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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.
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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
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Kałużna M, Czlapka-Matyasik M, Kompf P, Moczko J, Wachowiak-Ochmańska K, Janicki A, Samarzewska K, Ruchała M, Ziemnicka K. Lipid ratios and obesity indices are effective predictors of metabolic syndrome in women with polycystic ovary syndrome. Ther Adv Endocrinol Metab 2022; 13:20420188211066699. [PMID: 35035875 PMCID: PMC8755932 DOI: 10.1177/20420188211066699] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Insulin resistance (IR) is common in women with polycystic ovary syndrome (PCOS). Metabolic syndrome (MS) involves IR, arterial hypertension, dyslipidemia, and visceral fat accumulation. Therefore, fatness indices and blood lipid ratios can be considered as screening markers for MS. Our study aimed to evaluate the predictive potential of selected indirect metabolic risk parameters to identify MS in PCOS. METHODS This cross-sectional study involved 596 women aged 18-40 years, including 404 PCOS patients diagnosed according to the Rotterdam criteria and 192 eumenorrheic controls (CON). Anthropometric and blood pressure measurements were taken, and blood samples were collected to assess glucose metabolism, lipid parameters, and selected hormone levels. Body mass index (BMI), waist-to-height ratio (WHtR), homeostasis model assessment for insulin resistance index (HOMA-IR), visceral adiposity index (VAI), lipid accumulation product (LAP), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides-to-HDL cholesterol ratio (TG/HDL-C) were calculated. MS was assessed using the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria. RESULTS MS prevalence was significantly higher in PCOS versus CON. Patients with both MS and PCOS had more unfavorable anthropometric, hormonal, and metabolic profiles versus those with neither MS nor PCOS and versus CON with MS. LAP, TG/HDL-C, VAI, and WHtR were the best markers and strongest indicators of MS in PCOS, and their cut-off values could be useful for early MS detection. MS risk in PCOS increased with elevated levels of these markers and was the highest when TG/HDL-C was used. CONCLUSIONS LAP, TG/HDL-C, VAI, and WHtR are representative markers for MS assessment in PCOS. Their predictive power makes them excellent screening tools for internists and enables acquiring accurate diagnoses using fewer MS markers.
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Affiliation(s)
| | | | - Pola Kompf
- Department of Endocrinology, Metabolism and
Internal Diseases, Poznan University of Medical Sciences, Poznan,
Poland
| | - Jerzy Moczko
- Department of Computer Science and Statistics,
Poznan University of Medical Sciences, Poznan, Poland
| | | | - Adam Janicki
- Heliodor Świȩcicki Clinical Hospital, Poznan,
Poland
| | - Karolina Samarzewska
- Department of Clinical Auxiology and Pediatric
Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and
Internal Diseases, Poznan University of Medical Sciences, Poznan,
Poland
| | - Katarzyna Ziemnicka
- Department of Endocrinology, Metabolism and
Internal Diseases, Poznan University of Medical Sciences, Poznan,
Poland
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Alvero-Cruz JR, Fernández Vázquez R, Martínez Blanco J, Diaz AJ, Rosety I, Rosety MA, Rosety-Rodriguez M, Ordonez FJ. Sex differences for predicting metabolic syndrome by adipose dysfunction markers in institutionalized elderly. Eur J Cardiovasc Nurs 2021; 20:534-539. [PMID: 33580770 DOI: 10.1093/eurjcn/zvaa036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/05/2020] [Accepted: 12/19/2020] [Indexed: 11/13/2022]
Abstract
AIMS Recent studies have emphasized that metabolic syndrome (MetS) was the most important modifiable risk factor for cardiovascular and cerebrovascular diseases in the institutionalized elderly. In addition, the occurrence of MetS was higher in those with longer age-adjusted institutionalization time. The present study was conducted to assess predictive value of markers of adipose tissue dysfunction for the early screening of MetS in this population. METHODS AND RESULTS Two hundred and eleven institutionalized older adults (132 women, aged 74.3 ± 7.3 years; 79 men, aged 71.5 ± 7.3 years) were enrolled in the current cross-sectional study. Lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), and triglycerides (TG)/high-density lipoprotein (HDL)-cholesterol ratio were determined. The receiver operating characteristic curve was calculated to compare the area under the curve of each index. The total prevalence of MetS was 23.8%. In female group, VAI and TG/HDL ratio presented moderate-high sensitivity (77.78% and 78.38%, respectively) and specificity (77.62% and 73.49%, respectively). In males group, LAP presented moderate-high sensitivity (75%) and specificity (76.9%). CONCLUSION Gender played a key role on the prediction of MetS by adipose dysfunction markers in institutionalized elderly. Accordingly, VAI and TG/HDL-cholesterol ratio showed the highest predictive value for MetS in female elderly. LAP was the strongest predictor of MetS in male elderly.
