Metabolic Syndrome In Polycystic Ovary Syndrome Research Articles

Value of the triglyceride-glucose index and non-traditional blood lipid parameters in predicting metabolic syndrome in women with polycystic ovary syndrome.

Insulin resistance (IR) is common in patients with polycystic ovary syndrome (PCOS). Metabolic syndrome (MS) includes, inter alia, IR, hypertension, dyslipidemia, and disturbances in glucose metabolism. The triglyceride-glucose (TyG) index and non-traditional lipid parameters are strong predictors of IR and cardiovascular disease and can be considered as screening indicators for MS. This study aimed to evaluate the predictive potential of non-traditional lipid parameters and the TyG index to identify MS in PCOS. This cross-sectional study included 134 women diagnosed with PCOS (50 patients with comorbid MS and 84 patients without MS). Biochemical indices were collected, and triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, non-HDL-C, TyG, and TyG-BMI indices were calculated. Logistic regression analysis was used to compare and determine the association of the six parameters with MS, and the receiver operating characteristic (ROC) curve was used to evaluate the performance of each parameter in identifying MS in the PCOS population. After adjusting for age and body mass index (BMI), TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, TyG, and TyG-BMI were associated with MS (all P<0.05). The odds ratios were 4.075 (0.891, 1.107), 3.121 (1.844, 5.282), 3.106 (1.734, 5.561), 2.238 (1.302, 3.848), 13.422 (4.364, 41.282), and 1.102 (1.056, 1.150), respectively. TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, TyG, and TyG-BMI are effective predictors of MS in PCOS, and their cut-off values can be used for the early detection of MS. TyG-BMI had the strongest performance in predicting MS (area under the curve 0.905, 95% CI 0.855-0.956), and its optimal critical value for predicting MS was 202.542. TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, TyG, and TyG-BMI are novel, clinically convenient and practical markers for the early identification of MS risk in PCOS patients.

Waist circumference and waist-to-hip ratio as indicators of abdominal obesity

Obesity is linked to various gynaecological conditions like polycystic ovary syndrome (PCOS) and leads to metabolic syndrome. Early diagnosis of visceral obesity would help control the occurrence and progression of these diseases The aim of the study was to compare waist circumference and waist-to-hip ratio with body mass index (BMI) as indicators of abdominal obesity. This cross-sectional study was conducted on 44 women with Polycystic ovary syndrome (PCOS) fulfilling Rotterdam criteria over a period of one year. Height, weight, waist circumference and hip circumference were measured. BMI and waist to hip ratio were calculated. These were compared with each other. Overall, average waist circumference and waist to hip ratio were found to be 68. 69 cm and 0. 82 respectively and mean BMI was 23. 07 kg/m2. The prevalence of obesity by BMI was 69%, abdominal obesity for WC was 59. 1% while for WHR 61. 36 %. Waist circumference was found to have high positive correlation with BMI (r=0. 75) compared to waist to hip ratio (r=0. 40). Thus, waist circumference and waist hip ratio are easy methods of measuring fat distribution and can be used for the monitoring the development of metabolic syndrome in PCOS.

METABOLIC SYNDROME IN POLYCYSTIC OVARY SYNDROME TUNISIAN WOMEN

Objective: Polycystic ovary syndrome (PCOS) is known to reproduce metabolic syndrome (MS) features. This association seems to be heterogeneous. To investigate the profile of MS in patients with PCOS in Tunisia. Design and method: Our study was conducted on women diagnosed with PCOS in 2020 and age matched controls. PCOS and MS diagnosis were made according to the Rotterdam criteria and the definition of the International Diabetes Federation (IDF) respectively. Biochemical tests were analysed via an automated method (Cobas-Roche). Results: Our study was conducted on 96 patients and 108 controls. The median age in patients was at 25 years vs 27 in controls. Only 19.7% of patients met the criteria of MS. However, in controls the prevalence of MS was 12.6%. All MS criteria were more prevalent in PCOS patients compared to controls. We observed in decreasing order: android fat distribution, followed by elevated fasting glucose and decreased HDLc, followed by hypertension, and finally hypertriglyceridemia. Conclusions: In the literature, the prevalence of MS in PCOS was estimated between 22% and 42%. The relatively low prevalence of MS in Tunisian PCOS could be explained by age and geographical heterogeneity of MS distribution. Since, these patients are likely at risk of chronic comorbidities we suggest initiating a specific management.

