: PMC8562723 DOI: 10.3389/fendo.2021.759835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is an endocrine disorder that commonly affects women of childbearing age and has been associated with metabolic and reproductive abnormalities. Only a few studies have investigated metabolic traits in women with PCOS in Latin America. Therefore, we conducted a systematic review to provide an overview of the available evidence on the metabolic profile of Latin American women with PCOS. METHODS We searched PubMed, Cochrane Central Register of Controlled Trials, and Embase databases for cross-sectional, case-control, or cohort studies focusing on populations of countries in South and Central America and Mexico, published until October 31, 2019. We selected studies that reported the diagnostic criteria for PCOS. In the absence of a control group, we included studies if they reported relevant metabolic data. RESULTS The initial search yielded 4878 records, of which 41 studies were included in the systematic review. Sample sizes ranged from 10 to 288 in PCOS groups and from 10 to 1500 in control groups. The prevalence of phenotypes A and B (classic PCOS) ranged from 65.8% to 87.5% as reported in studies from Argentina, Brazil, and Chile. Metabolic syndrome ranged from 33.3% to 44.0% for phenotype A, from 15.0% to 58.0% for phenotype B, from 11.9% to 36.0% for phenotype C, and from 14.2% to 66.0% for phenotype D. Women with PCOS had higher body mass index, waist circumference, blood pressure, glucose, and homeostasis model assessment index as well as a more adverse lipid profile than those without PCOS. CONCLUSIONS Evidence from the present systematic review suggests that anthropometric and metabolic profiles are worse in women with PCOS who live in different Latin American countries than in women without PCOS living in the same region. Additional studies assessing metabolic comorbidities, such as diabetes, and distinct PCOS phenotypes in different Latin American countries are warranted and may produce invaluable information for primary and secondary prevention of PCOS in the region. This systematic review was registered with PROSPERO under number CRD42016038537. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier CRD42016038537.
Collapse
Affiliation(s)
- Lucas Bandeira Marchesan
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramon Bossardi Ramos
- Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- *Correspondence: Poli Mara Spritzer,
| |
Collapse
|
9
|
Bahadur A, Mundhra R, Kashibhatla J, Rajput R, Verma N, Kumawat M. Prevalence of metabolic syndrome among women with different PCOS phenotypes - a prospective study. Gynecol Endocrinol 2021; 37:21-25. [PMID: 32516071 DOI: 10.1080/09513590.2020.1775193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To study prevalence of different polycystic ovary syndrome (PCOS) phenotypes in our population and to compare the anthropometric measurements and metabolic syndrome (MetS) risk factors among different phenotypes. MATERIAL AND METHODS Two hundred and forty-eight PCOS women were prospectively classified into four phenotypes based on Rotterdam criteria, over a period of 18 months from June 2018 to November 2019. MetS was defined as per International diabetes federation consensus held in 2009. To evaluate the prevalence of MetS, we measured serum triglyceride levels, HDL cholesterol, fasting blood glucose, blood pressure, and waist circumference. RESULTS The mean age group of the study population was 23.16 ± 4.42, with maximum cases belonging to 20-25 years age group (40.72%). The prevalence of Phenotypes A, B, C, and D were 36.7%, 10.1%, 4.4%, and 48.8%, respectively. Phenotype D had the highest prevalence of MetS (14.9%). Phenotype A had significantly higher waist circumference, hip circumference, cholesterol, triglycerides, and LDL values as compared to Phenotype D (p<.05). CONCLUSIONS Phenotype A was at higher risk of adverse MetS risk profile. The overall prevalence of MetS was quite low as compared to similar Indian studies. A substantial proportion of study cohort had higher waist circumference (almost 60%) and lower HDL levels (88.70% cases), hence all women with PCOS should be screened for metabolic profile risk factors at a young age itself.
