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RRM Academy Synopsis
Metabolic syndrome in 78 of 122 women with obesity, 24 with PCOS
In this clinic study, 78 of 122 women with obesity had metabolic syndrome, and 24 of those 78 also had PCOS. The study looked at 122 women aged 18 to 40 with regular cycles, seen by family medicine and general practice doctors. PCOS is now also called polyendocrine metabolic ovarian syndrome (PMOS).
Key Findings
Of 122 women with obesity, 78 had metabolic syndrome and 44 had obesity without metabolic syndrome.
Among the 78 women with metabolic syndrome, 24 (30.76%) also had PCOS. Six of the 44 women without metabolic syndrome (13.63%) had PCOS.
Among the 24 women with PCOS and metabolic syndrome, 75% (n=18) had three metabolic syndrome components and 25% (n=6) had four.
Of the women with PCOS and metabolic syndrome, 70.83% had low HDL cholesterol and 54.17% had high triglycerides.
Insulin resistance appeared in 50% of women with PCOS and metabolic syndrome and in 46.15% of women with metabolic syndrome.
Interpretation
The study is a single-group observational report. It describes which conditions occurred together and cannot show that PCOS or obesity caused metabolic syndrome. All 122 women had obesity, so the results say nothing about women of other weights, and no comparison group without obesity was included. Women taking medicines for blood pressure, cholesterol or diabetes were excluded. The PCOS group was small: 24 women with metabolic syndrome and six without. The authors write that a cause-and-effect link between insulin resistance and PCOS remains unclear. They call for screening guidelines to detect metabolic syndrome early in women with PCOS.
RRM Context
Restorative reproductive medicine looks for the underlying cause of ovulation problems, and metabolic health belongs in that search. The 2026 renaming of PCOS to PMOS puts the metabolic side in the name. A cycle chart records ovulation, which clinicians can read alongside the insulin resistance, blood fat and blood pressure markers this paper reports.
Our editorial summary of this paper, not the article's abstract.
Abstract
Women with polycystic ovary syndrome (PCOS) have a high prevalence of metabolic syndrome (MS), with rates up to 33%. This is associated with long-term consequences such as cardiovascular diseases, type 2 diabetes mellitus (T2DM), cancer, sleep apnea, and psychological issues. The prevalence of MS worldwide is often associated with obesity and T2DM, yet regional variations are reported. In this study, 122 women consulting general practice and family medicine physicians were evaluated, revealing a BMI exceeding 30 kg/m2. Among MS criteria, the most common diagnoses were T2DM in 29 patients, insulin resistance (IR) in 36, arterial hypertension (AH) in 51, reduced HDL levels in 53, and elevated triglycerides in 39. Further analysis revealed 16 unique combinations of MS components in these patients, with 75% of PCOS cases exhibiting three MS components and 25% having four. Additionally, research indicated that most women with PCOS face persistent, treatment-resistant obesity, with a notably higher BMI (ρ=0.87; r=0.76). These findings highlight the multifactorial nature of PCOS and MS etiology.
Salmanov AG et al., 2024·Wiadomosci lekarskie (Warsaw, Poland : 1960)
To determine the current prevalence of endometritis after hysteroscopic procedures and antimicrobial resistance of responsible pathogens in Ukraine.
Materials and Multicenter prospective cohort study was conducted from January 2020 to December 2022 in fifteen hospitals from twelve regions of Ukraine. Definitions of endometritis were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST.
Among 13,872 patients with hysteroscopic procedures, 1027 (7.4%) endometritis were observed. Of these cases, 0.4% were detected after diagnostic hysteroscopy, and 7.0% were detected after operative hysteroscopy. Of all endometritis cases, 64.2% were detected after hospital discharge. The most commonly reported bacterial species were Escherichia coli (24.3%), followed by Enterobacter spp. (12.7%), Enterococcus spp. (8.3%), Pseudomonas aeruginosa (8.1%), Serratia marcescens (6.8%), Staphylococcus aureus (5.9%), Proteus mirabilis (5.8%), Klebsiella oxytoca (5.1%), Stenotrophomonas maltophilia (4.5%), Klebsiella pneumoniae (4.1%). A significant proportion of patients were affected by endometritis caused by bacteria developed resistance to several antimicrobials, varying widely depending on the bacterial species, antimicrobial group, and geographical region of Ukraine.
