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Current Obesity Reports
Published in: Current Obesity Reports 4/2014

01-12-2014 | Metabolism (R Pasquali, Section Editor)

Aspects of Cardiometabolic Risk in Women with Polycystic Ovary Syndrome

Authors: Thomas S. Paterakis, Evanthia Diamanti-Kandarakis

Published in: Current Obesity Reports | Issue 4/2014

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Abstract

Women with polycystic ovary syndrome (PCOS), the most common endocrine disorder among women of reproductive age, exhibit an adverse cardiovascular risk profile characteristic of the cardiometabolic syndrome. These women, compared with age- and body mass index-matched women without PCOS, appear to present a higher risk of insulin resistance, glucose intolerance, and dyslipidemia, and possibly a higher rate of type 2 diabetes mellitus and cardiovascular disease. However, despite the presence of cardiovascular risk factors and increased surrogate markers of cardiovascular disease, it is unclear whether they have accelerated atherosclerosis and greater mortality, the latter mainly because of a lack of endpoint studies. This article addresses, summarizes, and discusses salient data from the existing literature, including gaps and uncertainties, aspects, and mechanisms related to the spectrum of adverse cardiometabolic profile factors in women with PCOS.
Literature
1.••
Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polysystic ovary syndrome. Clin Epidemiol. 2013;6:1–13. An essential review on epidemiology, diagnosis and management of PCOS. The prevalence of PCOS varies depending on which criteria are used to make the diagnosis. Proper diagnosis and management of PCOS is essential to address patient concerns but also to prevent future metabolic, endocrine, psychiatric, and cardiovascular complications.PubMedCentralPubMedCrossRef
2.
Diamanti-Kandarakis E, Kouli CR, Bergiele AT, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84(11):4006–11.PubMedCrossRef
3.
Carmina E, Campagna AM, Lobo RA. Emergence of ovulatory cycles with aging in women with polycystic ovary syndrome (PCOS) alters the trajectory of cardiovascular and metabolic risk factors. Hum Reprod. 2013;28:2245–52.PubMedCrossRef
4.
Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome. In: Givens JHF, Merriman G, editors. The polycystic ovary syndrome. Cambridge: Blackwell Scientific; 1992. p. 377–84.
5.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.CrossRef
6.
Azziz R, Carmina E, Dewailly D, et al. Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91(11):4237–45.PubMedCrossRef
7.••
Randeva HS, Tan BK, Weickert MO, et al. Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev. 2012;33(5):812–41. Great review on the same topic.PubMedCentralPubMedCrossRef
8.•
Livadas S, Diamanti-Kandarakis E. Polycystic ovary syndrome: definitions, phenotypes and diagnostic approach. Front Horm Res. 2013;40:1–21. Very useful information regarding grey zones in assessing anovulation, hyperandrogenism, ovarian morphology and the difficulties in differential diagnosis of PCOS. Furthermore, the lack of substantial data characterizing metabolic/hormonal profile and the potential cardiovascular risk in newer PCOS phenotypes, as well as the absence of longitudinal data questioning a possible shift from one phenotype to another are underlined.PubMedCrossRef
9.
Diamanti-Kandarakis E. Role of obesity and adiposity in polycystic ovary syndrome. Int J Obes (Lond). 2007;31 Suppl 2:S8–13. discussion S31-2.CrossRef
10.
Lim SS, Davies MJ, Norman RJ, et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(6):618–37.PubMedCrossRef
11.
Androulakis II, Kandaraki E, Christakou C, et al. Visceral adiposity index (VAI) is related to the severity of anovulation and other clinical features in women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2014 Mar 7.
12.••
Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012;33(6):981–1030. This article summarizes the state of the science regarding the association between insulin resistance and PCOS. The association between insulin resistance and PCOS has led to the discovery that insulin is an important reproductive hormone and that insulin signaling in the CNS is critical for ovulation. Androgens also have important effects on insulin sensitivity and secretion.PubMedCrossRef
13.