Quantitative Changes in White Blood Cells: Correlation with the Hallmarks of Polycystic Ovary Syndrome.

Background and Objectives: In women of reproductive age, leukocytosis is a risk factor that bridges low-grade chronic inflammation (metabolic inflammation), metabolic changes, and polycystic ovary syndrome (PCOS) and is a potential early predictor of PCOS. This study aims to explore the predictive role of quantitative changes in white blood cells (WBCs) and neutrophils in PCOS-associated metabolic changes. Materials and Methods: A total number of 176 blood samples were obtained from age-matched women of the reproductive period, comprising 88 PCOS cases and 88 healthy controls. Hematological, metabolic, and anthropometric indices and ultrasonic assessment were recorded. Results: Elevated levels of luteinizing hormone, testosterone, and lipid parameters except HDL-C levels, and the prevalence of metabolic syndrome in PCOS were statistically significant (p < 0.001). The neutrophil count and neutrophil–lymphocyte ratio (NLR) in PCOS patients were significantly higher (p < 0.001) than their counterparts. The predictive ability of the neutrophil count and neutrophil–lymphocyte ratio (NLR) for PCOS, and possibly its associating subclinical inflammation at optimum cut-off values for the neutrophil count and NLR of >46.62% (sensitivity 94.32% and specificity 74.42%) and >1.23 (sensitivity 71.59% and specificity 100%), respectively. With regard to the areas under the curve (AUC) and Youden indices, they constituted 0.922 and 0.697 for neutrophil count and 0.926 and 0.716 for NLR, respectively. The comparative ROC z-statistic value was 2.222 and a p = 0.026. The multiple linear regression analysis revealed no significant influence for hormonal and metabolic independent variables on the neutrophil count in PCOS cases, but, as can be expected, revealed a significant negative relationship with the other components of WBCs. Conclusion: In conclusion, relative neutrophilia and elevated NLR are potential cost-effective, sensitive, and specific predictors of PCOS that may also shed light on the mechanism of chronic low-grade inflammation that is characteristic of the disease.

Lipid ratios and obesity indices are effective predictors of metabolic syndrome in women with polycystic ovary syndrome.

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.

Amino acid signatures in relation to polycystic ovary syndrome and increased risk of different metabolic disturbances

Research questionDo women with polycystic ovary syndrome (PCOS) have a distinct plasma amino acid profile and do potential amino acid markers exist for different metabolic risks of PCOS? DesignChinese Han women (n = 380; 190 with PCOS and 190 controls matched for age and BMI) were recruited and basal state plasma collected. The concentrations of 50 amino acids were quantitatively determined by high-performance LCMS. ResultsThirty-one amino acids had abnormal levels in the PCOS group versus the control group. Twenty-eight amino acids were upregulated and three amino acids downregulated. Multivariate statistical analysis identified 13 amino acids as potential metabolic markers of PCOS; of these, ROC curve analysis revealed 10 amino acids with high sensitivity and specificity for diagnosing PCOS (AUC >0.80). The combination of these 10 amino acids were better able to diagnose PCOS than clinical endocrine parameters. Specific amino acids were associated with increased odds of obesity, insulin resistance and metabolic syndrome in PCOS. Alterations of tyrosine, lysine, methionine, hydroxyarginine, 3-methyhistidine, GABA, methylhistidine and glycine were related to obesity in women with PCOS; enhanced levels of branched-chain amino acids, tyrosine, alanine and lysine were correlated to insulin resistance in the PCOS group; a combination of alanine, valine, leucine, tyrosine, glutamic acid, cysteine and glycine indicated the predictive potential of metabolic syndrome risk in women with PCOS. ConclusionsWomen with PCOS suffered from severe dysfunction of amino acid metabolism. Specific amino acid signatures could be used as powerful markers for diagnosing PCOS and predicting metabolic disturbances.