Our data suggest a high prevalence of endometritis after hysteroscopic procedures. Risk for endometritis was higher after operative hysteroscopy compared with diagnostic hysteroscopy. Many most of patients were affected by endometritis caused by bacteria developed resistance to several antimicrobials. These data underscore the importance of tracking antimicrobial resistance of responsible pathogens of HAIs in hospitals.
Salmanov AG et al., 2022·Wiadomosci lekarskie (Warsaw, Poland : 1960)
The To obtain the first estimates of the current prevalence of healthcare-associated cervicitis (HACs) and antimicrobial resistance of responsible pathogens in Ukraine.
Materials and We conducted a retrospective multicentre cohort study was based on surveillance data from January 1st, 2019 to December 31st, 2021 in Ukraine. Antibiotic susceptibility testing was determined by Kirby-Bauer disc diffusion test according to the protocol of the European Committee on Antimicrobial Susceptibility Testing.
Of the 6,885 participants in this study, 1746 women (25.5%) met the clinical definition of cervicitis. Prevalence of HACs and cervcits caused sexually transmitted pathogens were 12.7% and 8.3%, respectively. The incidence of HACs among women with a history of gynecological procedures was 25.4%. The main causes of HACs were legal induced abortions (28.8%), vaginal hysterectomy (23.9%), and postpartum instrumental examination (12.8%). The predominant pathogens of HACs were: Escherichia coli, Enterobacter spp., Klebsiella spp., Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis. Methicillin-resistance was observed in 20.8% of S. aureus (MRSA). Vancomycin resistance was observed in 7.4% of isolated enterococci (VRE). Resistance to third-generation cephalosporins was observed in 13.1% Klebsiella spp. and E.coli 17.5% isolates. Carbapenem resistance was identified in 11.6% of P.aeruginosa isolates. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (33.5%, vs 8.7%). The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 34.6%.
This study showed that the prevalence of healthcare-associated cervicitis in Ukraine is high, and many cases were caused by antibiotic-resistant pathogens.
Napolean N et al., 2026·Cureus·Free full text on PubMed Central
Background Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic disorder characterized by reproductive, hormonal, and metabolic disturbances. This study aimed to evaluate the association between clinical features, anthropometric indices, hormonal parameters, metabolic profile, ultrasonographic findings, and the second-to-fourth digit (2D:4D) ratio in women with PCOS compared to age-matched healthy controls. Methods A case-control study was conducted, including women diagnosed with PCOS and age-matched healthy controls. Clinical features, anthropometric measurements (BMI, waist-hip ratio (WHR), waist-height ratio (WHtR)), hormonal parameters (luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH)), metabolic variables (fasting glucose, lipid profile), ultrasonographic findings, and 2D:4D digit ratio were assessed. Statistical analysis was performed using appropriate tests, and a p-value < 0.05 was considered statistically significant. Results Women with PCOS exhibited a significantly higher prevalence of menstrual irregularity, polycystic ovarian morphology, hirsutism, and acne (p < 0.001). Hormonal analysis showed significantly elevated LH, FSH, and AMH levels in PCOS cases (p < 0.001). Anthropometric indices, including BMI, WHR, and WHtR, were significantly higher among PCOS cases (p < 0.01), indicating increased general and central adiposity. In contrast, fasting glucose and lipid profile levels did not differ significantly between groups. Additionally, the 2D:4D ratio was significantly lower in PCOS cases (p < 0.01) and showed significant negative correlations with BMI, WHR, WHtR, and cholesterol levels. Conclusion The study demonstrates that PCOS is associated with significant hormonal dysregulation, central obesity, and early metabolic alterations. The lower 2D:4D ratio observed in PCOS supports the role of prenatal androgen exposure in disease pathogenesis. These findings highlight the complex interplay between developmental, metabolic, and endocrine factors in PCOS and underscore the importance of early identification and comprehensive management strategies.