Kelly CJ, Speirs A, Gould GW, et al. Altered vascular function in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2002;87(2):742–6.PubMedCrossRef
14.
Legro RS, Kunselman AR, Dodson WC, et al. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84(1):165–9.PubMed
15.
Trakakis E, Basios G, Peppa M, et al. The prevalence of glucose metabolism abnormalities in Greek women with polycystic ovary syndrome. Gynecol Endocrinol. 2012;28(11):867–70.PubMedCrossRef
16.
Diamanti-Kandarakis E, Papailiou J, Palimeri S. Hyperandrogenemia: pathophysiology and its role in ovulatory dysfunction in PCOS. Pediatr Endocrinol Rev. 2006;3 Suppl 1:198–204.PubMed
17.
Livadas S, Pappas C, Karachalios A, et al. Prevalence and impact of hyperandrogenemia in 1218 women with polycystic ovary syndrome. Endocrine. 2014 Apr 22.
18.
Lovejoy JC, Bray GA, Bourgeois MO, et al. Exogenous androgens influence body composition and regional body fat distribution in obese postmenopausal women—a clinical research center study. J Clin Endocrinol Metab. 1996;81(6):2198–203.PubMed
19.
Dunaif A, Green G, Futterweit W, et al. Suppression of hyperandrogenism does not improve peripheral or hepatic insulin resistance in the polycystic ovary syndrome. J Clin Endocrinol Metab. 1990;70(3):699–704.PubMedCrossRef
20.
Diamanti-Kandarakis E, Mitrakou A, Hennes MM, et al. Insulin sensitivity and antiandrogenic therapy in women with polycystic ovary syndrome. Metabolism. 1995;44(4):525–31.PubMedCrossRef
21.
Elkind-Hirsch KE, Valdes CT, Malinak LR. Insulin resistance improves in hyperandrogenic women treated with Lupron. Fertil Steril. 1993;60(4):634–41.PubMed
22.
Moghetti P, Tosi F, Castello R, et al. The insulin resistance in women with hyperandrogenism is partially reversed by antiandrogen treatment: evidence that androgens impair insulin action in women. J Clin Endocrinol Metab. 1996;81(3):952–60.PubMed
23.
Cagnacci A, Paoletti AM, Arangino S, et al. Effect of ovarian suppression on glucose metabolism of young lean women with and without ovarian hyperandrogenism. Hum Reprod. 1999;14(4):893–7.PubMedCrossRef
24.
Messer C, Boston R, Leroith D, et al. Pancreatic β-cell dysfunction in polycystic ovary syndrome: the role of metformin. Endocr Pract. 2012;18(5):685–93.PubMedCentralPubMedCrossRef
25.
Dunaif A, Finegood DT. Beta-cell dysfunction independent of obesity and glucose intolerance in the polycystic ovary syndrome. J Clin Endocrinol Metab. 1996;81(3):942–7.PubMed
26.
Arslanian SA, Lewy VD, Danadian K. Glucose intolerance in obese adolescents with polycystic ovary syndrome: roles of insulin resistance and beta-cell dysfunction and risk of cardiovascular disease. J Clin Endocrinol Metab. 2001;86(1):66–71.PubMed
27.
Ehrmann DA, Sturis J, Byrne MM, et al. Insulin secretory defects in polycystic ovary syndrome. Relationship to insulin sensitivity and family history of noninsulin-dependent diabetes mellitus. J Clin Invest. 1995;96(1):520–7.PubMedCentralPubMedCrossRef
28.
Holte J, Bergh T, Berne C, et al. Enhanced early insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose tolerance. J Clin Endocrinol Metab. 1994;78(5):1052–8.PubMed
29.
Holte J, Bergh T, Berne C, Wide L, Lithell H. Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1995;80(9):2586–93.PubMed
30.
Morin-Papunen LC, Vauhkonen I, Koivunen RM, et al. Insulin sensitivity, insulin secretion, and metabolic and hormonal parameters in healthy women and women with polycystic ovarian syndrome. Hum Reprod. 2000;15(6):1266–74.PubMedCrossRef
31.
