Vnitr Lek 2016, 62(5):392-397

Clinical implications of polycystic ovary syndrome

Ingrid Dravecká
I. interná klinika LF UPJŠ a UN L. Pasteura Košice, Slovenská republika

Polycystic ovary syndrome (PCOS) is a heterogeneous and complex endocrine disease which among the female population belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycaemia in a majority of women with PCOS (60-80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications. Reproduction disorders include hyperthyroidism, menstruation cycle disorders, infertility and pregnancy complications as well as early abortions, gestational diabetes and pregnancy induced hypertension. Long-term metabolic risks of PCOS include type 2 diabetes mellitus, dyslipidemia, arterial hypertension and endothelial dysfunction. The available data confirms higher incidence of cardiovascular diseases in women with PCOS. In particular among obese women PCOS is more frequently associated with non-alcoholic hepatic steatosis, sleep apnoea syndrome and endometrial cancer. The literature includes some controversial data about the relationship between PCOS and autoimmunity. Women with PCOS are more prone to suffer from insufficient confidence with higher incidence of anxiety, depression, bipolar disorder and eating disorders.

Keywords: autoimmunity; diabetes mellitus; pregnancy; insulin resistance; metabolic syndrome; menstrual disorders; polycystic ovary syndrome

Received: December 21, 2015; Accepted: February 14, 2015; Published: May 1, 2016  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Dravecká I. Clinical implications of polycystic ovary syndrome. Vnitr Lek. 2016;62(5):392-397.
Download citation