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Affiliation(s)
| | | | | | | | - Ignacio Rosety
- School of Medicine, University of Cádiz, Plaza Fragela s/n 11003, Cádiz, Spain
| | - Miguel Angel Rosety
- School of Medicine, University of Cádiz, Plaza Fragela s/n 11003, Cádiz, Spain
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Krentowska A, Łebkowska A, Jacewicz-Święcka M, Hryniewicka J, Leśniewska M, Adamska A, Kowalska I. Metabolic syndrome and the risk of cardiovascular complications in young patients with different phenotypes of polycystic ovary syndrome. Endocrine 2021; 72:400-410. [PMID: 33442790 DOI: 10.1007/s12020-020-02596-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/15/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE Insulin resistance is an important factor in the pathogenesis of polycystic ovary syndrome (PCOS), which is associated with higher risk of metabolic syndrome (MetS) and cardiovascular complications. Early atherosclerotic lesions may be diagnosed by ultrasonographic parameters: brachial artery flow-mediated dilation after reactive hyperaemia (FMD) and intima-media thickness of common carotid artery (IMT). The aim of the study was to assess the relation of IMT and FMD with clinical and laboratory parameters reflecting metabolic status in young women with different PCOS phenotypes. METHODS The study included 154 PCOS patients diagnosed with the Rotterdam criteria, divided into four phenotypes, and 113 healthy women. Laboratory analyses, transvaginal ultrasound, and IMT and FMD measurements were conducted. MetS was diagnosed with International Diabetes Federation/American Heart Association (IDF/AHA) consensus criteria. RESULTS MetS was more prevalent in PCOS patients than healthy women (14.29 vs. 5.31%; p = 0.019), with highest prevalence in phenotypes I and II (p = 0.039). IMT and FMD did not differ between PCOS patients and the controls, nor between the PCOS phenotypes. PCOS patients with MetS presented lower FMD than other PCOS patients (p = 0.018). In women with PCOS, FMD correlated with glucose and insulin concentrations in the fasting state (R = -0.33, p = 0.002; R = -0.23, p = 0.026) and at 2 h of OGTT (R = -0.29, p = 0.006; R = -0.26, p = 0.014). In patients with phenotype I, correlations were found between IMT and BMI (R = 0.45, p = 0.006) and between FMD and fasting glucose concentrations (R = -0.46, p = 0.011). CONCLUSIONS Metabolic disturbances and the diagnosis of MetS in patients with PCOS, especially in hyperandrogenic phenotypes, might be associated with alterations in IMT and FMD.
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Affiliation(s)
- Anna Krentowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland.
| | - Agnieszka Łebkowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
| | - Małgorzata Jacewicz-Święcka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
| | - Justyna Hryniewicka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
| | - Monika Leśniewska
- Department of Reproduction and Gynaecological Endocrinology, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
| | - Agnieszka Adamska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
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Dadachanji R, Patil A, Joshi B, Mukherjee S. Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women. PLoS One 2021; 16:e0246862. [PMID: 33635862 PMCID: PMC7909663 DOI: 10.1371/journal.pone.0246862] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 01/27/2021] [Indexed: 12/23/2022] Open
Abstract
Polycystic ovary syndrome is a complex endocrinopathy with heterogeneous presentation and multifactorial etiology. We have undertaken this case-control study to compare metabolic and endocrine characteristics in different phenotypic subgroups of women with PCOS and the impact of obesity on them. Women with PCOS (n = 489) were classified into 4 phenotypes according to Rotterdam criteria. Comparisons of clinical, biochemical and hormonal parameters were performed across all phenotypic groups of PCOS and with controls (n = 270) by Welch’s ANOVA with subsequent Games-Howell post-hoc test. We found maximum prevalence of normoandrogenic phenotype D, which is milder form of PCOS in terms of insulin resistance, gonadotropin levels and dyslipidemia, followed by phenotype A, in our total study population. After classification of the study group into lean and obese groups, only few insulin and lipid-related traits showed marked differences between phenotypes. Further, we noted that obese women showed adverse metabolic but not androgenic traits compared to lean counterparts in the same phenotype. Metabolic syndrome frequency is increased in hyperandrogenic phenotypes with HDL-C and waist circumference being most predominant contributing factors in total, lean and obese groups. We demonstrate that in our study population there is greater occurrence of phenotype D of PCOS. Our study highlights the importance of clinicians concurrently employing Rotterdam criteria along with obesity status for ascertaining accurate PCOS status and formulating suitable therapeutic intervention.