Gennarelli G, Rovei V, Novi RF, et al. Preserved insulin sensitivity and {beta}-cell activity, but decreased glucose effectiveness in normal-weight women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90(6):3381–6.PubMedCrossRef
32.
Svendsen PF, Nilas L, Norgaard K, et al. Obesity, body composition and metabolic disturbances in polycystic ovary syndrome. Hum Reprod. 2008;23(9):2113–21.PubMedCrossRef
33.
Glueck CJ, Morrison JA, Goldenberg N, et al. Coronary heart disease risk factors in adult premenopausal white women with polycystic ovary syndrome compared with a healthy female population. Metabolism. 2009;58(5):714–21.PubMedCrossRef
34.
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):1358–64.PubMedCrossRef
35.
Wild RA. Polycystic ovary syndrome: a risk for coronary artery disease? Am J Obstet Gynecol. 2002;186(1):35–43.PubMedCrossRef
36.
Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis SA, et al. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab. 2007;18(7):280–5.PubMedCrossRef
37.
Wild RA, Rizzo M, Clifton S, et al. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011;95(3):1073–9.PubMedCrossRef
38.
Essah PA, Nestler JE, Carmina E. Differences in dyslipidemia between American and Italian women with polycystic ovary syndrome. J Endocrinol Investig. 2008;31(1):35–41.CrossRef
39.
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):2038–49.PubMedCrossRef
40.
Bentley-Lewis R, Seely E, Dunaif A. Ovarian hypertension: polycystic ovary syndrome. Endocrinol Metab Clin N Am. 2011;40(2):433–49.CrossRef
41.
Elting MW, Korsen TJ, Bezemer PD, et al. Prevalence of diabetes mellitus, hypertension and cardiac complaints in a follow-up study of a Dutch PCOS population. Hum Reprod. 2001;16(3):556–60.PubMedCrossRef
42.
Cibula D, Cifkova R, Fanta M, et al. Increased risk of non-insulin dependent diabetes mellitus, arterial hypertension and coronary artery disease in perimenopausal women with a history of the polycystic ovary syndrome. Hum Reprod. 2000;15(4):785–9.PubMedCrossRef
43.
Wild S, Pierpoint T, McKeigue P, et al. Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol (Oxf). 2000;52(5):595–600.CrossRef
44.
Wild S, Pierpoint T, Jacobs H, et al. Long-term consequences of polycystic ovary syndrome: results of a 31 year follow-up study. Hum Fertil (Camb). 2000;3(2):101–5.CrossRef
45.
Holte J, Gennarelli G, Berne C, et al. Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state? Hum Reprod. 1996;11(1):23–8.PubMedCrossRef
46.
Dahlgren E, Johansson S, Lindstedt G, et al. Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a longterm follow-up focusing on natural history and circulating hormones. Fertil Steril. 1992;57(3):505–13.PubMed
47.
Lo JC, Feigenbaum SL, Yang J, et al. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(4):1357–63.PubMedCrossRef
48.
Christakou CD, Diamanti-Kandarakis E. Role of androgen excess on metabolic aberrations and cardiovascular risk in women with polycystic ovary syndrome. Women’s Health (Lond Engl). 2008;4(6):583–94.CrossRef
49.
Shaw LJ, Bairey Merz CN, Azziz R, et al. Postmenopausal 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):1276–84.PubMedCentralPubMedCrossRef
50.
Orio Jr F, Palomba S, Cascella T, et al. Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2004;89(9):4588–93.PubMedCrossRef
51.
Kelly CC, Lyall H, Petrie JR, et al. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab. 2001;86(6):2453–5.PubMedCrossRef
52.
Koiou E, Tziomalos K, Dinas K, et al. Plasma plasminogen activator inhibitor-1 levels in the different phenotypes of the polycystic ovary syndrome. Endocr J. 2012;59(1):21–9.PubMedCrossRef
53.
Diamanti-Kandarakis E, Spina G, Kouli C, et al. Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J Clin Endocrinol Metab. 2001;86(10):4666–73.PubMedCrossRef
54.