Collapse
Affiliation(s)
| | | | | | - Rashmi Rajput
- All India Institute of Medical Sciences, Rishikesh, India
| | - Neha Verma
- All India Institute of Medical Sciences, Rishikesh, India
| | - Mumta Kumawat
- All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
10
|
Wang C, Yue S, Jiang Y, Mao Y, Zhao Z, Liu X, Zhang X, Pei D, Li Y. LncRNA GAS5 is upregulated in polycystic ovary syndrome and regulates cell apoptosis and the expression of IL-6. J Ovarian Res 2020; 13:145. [PMID: 33308258 PMCID: PMC7733246 DOI: 10.1186/s13048-020-00748-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 11/30/2020] [Indexed: 11/27/2022] Open
Abstract
Background GAS5 contains a hormone response element that can induce cell apoptosis in breast cancer. It is known that cell apoptosis and hormone response play crucial roles in polycystic ovary syndrome (PCOS), indicating the potential involvement of GAS5 in PCOS. This study was performed to investigate the potential involvement of GAS5 and IL-6 (a critical player in PCOS) in PCOS. Methods Research subjects of this study included 60 PCOS patients and 60 healthy controls. The expression levels of GAS5 and IL-6 in plasma of both patients and controls were measured by qPCR and ELISA, respectively. Cell transfections were performed to analyze the interaction between GAS5 and IL-6. Cell apoptosis was analyzed by cell apoptosis assay. Results GAS5 was upregulated in plasma of PCOS patients. The expression levels of GAS5 were positively correlated with the expression levels of IL-6. Altered expression levels of GAS5 and IL-6 distinguished PCOS patients from healthy controls. In cells of a granulosa-like tumor cell line (KGN), overexpression of GAS5 led to upregulated IL-6, while silencing of GAS5 played an opposite role. Cell apoptosis analysis showed that overexpression of GAS5 significantly decreased apoptosis rate of KGN cells. Silencing of GAS5 increased the rate of KGN cell apoptosis. Conclusions GAS5 is upregulated in PCOS and regulates cell apoptosis and the expression of IL-6.
Collapse
Affiliation(s)
- Chunxia Wang
- Department of Reproductive medicine, The Second Affiliated Hospital of Henan, University of TCM, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Shishi Yue
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Yaru Jiang
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Yanjia Mao
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Zhijing Zhao
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Xinwei Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Xiaoqian Zhang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Dongxu Pei
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Yongwei Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China.
| |
Collapse
|
11
|
Lana MP, Demayo S, Giannone L, Nolting M, D'isa E, Servetti V, Rolo G, Gutierrez G, Jarlip M. Metabolic compromise in women with PCOS: earlier than expected. ACTA ACUST UNITED AC 2020; 66:1225-1228. [PMID: 33027449 DOI: 10.1590/1806-9282.66.9.1225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 02/23/2020] [Indexed: 11/22/2022]
Abstract
METHODS Polycystic ovary syndrome (PCOS) is an endocrinopathy with unknown pathophysiology among women of reproductive age. Several studies have been conducted to determine the prevalence of metabolic syndrome (MetS) among PCOS patients. Recent studies have reported varied prevalence of metabolic syndrome (MetS) in women with PCOS. The aim of this study is to determine if women with PCOS are at a higher risk of MetS or some degree of metabolic compromise. This is an observational study. A total of 96 women diagnosed with PCOS (according to the Rotterdam consensus criteria) were included. Variables of diagnostic criteria for MetS according to the ATP III were analyzed at the first consultation. Data analysis was performed using Epi Info™ 7.2.2.16. RESULTS We assessed the prevalence of obesity, blood pressure, glucose intolerance, and dyslipidemia in 96 women with PCOS and an average age of 28 (17-39) years. Forty percent of the women had BMI <25 kg/m2; 85.4% had blood pressure <130/85 mm Hg; 22.9% had HDL cholesterol >50 mg/dl, 57.3% had triglycerides <150 mg/dl, 63.5% had fasting glucose <100 mg/dl. According to the ATP III criteria for MetS, 8.33% met none of the criteria, 19.79% met one criterion, 15.63% two criteria, 41.67% 3 criteria, 13.54% 4 criteria, and 1.04% met the 5 criteria. CONCLUSION Considering the high prevalence of MetS or altered metabolic components in PCOS patients at the moment of the diagnosis, its regular screening is necessary to reduce the mortality and morbidity rates in these women.
