Complications and challenges associated with polycystic ovary syndrome: current perspectives.
TL;DR: Women with PCOS are considered to be at increased risk of obstetric, cardiometabolic, oncology, and psychological complications throughout life, and it is recommended that these women be accurately assessed with periodic follow-up.
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Abstract: Polycystic ovary syndrome (PCOS) represents the most common endocrine dysfunction in fertile women and it is considered a heterogeneous and multifaceted disorder, with multiple reproductive and metabolic phenotypes which differently affect the early- and long-term syndrome's risks. Women with PCOS present an adverse reproductive profile, including a high risk of pregnancy-induced hypertension, preeclampsia, and gestational diabetes mellitus. Patients with PCOS present not only a higher prevalence of classic cardiovascular risk factors, such as hypertension, dyslipidemia, and type-2 diabetes mellitus, but also of nonclassic cardiovascular risk factors, including mood disorders, such as depression and anxiety. Moreover, at the moment, clinical data on cardiovascular morbidity and mortality in women with PCOS are controversial. Finally, women with PCOS show an increased risk of endometrial cancer compared to non-PCOS healthy women, particularly during premenopausal period. Currently, we are unable to clarify if the increased PCOS early- and long-term risks are totally due to PCOS per se or mostly due to obesity, in particular visceral obesity, that characterized the majority of PCOS patients. In any case, the main endocrine and gynecological scientific societies agree to consider women with PCOS at increased risk of obstetric, cardiometabolic, oncology, and psychological complications throughout life, and it is recommended that these women be accurately assessed with periodic follow-up.
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Citations
Diagnostic criteria for polycystic ovary syndrome
Dolian Gg,Burnazian Ra,Vanetsian Al,Okoev Gg,Abgarian Mt +4 more
- 01 Jul 1989
TL;DR: It is suggested that ultrasound, laparoscopic, hormonal and endometrial parameters should be employed as diagnostic criteria for ovarian polycystosis.
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A Novel Letrozole Model Recapitulates Both the Reproductive and Metabolic Phenotypes of Polycystic Ovary Syndrome in Female Mice.
Alexander S. Kauffman,Varykina G. Thackray,Genevieve E. Ryan,Kristen P. Tolson,Christine A. Glidewell-Kenney,Sheila J. Semaan,Matthew C. Poling,Nahoko Iwata,Kellie M Breen,Antoni J. Duleba,Elisabet Stener-Victorin,Shunichi Shimasaki,Nicholas J. G. Webster,Pamela L. Mellon +13 more
TL;DR: This is the first report of a LET paradigm in mice that recapitulates both reproductive and metabolic PCOS phenotypes and will be useful to genetically probe the PCOS condition.
Insulin, insulin receptors, and cancer
TL;DR: All conditions of hyperinsulinemia, both endogenous (prediabetes, metabolic syndrome, obesity, type 2 diabetes before pancreas exhaustion and polycystic ovary syndrome) and exogenous (type 1 diabetes) will increase the risk of cancer.
188
Polycystic ovary syndrome throughout a woman’s life
José Bellver,Luis Rodriguez-Tabernero,Ana Robles,Elkin Muñoz,Francisca Martínez,Jose Landeras,Juan A. Garcia-Velasco,Juan Fontes,Monica Alvarez,Claudio Alvarez,Belen Acevedo +10 more
TL;DR: Polycystic ovary syndrome exhibits a great metabolic complexity and its diagnosis needs to be revised once again and adapted to recent data obtained by new technologies.
175
Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials.
TL;DR: The trial sequential analysis of insulin meta-analysis illustrates that the cumulative z-curve crossed the monitoring boundary, providing firm evidence of the intervention effect of MI in improving the metabolic profile of women with PCOS, concomitantly reducing their hyperandrogenism.
References
PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis
Groot P C M de,Olaf M. Dekkers,Johannes A. Romijn,S.W.M. Dieben,Frans M. Helmerhorst +4 more
- 01 Apr 2011
TL;DR: A systematic review and meta-analysis of controlled observational studies showed a 2-fold risk of arterial disease for patients with PCOS relative to women without PCOS, suggesting the increased risk for cardiovascular events in PCOS is not completely related to a higher BMI in patients withPCOS.
267
Exercise therapy in polycystic ovary syndrome: a systematic review
TL;DR: The most consistent improvements included improved ovulation, reduced IR, and weight loss and were not dependant on the type of exercise, frequency or length of exercise sessions.
261
Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study
Stefano Palomba,Francesco Giallauria,Angela Falbo,Tiziana Russo,Rosamaria Oppedisano,Achille Tolino,A. Colao,Carlo Vigorito,Fulvio Zullo,Francesco Orio +9 more
TL;DR: Both SET and diet interventions improve fertility in obese PCOS patients with anovulatory infertility, and it is hypothesized that in both interventions an improvement in insulin sensitivity is the pivotal factor involved in the restoration of ovarian function but potentially acting through different mechanisms.
252
Androgens and mood dysfunction in women: comparison of women with polycystic ovarian syndrome to healthy controls.
TL;DR: Depression was significantly increased in the PCOS group and remained so after considering the variance related to physical symptomatology and other mood states, and a curvilinear relationship between FT and negative affect across groups was suggested.
247
Cardiovascular Disease and Risk Factors in PCOS Women of Postmenopausal Age: A 21-Year Controlled Follow-Up Study
TL;DR: The well-described cardiovascular/metabolic risk profile in pre- and perimenopausal PCOS women does not entail an evident increase in cardiovascular events during the postmenopausal period.
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