Diamanti-Kandarakis E, Paterakis T, Alexandraki K, et al. Indices of low-grade chronic inflammation in polycystic ovary syndrome and the beneficial effect of metformin. Hum Reprod. 2006;21(6):1426–31.PubMedCrossRef
55.
Boutzios G, Livadas S, Piperi C, et al. Polycystic ovary syndrome offspring display increased oxidative stress markers comparable to gestational diabetes offspring. Fertil Steril. 2013;99(3):943–50.PubMedCrossRef
56.
Diamanti-Kandarakis E, Piperi C, Kalofoutis A, et al. Increased levels of serum advanced glycation end-products in women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2005;62(1):37–43.CrossRef
57.
Diamanti-Kandarakis E, Katsikis I, Piperi C, et al. Increased serum advanced glycation end-products is a distinct finding in lean women with polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf). 2008;69(4):634–41.CrossRef
58.
Christakou C, Economou F, Livadas S, et al. Strong and positive association of endothelin-1 with AGEs in PCOS: a causal relationship or a bystander? Hormones (Athens). 2011;10:292–7.CrossRef
59.
Diamanti-Kandarakis E, Piperi C, Korkolopoulou P, Kandaraki E, et al. Accumulation of dietary glycotoxins in the reproductive system of normal female rats. J Mol Med (Berlin). 2007;85(12):1413–20.CrossRef
60.••
Christakou C, Diamanti-Kandarakis E. Structural, biochemical and non-traditional cardiovascular risk markers in PCOS. Curr Pharm Des. 2013;19(32):5764–74. The combination of anovulation and hyperandrogenism signifies the classic form of PCOS which displays the adverse metabolic phenotype of the syndrome. This phenotype includes visceral obesity and insulin resistance as well as a constellation of other traditional cardiovascular risk factors, mainly low grade inflammation, disturbances of glucose metabolism and dyslipidemia. The resultant increased risk for cardiovascular disease may affect not only obese but also lean women with classic PCOS. The mechanisms underlying the increased cardiovascular risk in the context of PCOS may include not only metabolic aberrations, but also hormonal factors, in particular hyperandrogenemia.PubMedCrossRef
61.
Chang AY, Ayers C, Minhajuddin A, et al. Polycystic ovarian syndrome and subclinical atherosclerosis among women of reproductive age in the Dallas heart study. Clin Endocrinol (Oxf). 2011;74(1):89–96.CrossRef
62.
Shroff R, Kerchner A, Maifeld M, et al. Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis. J Clin Endocrinol Metab. 2007;92(12):4609–14.PubMedCrossRef
63.
Allameh Z, Rouholamin S, Adibi A, et al. Does carotid intima-media thickness have relationship with polycystic ovary syndrome? Int J Prev Med. 2013;4(11):1266–70.PubMedCentralPubMed
64.
Meyer ML, Malek AM, Wild RA, et al. Carotid artery intima-media thickness in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:112–26.PubMedCentralPubMedCrossRef
65.
Arad Y, Spadaro LA, Goodman K, et al. Prediction of coronary events with electron beam computed tomography. J Am Coll Cardiol. 2000;36:1253–60.PubMedCrossRef
66.
Doneen AL, Bale BF. Carotid intima-media thickness testing as an asymptomatic cardiovascular disease identifier and method for making therapeutic decisions. Postgrad Med. 2013;125(2):108–23.PubMedCrossRef
67.
Alexander CJ, Tangchitnob EP, Lepor NE. Polycystic ovary syndrome: a major unrecognized cardiovascular risk factor in women. Rev Obstet Gynecol. 2009;2(4):232–9.PubMedCentralPubMed
68.
Domecq JP, Prutsky G, Mullan RJ, et al. Lifestyle modification programs in polycystic ovary syndrome: systematic review and meta-analysis. J Clin Endocrinol Metab. 2013;98(12):4655–63.PubMedCrossRef
69.