References

  1. de Melo AS, Dias SV, Cavalli Rde C et al. Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause. Reproduction 2015; 150(1): R11-R24. Go to original source... Go to PubMed...
  2. Ben-Shlomo I, Younis JS. Basic research in PCOS: are we reaching new frontiers? Reprod Biomed Online 2014; 28(6): 669-683. Go to original source... Go to PubMed...
  3. Jayasena CN, Franks S. The management of patients with polycystic ovary syndrome. Nat Rev Endocrinol 2014; 10(10): 624-638. Go to original source... Go to PubMed...
  4. Moran LJ, Norman RJ, Teede HJ et al. Metabolic risk in PCOS: phenotype and adiposity impact. Trends Endocrinol Metab 2015; 26(3): 136-143. Go to original source... Go to PubMed...
  5. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol 2013; 6: 1-13. Go to original source... Go to PubMed...
  6. Svačina Š. Metabolické aspekty syndromu polycystických ovárií. Vnitř Lék 2002; 48(12): 1142-1146. Go to PubMed...
  7. Stárka L, Cermáková I, Dusková M et al. Hormonal Profile of Men with Premature Balding. Exp Clin Endocrinol Diabetes 2004; 112(1): 24-28. Go to original source... Go to PubMed...
  8. Livadas S, Diamanti-Kandarakis E. Polycystic Ovary Syndrome: Definitions, Phenotypes and Diagnosis Approach. Front Horm Res 2013; 40: 1-21. Go to original source...
  9. Pasquali R, Gamberini A. Targeting insulin sensitivity in the treatment of polycystic ovary syndrome. Expert Opin Ther Targets 2009; 13(10): 1205-1226. Go to original source... Go to PubMed...
  10. [The Rotterdam ESHRE/ASRM-sponsored PCOS consensus Workshop Group]. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reprod 2004; 19(1): 41-47. Go to original source... Go to PubMed...
  11. Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Human Reprod Update 2009; 15(4): 477-488. Go to original source... Go to PubMed...
  12. Evidence-based Methology Workshop on Polycystic Ovary Syndrome. National Institutes of Health (NIH). 3-5.12. 2012. Dostupné z WWW: <https://prevention.nih.gov/programs-events/pathways-to-prevention/past-workshops/pcos>.
  13. Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. Int J Womens Health 2011; 3: 25-35. Go to original source... Go to PubMed...
  14. Nandi A, Chen Z, Patel R et al. Polycystic Ovary Syndrome. Endocrinol Metab Clin N Am 2014; 43(1): 123-147. Go to original source... Go to PubMed...
  15. Diamanti-Kandarakis E, Dunaif A. Insulin Resistance and the Polycystic Ovary Syndrome Revisited: An Update on Mechanisms and Implications. Endocrine Reviews 2012; 33(6): 981-1030. Go to original source... Go to PubMed...
  16. Vrbíkova J. Sexageny a lipidy u žen. Interní Med Prax 2005; 7(10): 430-432.
  17. Wild RA, Carmina E, Diamanti-Kandarakis E et al. Assessment of Cardiovascular Risk and Prevention of Cardiovascular Disease in Women with the Polycystic Ovary Syndrome: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab 2010; 95(5): 2038-2049. Go to original source... Go to PubMed...
  18. Schröder AK, Tauchert S, Ortmann O et al. Insulin resistance in patients with polycystic ovary syndrome. Ann Med 2004; 36(6): 426-439. Go to original source... Go to PubMed...
  19. Goodarzi MO, Korenman SG. The importance of insulin resistance in polycystic ovary syndrome. Fertil Steril 2003; 80(2): 255-258. Go to original source... Go to PubMed...
  20. Glintborg D, Andersen M. An update on the pathogenesis, inflammation, and metabolism in hirsutism and polycystic ovary syndrome. Gynecol Endocrinol 2010; 26(4): 281-296. Go to original source... Go to PubMed...
  21. Čermáková I, Vrbíková J, Dušková M et al. Sexuální steroidy a inzulinová rezistence. DMEV 2003; 6(3): 143-148.
  22. Bajuk Studen K, Jensterie Sever M, Pfeifer M. Cardiovascular risk and subclinical cardiovascular disease in polycystic ovary syndrome. Front Horm Res 2013; 40: 64-82. Go to original source... Go to PubMed...
  23. Rocha MP, Marcondes JA, Barcellos CR et al. Dyslipidemia in women with polycystic ovary syndrome: incidence, pattern and predictors. Gynecol Endocrinol 2010; 27(10): 814-819. Go to original source... Go to PubMed...
  24. Macut D, Bjekiuć-Macut J, Savić-Radjević A. Dyslipidemia and oxidative stress in PCOS. Front Horm Res 2013; 40: 51-63. Go to original source... Go to PubMed...
  25. Kim JJ, Choi YM. Dyslipidemia in women with polycystic ovary syndrome. Obstet Gynecol Sci 2013; 56(3): 137-142. Go to original source... Go to PubMed...
  26. Vrbíková J. Syndrom polycystických ovarií. Vnitř Lék 2015; 61(10): 886-895. Go to PubMed...
  27. Vassilatou E. Nonalcoholic fatty liver disease and polycystic ovary syndrome. World J Gastroenterol 2014; 20(26): 8351-8363. Go to original source... Go to PubMed...
  28. Wang ET, Cirillo PM, Vittinghoff E et al. Menstrual Irregularity and Cardiovascular Mortality. J Clin Endocrinol Metab 2011; 96(1): E114-E118. Go to original source... Go to PubMed...
  29. de Groot PC, Dekkers OM, Romijn JA et al. PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis. Human Reprod Update 2011; 17(4): 495-500. Go to original source... Go to PubMed...
  30. Schmidt J, Landin-Wilhelmsen K, Brännström M et al. Cardiovascular Disease and Risk Factors in PCOS Women of Postmenopausal Age: A 21-Year Controlled Follow-Up Study. J Clin Endocrinol Metab 2011; 96(12): 3794-3803. Go to original source... Go to PubMed...
  31. Shaw LJ, Bairey Merz CN, Azziz R et al. Postmenopasual women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health - National Heart, Lung, and Blood Institute sponsored Women's Ischemia Syndrome Evaluation. J Clin Endocrinol Metab 2008; 93(4): 1276-1284. Go to original source... Go to PubMed...
  32. Setji TL, Brown AJ. Polycystic Ovary Syndrome: Update on Diagnosis and Treatment. AMJMED 2014; 127(10): 912-919. Go to original source... Go to PubMed...
  33. Tasali E, Chapotot F, Leproult R et al. Treatment of Obstructive Sleep Apnea Improves Cardiometabolic Function in Young Obese Women with Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2011; 96(2): 365-374. Go to original source... Go to PubMed...
  34. Qin JZ et al. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrinol 2013; 11: 56. Go to original source... Go to PubMed...
  35. Diamanti-Kandarakis E, Christakou CD, Kandaraki E et al. Metformin: an old medication of new fashion: evolving new molecular mechanisms and clinical implications in polycystic ovary syndrome. Eur J Endocrinol 2010; 162(2): 193-212. Go to original source... Go to PubMed...
  36. Petríková J, Lazúrová I, Yehuda S. Polycystic ovary syndrome and autoimmunity. EJIM 2010; 21(5): 369-371. Go to original source... Go to PubMed...
  37. Janssen OE, Mehlmauer N, Hahn S et al. High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Eur J Endocrinol 2004; 150(3): 363-369. Go to original source... Go to PubMed...
  38. Glintborg D, Andersen M, Hagen C et al. Association of Pioglitazone Treatment with Decreased Bone Mineral Density in Obese Premenopausal Patients with Polycystic Ovary Syndrome: A Randomized, Placebo-Controlled Trial. J Clin Endocrinol Metab 2008; 93(5): 1696-1701. Go to original source... Go to PubMed...
  39. Diamanti-Kandarakis E, Baillargeon JP, Iuorno MJ et al. A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills. J Clin Endocrinol Metab 2003; 88(5): 1927-1932. Go to original source... Go to PubMed...
  40. Haoula Z, Salman M, Atiomo W. Evaluating the Association Between Endometrial Cancer and Polycystic Ovary Syndrome. Hum Reprod 2012; 27(5): 1327-1331. Go to original source... Go to PubMed...
  41. Kaas R, Lukanova A, Kurzer MS. Obesity, Endogenous Hormones and Endometrial Cancer Risk: A Synthetic Review. Cancer Epidemiol Biomarkers Prev 2002; 11(12): 1531-1543.
  42. Galazis N, Afxentiou T, Xenophontos M et al. Proteomic biomarkers of type 2 diabetes mellitus risk in women with polycystic ovary syndrome. Eur J Endocrinol 2013; 168(2): R33-R43. Go to original source... Go to PubMed...
  43. Saha L, Kaur S, Saha PK. Pharmacotherapy of polycystic ovary syndrome - an update. Fundam Clin Pharmacol 2012; 26(1): 54-62. Go to original source... Go to PubMed...
  44. Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med 2006; 12(7): 324-332. Go to original source... Go to PubMed...




Vnitřní lékařství

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.