POLYCYSTIC OVARY SYNDROME WITH METABOLIC SYNDROME

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder, where the main clinical features include menstrual irregularities, sub-fertility, obesity, acne, and hirsuitism. The Rotterdam criteria are used for diagnosis. Metabolic syndrome (MS) is a constellation of metabolic disorders that include abdominal obesity, insulin resistance, impaired glucose metabolism, hypertension and dyslipidaemia. PCOS has high potential to develop metabolic syndrome and it’s consequences. Prevalence of MS is as high as 33% in women with PCOS, and is associated with consequences of cardiovascular disease (CVD), diabetes type II, cancers, sleep apnoea and psychological problems. Although PCOS may not present with MS rather present with chronic anovulation, hyprerandrogenism & infertility. But this could be the opportunity to intervene with lifestyle modification, medications to alter the risk profile for development of MS & cardiovascular disease. Despite the prevalence of MS in PCOS, it is a neglected entity. So it is prudent approach to emphasis on screening of MS in all PCOS. For that clinician’s need to be aware in-depth of MS. Accurate identification and timed intervention may prevent long-term complication. Lifestyle modification is the only universally accepted intervention. Metformin is widely used drug, it improves insulin sensitivity. The use of newer drugs such as myoinositol and liraglutide require further validation, while the use of statins should be limited only to women with dyslipidaemia. Bariatric surgery can be considered as a last resort. Timely intervention and screening of metabolic syndrome in PCOS women improve the quality of life. The aim of this review is to provide clear and up to date information about PCOS and its relationship with metabolic syndrome. Search done from AJOG, BJOG, Cochrane database, Pubmed, Webmed, UpToDate, Scholar Articles etc.

Correlation Between Serum AMH Levels and Cardiometabolic Indices in PCOS Women.

Introduction:Polycystic ovary syndrome (PCOS) has a predilection for several cardio-metabolic disorders in future. Levels of anti-Mullerian hormone (AMH), a marker of ovarian ageing, are higher in women with PCOS women than in controls. However, whether and how AMH concentrations influence the cardio-metabolic risk in PCOS is yet to be established.Objectives:This study was done to determine the correlation between AMH levels and various cardiometabolic parameters in women with PCOS and to compare AMH levels in PCOS with and without metabolic syndrome (MS).Materials and Methods:In total, 144 women aged 20–40 years and diagnosed as PCOS by the Rotterdam criteria were included in this cross-sectional study. Their anthropometry and blood pressure were recorded. Fasting lipid profile, fasting glucose, fasting insulin, homeostasis model assessment-insulin resistance, total testosterone, and AMH were estimated. The correlation between AMH and cardiometabolic parameters was determined.Results:Serum AMH levels had no correlation with any component of MS. The AMH values were comparable between those with and without MS despite differences in the metabolic profile (11.39 ± 5.31 vs 11.56 ± 5.64 ng/mL, P = 0.861).Conclusion:AMH levels do not correlate with components of MS so it may not be useful as an indicator of cardiovascular risk, insulin resistance, or MS in PCOS.

Особенности лечения пациенток с синдромом поликистозных яичников и метаболическим синдромом

This paper discusses polycystic ovary syndrome (PCOS), a common endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Insulin resistance which is considered the major causative factor for both PCOS and metabolic syndrome is emphasized. The early diagnosis of metabolic disorders which increase the risk of cardiovascular complications and the complications of pregnancy (including gestational diabetes and hypertension which may result in preeclampsia and placental abruption) is of particular importance. The presence of metabolic syndrome in PCOS is associated with poor prognosis in terms of fertility and has a negative impact on the outcomes of in vitro fertilization in infertile women with PCOS. When describing treatment approaches, the role of metformin, inositol, folates, vitamin D, and statins in treating metabolic disorders in PCOS and metabolic syndrome, reducing the risks of cardiovascular complications, and realizing fertile function is highlighted. The course of PCOS is complicated by psychic disorders (i.e., depression, anxiety, bipolar disorder, or eating disorders) which are common in these women and should be considered when prescribing medications. KEYWORDS: polycystic ovary syndrome, insulin resistance, infertility, metabolic syndrome, cardiovascular complications, inositol, folates. FOR CITATION: Il’ina I.Yu. Specificities of the treatment for polycystic ovary syndrome and metabolic syndrome. Russian Journal of Woman and Child Health. 2020;3(4):254–259. DOI: 10.32364/2618-8430-2020-3-4-254-259.