Diamanti-Kandarakis E, Christakou C, Marinakis E. Phenotypes and environmental factors: their influence in PCOS. Curr Pharm Des. 2012;18(3):270–82.PubMedCrossRef
70.
Case problem: dietary recommendations to combat obesity, insulin resistance, and other concerns related to polycystic ovary syndrome. J Am Diet Assoc. 2000;100(8):955–7; discussion 957–60.
71.
Moran LJ, Hutchison SK, Norman RJ, et al. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011;6(7), CD007506.
72.
Tantalaki E, Piperi C, Livadas S, et al. Impact of dietary modification of advanced glycation end products (AGEs) on the hormonal and metabolic profile of women with polycystic ovary syndrome (PCOS). Hormones (Athens). 2014;13(1):65–73.
73.••
Bargiota A, Diamanti-Kandarakis E. The effects of old, new and emerging medicines on metabolic aberrations in PCOS. Ther Adv Endocrinol Metab. 2012;3(1):27–47. Multiple metabolic aberrations, such as insulin resistance (IR) and hyperinsulinaemia, high incidence of impaired glucose tolerance, visceral obesity, inflammation and endothelial dysfunction, hypertension and dyslipidemia are associated with PCOS. Current therapeutic management of PCOS has incorporated new treatments resulting from the better understanding of the pathophysiology of the syndrome.PubMedCentralPubMedCrossRef
74.
Wehr E, Pilz S, Schweighofer N, et al. Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome. Eur J Endocrinol. 2009;161(4):575–82.PubMedCrossRef
75.
Selimoglu H, Duran C, Kiyici S, et al. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Investig. 2010;33(4):234–8.CrossRef
76.
Kotsa K, Yavropoulou MP, Anastasiou O, et al. Role of vitamin D treatment in glucose metabolism in polycystic ovary syndrome. Fertil Steril. 2009;92(3):1053–8.PubMedCrossRef
77.
78.
Kahn JA, Gordon CM. Polycystic ovary syndrome. Adolesc Med. 1999;10(2):321–36.PubMed
79.
Nader S, Riad-Gabriel MG, Saad MF. The effect of a desogestrel-containing oral contraceptive on glucose tolerance and leptin concentrations in hyperandrogenic women. J Clin Endocrinol Metab. 1997;82(9):3074–7.PubMed
80.
Cagnacci A, Paoletti AM, Renzi A, et al. Glucose metabolism and insulin resistance in women with polycystic ovary syndrome during therapy with oral contraceptives containing cyproterone acetate or desogestrel. J Clin Endocrinol Metab. 2003;88(8):3621–5.PubMedCrossRef
81.
Nader S, Diamanti-Kandarakis E. Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis. Hum Reprod. 2007;22(2):317–22.PubMedCrossRef
82.
Cibula D, Fanta M, Vrbikova J, et al. The effect of combination therapy with metformin and combined oral contraceptives (COC) versus COC alone on insulin sensitivity, hyperandrogenaemia, SHBG and lipids in PCOS patients. Hum Reprod. 2005;20(1):180–4.PubMedCrossRef
83.
Mastorakos G, Koliopoulos C, Deligeoroglou E, et al. Effects of two forms of combined oral contraceptives on carbohydrate metabolism in adolescents with polycystic ovary syndrome. Fertil Steril. 2006;85(2):420–7.PubMedCrossRef
84.
Hoeger K, Davidson K, Kochman L, et al. The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials. J Clin Endocrinol Metab. 2008;93(11):4299–306.PubMedCentralPubMedCrossRef
85.
Mastorakos G, Koliopoulos C, Creatsas G. Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives. Fertil Steril. 2002;77(5):919–27.PubMedCrossRef
86.
Pasquali R, Gambineri A, Anconetani B, et al. The natural history of the metabolic syndrome in young women with the polycystic ovary syndrome and the effect of long-term oestrogen-progestagen treatment. Clin Endocrinol (Oxf). 1999;50(4):517–27.CrossRef
87.
