Polycystic ovary syndrome: associations with cardiovascular disease

Flavonoid Supplementation Is Beneficial for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis

CONTEXT

Polycystic ovary syndrome (PCOS) is a prevalent hormonal imbalance that predominantly affects women in their reproductive years. Previous studies have yielded conflicting conclusions.

OBJECTIVE

This is an updated meta-analysis aiming to explore the connection between flavonoid supplementation and PCOS.

DATA SOURCES

Seven databases were searched: Cochrane Library, PubMed, Web of Science, Embase, Wanfang, China Science and Technology Journal, and China National Knowledge Infrastructure, spanning from their inception to April 15, 2024.

DATA EXTRACTION

Two authors independently searched the databases using the search terms.

DATA ANALYSIS

Following strict inclusion criteria, 8 papers were ultimately included. This updated meta-analysis suggests that flavonoid supplementation could enhance follicular development, promote the proliferation and differentiation of follicular granulosa cells, elevate estradiol levels, and mitigate testosterone, C-reactive protein, and ovarian index levels.

CONCLUSION

This analysis suggests that dietary flavonoids could potentially alleviate symptoms associated with PCOS.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42022382912.

Effects of vitamin D supplementation on metabolic parameters in women with polycystic ovary syndrome: a randomized controlled trial

OBJECTIVE

The aim of this study was to explore the effects of vitamin D supplementation on metabolic parameters in women with polycystic ovary syndrome (PCOS).

METHODS

A total of 60 PCOS women with vitamin D deficiency or insufficiency were enrolled in this randomized controlled trial. Participants were randomized to vitamin D group (2000 IU/day) or control group. The observational parameters were measured at baseline and after treatment, including body mass index (BMI), waist to hip ratio (WHR), oral glucose tolerance test (OGTT) and insulin release test, and lipid metabolism parameters.

RESULTS

The serum 25(OH)D concentrations at different time points after vitamin D supplementation were significantly higher than that in control group (P < 0.05). The BMI, WHR, insulin concentrations, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations in women of Vitamin D group after 12 weeks of treatment were significantly lower than that in women of control group (P < 0.05). The serum insulin concentrations and HOMA-IR at different time points of OGTT, serum TG, TC and LDL-C concentrations in women of vitamin D group (obesity) were significantly lower compared with control group (obesity) (P < 0.05). The BMI, WHR, TG, TC and LDL-C concentration in women of vitamin D group (IR) were significantly lower compared with control group (IR) (P < 0.05). No significant difference was observed in metabolic parameters between vitamin D group (non-obesity) and control group (non-obesity) (P > 0.05), and these differences of metabolic parameters were also not observed between vitamin D group (non-IR) and control group (non-IR) (P > 0.05).

CONCLUSION

Vitamin D supplementation had beneficial effects on metabolic parameters in PCOS women, especially in women with obesity or insulin resistance.

Anti-obesity pharmacological agents for polycystic ovary syndrome: A systematic review and meta-analysis to inform the 2023 international evidence-based guideline

This systematic review and meta-analysis evaluated the efficacy of anti-obesity agents for hormonal, reproductive, metabolic, and psychological outcomes in polycystic ovary syndrome (PCOS) to inform the 2023 update of the International Evidence-based Guideline on PCOS. We searched Medline, EMBASE, PsycInfo, and CINAHL until July 2022 with a 10-year limit to focus on newer agents. Eleven trials (545 and 451 participants in intervention and control arms respectively, 12 comparisons) were included. On descriptive analyses, most agents improved anthropometric outcomes; liraglutide, semaglutide and orlistat appeared superior to placebo for anthropometric outcomes. Meta-analyses were possible for two comparisons (exenatide vs. metformin and orlistat + combined oral contraceptive pill [COCP] vs. COCP alone). On meta-analysis, no differences were identified between exenatide versus metformin for anthropometric, biochemical hyperandrogenism, and metabolic outcomes, other than lower fasting blood glucose more with metformin than exenatide (MD: 0.10 mmol/L, CI 0.02-0.17, I2 = 18%, 2 trials). Orlistat + COCP did not improve metabolic outcomes compared with COCP alone (fasting insulin MD: -8.65 pmol/L, -33.55 to 16.26, I2 = 67%, 2 trials). Published data examining the effects of anti-obesity agents in women with PCOS are very limited. The role of these agents in PCOS should be a high priority for future research.

A Survey on Relation of Menopause to Metabolic Syndrome - SAFOMS STUDY (South Asian Federation of Menopause Societies) - Interim Analysis

Background

Metabolic syndrome (MS) is a spectrum of disorders that includes dysglycemia, dyslipidemia, central obesity, and hypertension. South Asian Indians are more prone to harbor MS at a younger age compared to Caucasians. However, there is a lack of large-scale data correlating menopause to MS in South Asian settings.

Aims and Objectives

The study aimed to determine the prevalence of MS and its components in pre- and postmenopausal women. It also assessed the relationship of age, menopausal status, personal and family history, anthropometric parameters, and biochemical markers to MS.

Materials and Methods

It was an interim analysis of a multicountry cross-sectional study in the South Asian Federation of Menopause Society (SAFOMS) countries: India, Pakistan, Bangladesh, Nepal, and Sri Lanka conducted through both online and physical methods. The survey questionnaire consisted of questions about details of personal history, demographics, and family history related to MS. Anthropometric measurements such as height, weight, basal metabolic index (BMI), waist circumference, and blood pressure readings were noted. Relevant history, history of polycystic ovarian syndrome, hypertensive disorders of pregnancy, and vasomotor symptoms were enquired. Biochemical evaluation of markers associated with MS was undertaken.

Results

In this interim analysis, 638 women were recruited. Out of them, 406 (63.6%) women were premenopausal and 232 (36.4%) were postmenopausal. 392 (61.4%) women had MS, while 246 (38.6%) women did not have MS. Increasing age, BMI, and visceral adiposity (waist circumference) were significantly correlated with incidence of MS. Raised fasting blood sugar, hemoglobin A1C, total cholesterol, low-density lipoprotein, serum triglyceride, and reduced high-density lipoprotein levels were significantly associated with the incidence of MS in both pre- and postmenopausal women. Peri- and postmenopausal hot flashes, night sweats, and sleep disturbances were also significantly associated with MS. Personal history of hypertension, diabetes, and dyslipidemia were the strongest factors to be associated with MS with a significantly high odds ratio.

Conclusion

The study has highlighted the role of BMI and waist circumference as the first warning signs, which will encourage to go for regular biochemical screening through lipid profile and fasting blood glucose measurements. Our study is a stepping stone for all future studies for relation of menopause to MS.