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Affiliation(s)
- Roshan Dadachanji
- Department of Molecular Endocrinology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Anushree Patil
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Beena Joshi
- Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Srabani Mukherjee
- Department of Molecular Endocrinology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
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Ni CM, Huang WL, Jiang YM, Xu J, Duan R, Zhu YL, Zhu XP, Fan XM, Luo GA, Wang YM, Li YY, He Q, Xu L. Improving the accuracy and efficacy of diagnosing polycystic ovary syndrome by integrating metabolomics with clinical characteristics: study protocol for a randomized controlled trial. Trials 2020; 21:169. [PMID: 32046752 PMCID: PMC7014640 DOI: 10.1186/s13063-020-4060-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/09/2020] [Indexed: 12/17/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a complex endocrine syndrome with poorly understood mechanisms. To provide patients with PCOS with individualized therapy, it is critical to precisely diagnose the phenotypes of the disease. However, the criteria for diagnosing the different phenotypes are mostly based on symptoms, physical examination and laboratory results. This study aims to compare the accuracy and efficacy of diagnosing PCOS by integrating metabolomic markers with common clinical characteristics. Methods This is a prospective, multicenter, analyst-blinded, randomized controlled trial. Participants will be grouped into (1) people without PCOS (healthy control group), (2) patients diagnosed with PCOS based on clinical indices (experimental group 1), and (3) patients diagnosed with PCOS based on metabolomic indices (experimental group 2). A total of 276 participants, including 60 healthy people and 216 patients with PCOS, will be recruited. The 216 patients with PCOS will be randomly assigned to the two experimental groups in a 1:1 ratio, and each group will receive a different 6-month treatment. The primary outcome for the experimental groups will be the effect of PCOS treatment. Discussion The results of this trial should help to determine whether using metabolomic indices is more accurate and effective than using clinical characteristics in diagnosing the phenotypes of PCOS. The results could provide a solid foundation for the accurate diagnosis of different PCOS subgroups and for future research on individualized PCOS therapy. Trial registration Chinese Clinical Trial Registry, ID: ChiCTR-INR-1800016346. Registered 26 May 2018.
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Affiliation(s)
- Cheng-Ming Ni
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, 214023, China
| | - Wen-Long Huang
- Department of Endocrinology, Jiangyin People's Hospital, Wuxi, 214400, China
| | - Yan-Min Jiang
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, 214023, China
| | - Juan Xu
- Department of Endocrinology, Jiangyin People's Hospital, Wuxi, 214400, China
| | - Ru Duan
- Department of Good Clinical Practice (GCP), The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Yun-Long Zhu
- Department of Endocrinology, The Affiliated Wuxi Maternal and Child Health Centers Clinical Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Xu-Ping Zhu
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, 214023, China
| | - Xue-Mei Fan
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100000, China
| | - Guo-An Luo
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100000, China
| | - Yi-Ming Wang
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100000, China
| | - Yan-Yu Li
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, 214023, China
| | - Qing He
- Department of Good Clinical Practice (GCP), The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China.
| | - Lan Xu
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, 214023, China.
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Otaghi M, Azami M, Khorshidi A, Borji M, Tardeh Z. The association between metabolic syndrome and polycystic ovary syndrome: A systematic review and meta-analysis. Diabetes Metab Syndr 2019; 13:1481-1489. [PMID: 31336510 DOI: 10.1016/j.dsx.2019.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/14/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND One of the most frequently encountered endocrinopathy in women of reproductive age is polycystic ovary syndrome (PCOS). Recent studies have reported varied prevalence of metabolic syndrome (MetS) in women with PCOS. The aim of this study is to determine if the women with PCOS are at a higher risk of MetS. METHOD The present systematic review and meta-analysis was conducted according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. To collect articles, we searched online databases of PubMed/Medline, Scopus, Web of Science, Science Direct, Embase, CINAHL, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved articles using MeSH keywords of "metabolic syndrome", "woman" and "polycystic ovary syndrome" without time limit until October 2018. Cochran's Q test and I2 Index were used to evaluate the heterogeneity among studies and the random effects model was used for combining the results. Data analysis was performed in STATA software version 11.1. RESULT Finally, 72 studies involving 10075 PCOS patients with an average age of 26.2 ± 5.01 years were included in the meta-analysis. The heterogeneity rate was high (I2 = 76.5%; p < 0.001) and the pooled estimate of the association between MetS and PCOS was significant (OR = 2.57, 95% CI: 2.18-3.02; P < 0.001). CONCLUSION According to the results, there is higher risk of MetS in women with PCOS. Therefore, diagnosis and treatment of MetS in women with PCOS may have a significant impact on this patients health and reduce the rate of mortality and morbidity.