Long non-coding RNA steroid receptor activator in polycystic ovary syndrome: possible association with metabolic syndrome

Introduction: Polycystic ovary syndrome (PCOS) is a metabolic and endocrine disorder which affects women of reproductive age with a prevalence of 8-18% and implies various severe consequences to female health, including alarming rates of infertility, which accounts for approximately 75% of anovulatory infertility. Long non-coding RNA steroid receptor activator (lncRNA-SRA) affects multiple biological processes. However, it is not known whether lncRNA-SRA is associated with PCOS and the possible accompanied metabolic syndrome (MetS). Material and Methods: The expression levels of lncRNA-SRA were measured by real-time quantitative-PCR in PCOS patients (n=30 women), and in control group (n=20 women), patients with metabolic syndrome were diagnosed, and the association between lncRNA-SRA and metabolic syndrome parameters in PCOS group and control were analyzed. Results: LncRNA-SRA expression mean level was significantly higher in the women with PCOS than that in the control group. There was a high significant positive correlation between lncRNA-SRA expression and hirsutism, BMI, waist circumference (WC), and insulin levels, also with significant positive correlation between lncRNA-SRA with HOMA/IR and testosterone in PCOS group. Conclusion: The authors found that the lncRNA-SRA expression is potentially increased with PCOS and it has positive correlation with hirsutism, obesity, testosterone, and insulin resistance in PCOS. LncRNA-SRA is significantly increased in MetS subgroup of PCOS, thereby suggesting that elevated lncRNA-SRA might be an important mediator not only associated to hormonal and clinical parameters but also associates metabolic syndrome in PCOS and may be a mediator in the pathogenesis of both syndromes.

Incidence of metabolic syndrome in polycystic ovarian syndrome in Iranian women

Introduction: Polycystic ovary syndrome (PCOS) is the most common cause of the chronic anovulation including 5-10% of women in reproductive ages. The association between increased insulin resistance and polycystic ovaries is now well-recognized. This clinical association of hyperinsulinemia and anovulatory hyperandrogenism is commonly found throughout the world. Insulin resistance is only one component of a condition which is now called metabolic syndrome. In different studies, the prevalence of this syndrome outbreak is reported 7-43% .This study was performed to determine the prevalence and predictors of the metabolic syndrome in PCOS in southwest of Iran. Materials and Methods: The study included 53 women were diagnosed with PCOS, according to the Rotterdam criteria. Metabolic syndrome was assessed according to the criteria of the American National Cholesterol Panel (ATP-III criteria). The prevalence of metabolic syndrome was studied through measuring the following items: fasting glucose, triglyceride, HDL cholesterol, blood pressure, weight, height and waist circumference. We considered the patients as a metabolic syndrome group who has 3 or more cases. Results: Based on this research, the prevalence of metabolic syndrome in Ahwaz women was estimated 13.5%, the prevalence for individual components comprising the metabolic syndrome were: fasting glucose concentrations greater than or equals to 110 mg/dl in 4 patient(7.7%), hypertension in 4 patients (7.7%), BMI higher or equals to 30 in 6 patients (11.5%), waist circumference greater than or equals to 88 cm in 14 patients (34.1%), HDL less than 40 mg/dl in 12 patients (24%), triglyceride greater than or equals to 150 mg/dl in 5 patients(9.4%), IFG in 17 patients (32.7%), diabetes in 3 patients (5.8%) and dislipidemia in 31 patients(60%). Conclusions: Our results show the metabolic syndrome and its elements occur frequently in women with PCOS, particularly those with the classic picture of the syndrome. The latter combination places them at risk for cardiovascular diseases and screening for those disturbances is required in patients with PCOS.

Managing polycystic ovary syndrome in primary care.

Polycystic ovary syndrome (PCOS) presents with a spectrum of conditions resulting from androgen excess, anovulation and metabolic syndrome. Patients with PCOS may see their primary care physicians for various presentations, including hirsutism, acne, menstrual irregularities, infertility, obesity, and psychiatric disorders such as anxiety and depression. Management of these patients should include screening for Type 2 diabetes mellitus, dyslipidaemia and hypertension. Treatment should be targeted to each patient's phenotype and personal expectations such as desire for pregnancy. Psychological well-being due to the effects on physical appearance is also an important consideration. Diet and exercise are major components in the management of patients with PCOS and obesity. The first-line therapy for fertility and metabolic syndrome in PCOS is lifestyle modification with diet and exercise, followed by pharmacological therapy.

Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression.

Women with polycystic ovary syndrome (PCOS) have increased risk of metabolic syndrome. The relative contribution of clinical, demographic or biochemical factors to metabolic syndrome in PCOS is not known. A literature search was conducted in MEDLINE, CINAHL, EMBASE and clinical trial registries. Of 4530 studies reviewed, 59 were included in the systematic review and 27 in the meta-analysis and meta-regression. In good and fair quality studies, women with PCOS had an overall increased prevalence of metabolic syndrome (odds ratio, OR 3.35, 95% confidence interval, CI 2.44, 4.59). Increased prevalence of metabolic syndrome occurred in overweight or obese women with PCOS (OR 1.88, 95% 1.16, 3.04) but not in lean women (OR 1.45, 95% CI 0.35, 6.12). In meta-regression analyses, the markers of metabolic syndrome diagnostic criteria (waist circumference, high-density lipoprotein cholesterol, triglyceride, blood pressure), BMI, glucose tolerance (2-hr oral glucose tolerance test) and surrogate markers of insulin resistance (HOMA-IR) but not markers of reproductive dysfunction (sex hormone binding globulin, testosterone, PCOS phenotypes) contributed significantly to the heterogeneity in the prevalence of metabolic syndrome. Women with PCOS have increased risk of metabolic syndrome which was associated with obesity and metabolic features but not with indices of hyperandrogenism.

New Therapeutic Approaches in Obesity and Metabolic Syndrome Associated with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a pathophysiological disorder affecting reproductive and metabolic indices. PCOS is commonly associated with a high prevalence of insulin resistance and obesity; this association carries an increased risk of developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. Guidelines recommend lifestyle modification, metformin, hormonal contraceptives (HCs), and bariatric surgery as the main treatment options in obese patients with PCOS. Studies are being conducted to test the efficacy of existing treatment options as well as to discover new therapies. This review focuses on the most recent advances in this regard and highlights new hypotheses and emerging studies to give a picture of the latest therapeutic trends in the treatment of obese patients with PCOS. In this respect, much attention is given to the role of inositols, the mediators of insulin action. A deficiency of d-chiro-inositol containing inositol-phospho-glycans may be the basis of insulin resistance frequently seen in PCOS patients. Moreover, evidence suggests the use of statins in obese women with PCOS, but guidelines call for further research. Adiponectin, quercetin, vitamin D, and anti-obesity drugs have also been studied and seem to have a useful role in the treatment of obesity and metabolic syndrome in PCOS. Many trials have been conducted on the use of non-pharmacological therapies. Therapies including resveratrol, acupuncture, and berberine have favorable effects in overweight PCOS patients. However, more research is needed to reveal the clinical complexity of PCOS and develop more effective treatment options.

Measures of body adiposity and visceral adiposity index as predictors of metabolic syndrome among Thai women with PCOS

Aim: To evaluate the relationship between measures of body adiposity and visceral adiposity index (VAI) and risk of metabolic syndrome (MS) and to identify the optimal cut-off points of each measurement in Thai polycystic ovary syndrome (PCOS).Methods: A cross-sectional study was completed physical examination, fasting plasma glucose, lipid profiles of 399 PCOS and 42 age-matched normal controls. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and VAI were calculated. Associations between different measures and MS were evaluated and the receiver-operating characteristic (ROC) curve was performed to determine appropriate cut-off points for identifying MS.Results: Percentage of MS in PCOS was 24.6%, whereas none MS in controls. Previously recommended cut-off values for body adiposity and VAI were significantly associated with MS. ROC curve analysis of the only PCOS showed newly obtained optimal cut-off points for BMI and VAI of ≥28 kg/m2 (AUC = 0.90) and >5.6 (AUC = 0.94), respectively. Values found to be more accurate than the original ones. VAI was the best predictor, followed by BMI and WHtR.Conclusion: All body adiposity and VAI parameters can predict the risk of MS. Optimal values for Thai PCOS were ≥28 kg/m2 for BMI, ≥0.85 for WHR, ≥0.5 for WHtR and >5.6 for VAI.

The association between Polycystic Ovary Syndrome (PCOS) and metabolic syndrome: a statistical modelling approach.