Collapse
Affiliation(s)
- Maria Perez Lana
- Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| | - Sandra Demayo
- Departament of Gynecology Argerich. Hospital. Buenos Aires, Argentina.,Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| | - Lorena Giannone
- Departament of Gynecology Argerich. Hospital. Buenos Aires, Argentina.,Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| | - Manuel Nolting
- Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| | - Estela D'isa
- Departament of Diagnosis Central Laboratory Argerich. Hospital, Buenos Aires, Argentina
| | - Valeria Servetti
- Departament of Gynecology Argerich. Hospital. Buenos Aires, Argentina.,Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| | - Guadalupe Rolo
- Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| | - Guillermo Gutierrez
- Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina.,Departament of Diagnosis Central Laboratory Argerich. Hospital, Buenos Aires, Argentina
| | - Mariana Jarlip
- Argentinian Society of Gynecological and Reproductive Endocrinology, Buenos Aires, Argentina
| |
Collapse
|
12
|
Maffazioli GDN, Lopes CP, Heinrich-Oliveira V, Lobo RA, Hayashida SAY, Soares JM, Maciel GAR, Baracat EC. Prevalence of metabolic disturbances among women with polycystic ovary syndrome in different regions of Brazil. Int J Gynaecol Obstet 2020; 151:383-391. [PMID: 32931592 DOI: 10.1002/ijgo.13374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/28/2020] [Accepted: 09/10/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe the prevalence of metabolic disturbances in a large cohort of women with polycystic ovary syndrome (PCOS) in southeastern Brazil and to compare the findings with other cohorts of Brazilian women with PCOS. METHODS A retrospective study analyzing clinical and laboratory data of 462 women with PCOS treated at an outpatient clinic in a tertiary hospital in southeastern Brazil. Prevalence of insulin resistance, glucose intolerance, type 2 diabetes, dyslipidemia, central obesity, hypertension, and metabolic syndrome was compared to that of other cohorts of age and body mass index-matched Brazilian women with PCOS. RESULTS Women with PCOS had a median age of 25.0 (21.0-29.0) years and BMI of 28.7 (23.9-34.0) kg/m2 . Prevalence of insulin resistance, glucose intolerance, and type 2 diabetes varied from 39.6% to 55.0%, 7.2% to 28.1%, and 2.0% to 4.1%, respectively. Prevalence of central obesity, dyslipidemia due to decreased high-density lipoprotein cholesterol, hypertriglyceridemia, and metabolic syndrome ranged from 57.8% to 66.4%, 54.1% to 70.4%, 22.9% to 35.1%, and 27.4% to 38.3%, respectively, which did not differ among regions in Brazil. CONCLUSION Prevalence of metabolic disturbances was high among Brazilian women with PCOS. This study suggests that, from a public health perspective, authorities in Brazil should be aware of and encourage screening for metabolic dysfunction in women with PCOS in all regions of the country.
Collapse
Affiliation(s)
- Giovana D N Maffazioli
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Caroline P Lopes
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Vanessa Heinrich-Oliveira
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rogerio A Lobo
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA
| | - Sylvia A Y Hayashida
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José Maria Soares
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gustavo A R Maciel
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Edmund C Baracat
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
13
|
Sekhon AK, Zergham AS, Tserenpil G, Mebasher A, Malik BH. The Association Between Polycystic Ovary Syndrome and Its Dermatological Manifestations. Cureus 2020; 12:e6855. [PMID: 32181090 PMCID: PMC7053678 DOI: 10.7759/cureus.6855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) commonly occurs in reproductive-age females. It elevates the hormonal levels, creates an imbalance in the metabolic system, and affects their reproductive system too. A number of studies have been conducted on PCOS, and it has been diagnosed together with several dermatological conditions. In this paper, we attempt a traditional review to study the relationship between PCOS and its cutaneous manifestations the patients are predisposed to. To uncover this association, we gathered information from English-language articles on the Pubmed database using six keywords. Materials were also collected from studies done on animal models, which helped in putting down all the data together and interlinking them with other studies. From this data collection, it is ultimately concluded that the association between PCOS and dermatological conditions is a very intricate interconnecting network comprising many factors, such as inflammation, genetics, and hormonal. This study raises some questions that are still unanswered. We believe further research is needed to uncover the various facts about this disease and its associations, in order to make its management more effective. As there is a strong association between PCOS and certain dermatological disorders, it is recommended to develop a questionnaire that should be distributed to every woman who presents to dermatology departments with symptoms that are linked to PCOS, as it will help in diagnosing the condition at an early stage.
Collapse
Affiliation(s)
- Amanpreet Kaur Sekhon
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Azka Shahid Zergham
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Gantuya Tserenpil
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Amal Mebasher
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Bilal Haider Malik
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| |
Collapse
|