Yildirim, B., Sabir, N., & Kaleli, B. (2003). Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertility and sterility, 79(6), 1358-1364. https://doi.org/10.1016/s0015-0282(03)00265-6
Yildirim B, Sabir N, Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2003;79(6):1358-1364. doi:10.1016/s0015-0282(03)00265-6
Yildirim, Basak, et al. "Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome." Fertility and sterility, vol. 79, no. 6, 2003, pp. 1358-1364.
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Department of Obstetrics and Gynecology, Faculty of Medicine, Pamukkale University, Denizli, Turkey. basakyildirim@hotmail.com
To investigate the relation between intra-abdominal fat distribution and metabolic disorders in nonobese patients with the polycystic ovary syndrome (PCOS).
Design
Prospective case-control study.
Setting
University-based hospital.
Patients
Thirty nonobese patients with PCOS and 30 lean women with regular menstrual cycles (controls). All participants had a body mass index < 25kg/m(2).
Main Outcome Measures
Subcutaneous and intra-abdominal visceral and preperitoneal fat thicknesses were assessed by ultrasonography. Glucose tolerance and insulin sensitivity were evaluated by standard 75-g oral glucose tolerance test and area-under-the-curve analysis. Serum hormones and lipid profile were measured.
Results
The mean preperitoneal and visceral fat thicknesses were significantly greater in nonobese patients with PCOS. Subcutaneous fat mass was similar between the PCOS and control groups. Nonobese patients with PCOS had glucose intolerance, hyperinsulinemia, and dyslipidemia, manifested by high serum levels of triglyceride, total cholesterol, and high-density lipoprotein (HDL) levels and low serum low-density lipoprotein (LDL) levels. No correlation existed between subcutaneous fat thickness and the metabolic variables in nonobese patients with PCOS. However, serum triglyceride levels correlated with visceral fat and preperitoneal fat thickness. The mean HDL level correlated negatively with visceral fat and preperitoneal fat thickness. The area under the curve for insulin and mean fasting insulin levels correlated positively with visceral fat thickness. In multiple regression analysis, visceral fat thickness contributed significantly to high serum triglyceride and fasting insulin levels.
Conclusions
Intra-abdominal preperitoneal and visceral fat accumulation may contribute to the development of glucose and lipid metabolism disorders in nonobese patients with PCOS.
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.
It is unknown which phenotype of polycystic ovary syndrome (PCOS) has a greater metabolic risk and how to detect this risk. The aim of this study was therefore to compare the incidence of metabolic syndrome (MetS) and metabolic risk profile (MRP) for different phenotypes. A total of 100 consecutive newly diagnosed PCOS women in a tertiary referral hospital were recruited. Patients were classified into four phenotypes according to the Rotterdam criteria, on the presence of at least two of the three criteria hyperandrogenism (H), oligo/anovulation (O) and PCO appearance (P): phenotype A, H + O + P; phenotype B, H + O; phenotype C, H + P; phenotype D, O + P. Prevalence of MetS and MRP were compared among the four groups. Based on Natural Cholesterol Education Program Adult Treatment Panel III diagnostic criteria, MetS prevalence was higher in phenotypes A and B (29.6% and 34.5%) compared with the other phenotypes (10.0% and 8.3%; P < 0.001). Although the prevalence of obesity was similar, the number of patients with homeostatic model assessment insulin resistance index (HOMA-IR) >3.8 was significantly higher in androgenic PCOS phenotypes. After logistic regression analysis, visceral adiposity index (VAI) was the only independent predictor of MetS in PCOS (P = 0.002). VAI was also significantly higher in phenotype B, when compared with the others (P < 0.01). Phenotypes A and B had the highest risk of MetS among the four phenotypes, and VAI may be a predictor of metabolic risk 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.
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.
PMOS / PCOS › Long Term Health › Metabolic Risk · Diagnostics › Ultrasound › Transvaginal Ultrasound
Basak Yildirim, Nuran Sabir, Babur Kaleli
B Yildirim, N Sabir, B Kaleli
PMID 12798883 12798883 DOI 10.1016/s0015-0282(03)00265-6 10.1016/s0015-0282(03)00265-6 Yildirim et al. 2003, Yildirim 2003
Cite this article
Yildirim, B., Sabir, N., & Kaleli, B. (2003). Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertility and sterility, 79(6), 1358-1364. https://doi.org/10.1016/s0015-0282(03)00265-6
Yildirim B, Sabir N, Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2003;79(6):1358-1364. doi:10.1016/s0015-0282(03)00265-6
Yildirim, Basak, et al. "Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome." Fertility and sterility, vol. 79, no. 6, 2003, pp. 1358-1364.
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