Polycystic ovary syndrome (PCOS) affects 12-21% of women. Women with PCOS exhibit clustering of metabolic features. We applied rigorous statistical methods to further understand the interplay between PCOS and metabolic features including insulin resistance, obesity and androgen status. Retrospective cross-sectional analysis. Women with PCOS attending reproductive endocrine clinics in South Australia for the treatment of PCOS (n = 172). Women without PCOS (controls) in the same Australian region (n = 335) from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), a national population-based study (age- and BMI-matched within one standard deviation of the PCOS cohort). The factor structure for metabolic syndrome for women with PCOS and control groups was examined, specifically, the contribution of individual factors to metabolic syndrome and the association of hyperandrogenism with other metabolic factors. Women with PCOS demonstrated clustering of metabolic features that was not observed in the control group. Metabolic syndrome in the PCOS cohort was strongly represented by obesity (standardized factor loading = 0·95, P < 0·001) and insulin resistance factors (loading = 0·92, P < 0·001) and moderately by blood pressure (loading = 0·62, P < 0·001) and lipid factors (loading = 0·67, P = 0·002). On further analysis, the insulin resistance factor strongly correlated with the obesity (r = 0·70, P < 0·001) and lipid factors (r = 0·68, P < 0·001) and moderately with the blood pressure factor (loading = 0·43, P = 0·002). The hyperandrogenism factor was moderately correlated with the insulin resistance factor (r = 0·38, P < 0·003), but did not correlate with any other metabolic factors. PCOS women are more likely to display metabolic clustering in comparison with age- and BMI-matched control women. Obesity and insulin resistance, but not androgens, are independently and most strongly associated with metabolic syndrome in PCOS.

Morbidity and risk factors of metabolic syndrome in different phenotypes of polycystic ovary syndrome

Objective To test the hypothesis that different phenotypes Chinese women with polycystic ovary syndrome(PCOS) have various risk of metabolic syndrome(MS) and different metabolic phenotypes.Methods This was a prospective case-control study.A total of 305 women were diagnosed as PCOS based on the 2003 Rotterdam criteria.123 women with regular menstrual cycles and without hyperandrogenism were recruited and served as controls.PCOS patients were divided into two subgroups:according to their phenotypes with and without hyperandrogenism.The diagnosis of MS was based on 2005 modified International Diabetes Federation criteria.Results The prevalence of MS was 12.3％ in PCOS without hyperandrogenism,22.9％ in PCOS with hyperandrogenism,both significantly higher than 6.5％ in control group (P＜0.05).The rates of MS components,except for the fasting glucose level and blood pressure,all were significantly higher in both PCOS groups than those in control group(both P＜0.05).Furthermore,the triglyceride level was significantly higher in PCOS women without hyperandrogenism than that in PCOS women with hyperandrogenism as well as control women (both P＜0.05).The incidence of lowered high density lipoprotein-cholesterol (HDL-C) level was the highest in PCOS women with hyperandrogenism.The disposition index(DI) and Matsuda Index in PCOS women with and without hyperandrogenism were significantly lower compared with the control subjects after adjustment for body mass index (BMI,all P ＜O.05).However,there was no significant difference in DI and Matsuda Index between PCOS women with and without hyperandrogeuism.The results of logistic regression analysis revealed that Matsuda Index and BMI were the independent predictors of MS (both P ＜ 0.05).Conclusion Obesity and Matsuda Index are the independent predictors of MS in PCOS women.PCOS women with hyperandrogenism have high risk of MS.The rates of MS components in PCOS women with and without hyperandrogenism are different. Key words: Polycystic ovarian syndrome; Phenotype; Metabolic syndrome; Obesity

Association between β2‐adrenoceptor (ADRB2) haplotypes and insulin resistance in PCOS