Giri A et al., 2022·JNMA; journal of the Nepal Medical Association·Free full text on PubMed Central
Metabolic syndrome in polycystic ovarian syndrome is associated with a long-term risk of developing type 2 diabetes mellitus and cardiovascular disease. This study aims to find the prevalence of metabolic syndrome among patients with polycystic ovarian syndrome presenting to a tertiary care hospital. A descriptive cross-sectional study was done on women attending the obstetrics and gynecology outpatient department of a tertiary care hospital from June 2020 to May 2021. A total of 106 women diagnosed with polycystic ovarian syndrome using Rotterdam criteria 2003 were recruited for the study and cases of metabolic syndrome was defined according to the modified American Heart Association/National Heart Lung and Blood Institute. Ethical approval was taken from the Institutional Review Committee of Nepal Medical College and Teaching Hospital (Reference number: 001-077/078). Convenience sampling was done. The collected data was entered and analyzed in Statistical Package for the Social Sciences version 21. Calculation of point estimate at 95% confidence interval was done along with frequency and proportion for binary data. Among 106 women with polycystic ovarian syndrome, 50 (47.1%) had metabolic syndrome (37.59-56.60 at 95% Confidence Interval). The most common component of metabolic syndrome was low high-density lipoprotein cholesterol in 90 (84.9%) followed by central obesity in 60 (56.6%), hypertriglyceridemia in 47 (44.33%), high fasting sugar in 34 (32.07%), and high blood pressure in 14 (13.2%). The prevalence of metabolic syndrome among patients with the polycystic ovarian syndrome was similar to other studies done in similar settings.
Chandrasekaran S et al., 2018·The Obstetrician & Gynaecologist
Key content The risk factors for metabolic syndrome include central obesity, hypertension, atherogenic dyslipidaemia and insulin resistance. Metabolic syndrome affects 33% of women with polycystic ovary syndrome (PCOS) and has been less well researched than other features such as infertility, anovulation and hirsutism. Consequences of metabolic syndrome include cardiovascular disease, type II diabetes, cancer, sleep apnoea and psychological problems. Cardiometabolic risk screening involves obtaining data on smoking history, weight, body mass index, waist circumference, blood pressure, lipid profile, and taking an oral glucose tolerance test. Management of metabolic syndrome should focus on risk factors and individual components. Lifestyle modification is the only recommended intervention at present. Learning objectives To know the pathogenesis and consequences of metabolic syndrome in women with PCOS. To understand the diagnostic criteria and screening procedures for metabolic syndrome. To learn how to manage metabolic syndrome in women with PCOS. Ethical issues Potential preventive long‐term medication raises two issues: duration of therapy and unwarranted adverse effects. Advocating bariatric surgery without availability of robust evidence in PCOS women.
Torchen LC, 2017·Current diabetes reports·Free full text on PubMed Central
Polycystic ovary syndrome (PCOS) is diagnosed by its characteristic reproductive features. However, PCOS is also associated with metabolic abnormalities, including insulin resistance and β-cell dysfunction. The severity of these abnormalities varies according to the reproductive phenotype, with the so-called NIH or classic phenotype conferring the greatest metabolic risk. The increased risk for type 2 diabetes (T2D) is well established among affected women with the NIH phenotype, but whether PCOS also confers an increased risk for cardiovascular events remains unknown. Recent studies in daughters of affected women have found evidence for pancreatic β-cell dysfunction prior to menarche. Further, genetic analyses have provided evidence that metabolic abnormalities such as obesity and insulin resistance contribute to the pathogenesis of PCOS. PCOS increases the risk for T2D. However, the risk for cardiovascular disease has not been quantified, and prospective, longitudinal studies are still critically needed.
Reproductive Endocrinology › Thyroid and Metabolic Function › Insulin and Metabolism · PMOS / PCOS › Long Term Health › Metabolic Risk