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Affiliation(s)
- Masoumeh Otaghi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Milad Azami
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Khorshidi
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Milad Borji
- Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zainab Tardeh
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran.
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Vassilatou E, Lafoyianni S, Vassiliadi DA, Ioannidis D, Paschou SA, Mizamtsidi M, Panagou M, Vryonidou A. Visceral adiposity index for the diagnosis of nonalcoholic fatty liver disease in premenopausal women with and without polycystic ovary syndrome. Maturitas 2018; 116:1-7. [DOI: 10.1016/j.maturitas.2018.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/27/2018] [Accepted: 06/30/2018] [Indexed: 12/18/2022]
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Medical comorbidity in polycystic ovary syndrome with special focus on cardiometabolic, autoimmune, hepatic and cancer diseases: an updated review. Curr Opin Obstet Gynecol 2018; 29:390-396. [PMID: 28901968 DOI: 10.1097/gco.0000000000000410] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is defined by hyperandrogenism, irregular menses and polycystic ovaries when other causes are excluded. The possible implication of increased morbidity in PCOS for screening and follow-up is uncertain and is reviewed in this article. RECENT FINDINGS The increased risk of type 2 diabetes and cardiovascular disease in PCOS is closely associated with BMI. Women with PCOS should be screened for the elements of the metabolic syndrome upon diagnosis. Measurement of HbA1c and the lipid accumulation product could be important tools to differentiate women with high metabolic risk. The immune function in PCOS is impaired with increased secretion of autoantibodies and increased risk of type 1 diabetes, asthma and thyroid disease. The occurrence of thyroid disease could be modified by BMI and D-vitamin status. Screening for diabetes and thyroid disease is part of routine evaluation for endocrine diseases at baseline in PCOS, whereas the necessity of prospective screening for thyroid disease awaits future studies. Especially obese women with PCOS are at an increased risk of nonalcoholic fatty liver disease, gall bladder disease and endometrial cancer. SUMMARY Recent data support that screening and follow-up in patients with PCOS should be stratified according to BMI.
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Zhang K, Li Q, Chen Y, Wang N, Lu Y. Visceral adiposity and renal function: an observational study from SPECT-China. Lipids Health Dis 2017; 16:205. [PMID: 29078775 PMCID: PMC5658976 DOI: 10.1186/s12944-017-0597-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/20/2017] [Indexed: 12/14/2022] Open
Abstract
Background Lipid accumulation product (LAP) is a novel and effective index of visceral adiposity distribution based on waist circumference and triglycerides concentration. Few studies investigated the relationship between LAP and eGFR. We aimed to explore whether LAP was associated with declined renal function (eGFR < 60 mL/min/1.73m2), and also whether it exhibited obvious superiority in predicting kidney impairment compared with other obesity indices. Methods In this cross-sectional study, 10,012 subjects were recruited from 22 sites in East China. LAP was calculated with the following formula: (WC-65) x TG for males, (WC-58) x TG for females. Results 4.7% participants with declined renal function had a higher LAP quartile. LAP was strongly associated with eGFR level (Beta: -0.073, P < 0.001) and declined renal function (P < 0.001) even after adjustment for age, sex, smoking, drinking, diabetes and hypertension. The risk of renal dysfunction increased 2.32-fold for the highest quartile LAP relative to the lowest quartile (OR: 2.32, 95%CI:1.52–3.53, P < 0.001). LAP exerted the largest area under the curve among different obesity indices (AUC ROC:0.644, 95%CI: 0.618–0.670, P < 0.001). Conclusions Our findings showed that LAP strongly associated with declined renal function and could be one of markers for predicting the risk of renal dysfunction in the general Chinese population. Trial registration ChiCTR-ECS-14005052 (WHO international clinical trials register platform in China). Registered 20 July 2014.
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Affiliation(s)
- Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China.
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