The aim of this study was to explore β2-adrenoceptor (ADRB2) haplotype associations with phenotypes and quantitative traits related to insulin resistance (IR) and the metabolic syndrome (MS) in a polycystic ovary syndrome (PCOS) population. A secondary purpose was to assess the association between ADRB2 haplotype and PCOS. Genetic polymorphism analysis. Cross-sectional case-control association study. Medical University Hospital and research laboratory. One hundred and sixty-five unrelated women with PCOS and 116 unrelated women without PCOS (control sample). Clinical and biochemical measurements, and ADRB2 genotyping in PCOS patients and control subjects. ADRB2 haplotypes (comprising rs1042711, rs1801704, rs1042713 and rs1042714 in that order), genotyping and statistical analysis to evaluate associations with continuous variables and traits related to IR and MS in a PCOS population. Associations between ADRB2 haplotypes and PCOS were also assessed. We observed an age-adjusted association between ADRB2 haplotype CCGG and lower insulin (P = 0·018) and HOMA (P = 0·008) in the PCOS sample. Interestingly, the expected differences in surrogate measures of IR between cases and controls were not significant in CCGG/CCGG carriers. In the case-control study, genotype CCGG/CCGG was associated with a 14% decrease in PCOS risk (P = 0·043), taking into account confounding variables. Haplotype I (CCGG) has a protective role for IR and MS in PCOS.

Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria

What is the prevalence, phenotype and metabolic features of polycystic ovary syndrome (PCOS) in the same population according to three different diagnostic criteria? The prevalence of PCOS under National Institutes of Health (NIH), Rotterdam and Androgen Excess and PCOS (AE-PCOS) Society criteria was 6.1, 19.9 and 15.3%, respectively. PCOS carried a 2-fold increased risk of metabolic syndrome regardless of the diagnostic criteria used. The prevalence rates of PCOS differ depending on the diagnostic criteria used to define the syndrome. The current paper gives the prevalence rates of the component and composite phenotypes of PCOS in the same population and reports similar rates of metabolic syndrome in women with PCOS under contrasting diagnostic criteria. In this cross-sectional study, 392 women between the ages of 18 and 45 years were analyzed. When the prevalence of PCOS according to NIH was set to 8% with a precision of 2.2% and confidence interval of 95%, the sample size required for a prevalence survey was found to be 400 subjects. The study was carried out in the General Directorate of Mineral Research and Exploration, a government-based institute, in which the largest number of female staff (n = 527) are employed within a single institute in Ankara, Turkey. The study was performed between 7 December 2009 and 30 April 2010. All female subjects between the ages of 18 and 45 years were invited to participate. Women older than 45 or younger than 18 years, post-menopausal women, women with a history of hysterectomy or bilateral oopherectomy and pregnant women were excluded. Totally, 392 of the employees were recruited for the final analyses. The prevalence of PCOS under NIH, Rotterdam and AE-PCOS Society criteria were 6.1, 19.9 and 15.3%, respectively. While the prevalence of metabolic syndrome was 6.1% in the whole study group, within the patients diagnosed as PCOS according to NIH, Rotterdam and AE-PCOS Society criteria, it was 12.5, 10.3 and 10.0%, respectively. Even though we have included women working at a single institution with a high response rate for the participation, we cannot exclude potential selection bias due to undetermined differences between our sample and background community. We might have underestimated actual prevalence of metabolic syndrome in PCOS due to lack of oral glucose tolerance test 2 h glucose data. Current results can be generalized to Caucasian populations and may present variations in other populations according to race and ethnicity. This work was, in part, sponsored by Merck Serono. Not applicable.

Prevalence of metabolic syndrome in women with polycystic ovary syndrome, using two proposed definitions

Aim. To compare the prevalence rate of metabolic syndrome (MS) in women with polycystic ovary syndrome (PCOS) using the Adult Treatment Panel III (ATP III) criteria, with that using the International Diabetes Federation (IDF) criteria and also to assess the metabolic risk factors for this syndrome.Methods. This was a cross-sectional study, 198 women with PCOS were studied. MS was diagnosed as per the ATP III and IDF criteria, separately.Results. MS was found in 37.9% cases (ATP III criteria) and 47.5% cases of PCOS (IDF criteria) (p = 0.02). In adolescents, prevalence of MS was more with the IDF criteria (p = 0.009) but in adults, the prevalence rates were similar between the two criteria (p = 0.08). Women with MS had significantly higher body mass index, irrespective of age and the definition used. Dyslipidemia was found more common than elevated fasting glucose abnormality, using either of the criteria.Conclusion. Prevalence rate of MS in PCOS depends on the definition used. With IDF criteria, in the whole group, the prevalence was significantly higher. A universally accepted definition of MS, suitable for adolescents and adults, is urgently needed.