Christakou C, Kollias A, Piperi C, et al. The benefit-to-risk ratio of common treatments in PCOS: effect of oral contraceptives versus metformin on atherogenic markers. HORMONES. 2014;13:1–10.
88.
Vlassara H. Advanced glycation in health and disease: role of the modern environment. Ann N Y Acad Sci. 2005;1043:452–60.PubMedCrossRef
89.
90.
Bruno RV, de Avila MAP, Neves FB, et al. Comparison of two doses of metformin (2.5 and 1.5 g/day) for the treatment of polycystic ovary syndrome and their effect on body mass index and waist circumference. Fertil Steril. 2007;88(2):510–2.PubMedCrossRef
91.
Gambineri A, Patton L, Vaccina A, et al. Treatment with flutamide, metformin, and their combination added to a hypocaloric diet in overweight-obese women with polycystic ovary syndrome: a randomized, 12-month, placebo-controlled study. J Clin Endocrinol Metab. 2006;91(10):3970–80.PubMedCrossRef
92.
Tang T, Glanville J, Hayden CJ, et al. Combined lifestyle modification and metformin in obese patients with polycystic ovary syndrome. A randomized, placebo-controlled, double-blind multicentre study. Hum Reprod. 2006;21(1):80–9.PubMedCrossRef
93.
Weickert MO, Hodges P, Tan BK, et al. Neuroendocrine and endocrine dysfunction in the hyperinsulinemic PCOS patient: the role of metformin. Minerva Endocrinol. 2012;37(1):25–40.PubMed
94.
Arslanian SA, Lewy V, Danadian K, et al. Metformin therapy in obese adolescents with polycystic ovary syndrome and impaired glucose tolerance: amelioration of exaggerated adrenal response to adrenocorticotropin with reduction of insulinemia / insulin resistance. J Clin Endocrinol Metab. 2002;87(4):1555–9.PubMedCrossRef
95.
Diamanti-Kandarakis E, Kouli C, Tsianateli T, et al. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. Eur J Endocrinol. 1998;138(3):269–74.PubMedCrossRef
96.
Palomba S, Falbo A, Russo T, et al. Insulin sensitivity after metformin suspension in normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92(8):3128–35.PubMedCrossRef
97.
Banaszewska B, Duleba AJ, Spaczynski RZ, et al. Lipids in polycystic ovary syndrome: role of hyperinsulinemia and effects of metformin. Am J Obstet Gynecol. 2006;194(5):1266–72.PubMedCrossRef
98.
Santana LF, de Sá MFS, Ferriani RA, et al. Effect of metformin on the clinical and metabolic assessment of women with polycystic ovary syndrome. Gynecol Endocrinol. 2004;19(2):88–96.PubMedCrossRef
99.
Muniyappa R, Montagnani M, Koh KK, et al. Cardiovascular actions of insulin. Endocr Rev. 2007;28(5):463–91.PubMedCrossRef
100.
Diamanti-Kandarakis E, Alexandraki K, Protogerou A, et al. Metformin administration improves endothelial function in women with polycystic ovary syndrome. Eur J Endocrinol. 2005;152(5):749–56.PubMedCrossRef
101.
Morin-Papunen L, Rautio K, Ruokonen A, et al. Metformin reduces serum C-reactive protein levels in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88(10):4649–54.PubMedCrossRef
102.
Diamanti-Kandarakis E, Alexandraki K, Piperi C, et al. Effect of metformin administration on plasma advanced glycation end product levels in women with polycystic ovary syndrome. Metab Clin Exp. 2007;56(1):129–34.PubMedCrossRef
103.
Carmina E, Guastella E, Rizzo M. When periods stop: long-term consequences of PCOS. In: Farid NR, Diamanti-Kandarakis E, editors. Diagnosis and management of polycystic ovary syndrome. Boston: Springer US; 2009.
104.
Solomon CG, Hu FB, Dunaif A, et al. Menstrual cycle irregularity and risk for future cardiovascular disease. J Clin Endocrinol Metab. 2002;87(5):2013–7.PubMedCrossRef
105.
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):3794–803. Diabetes, cancer, and mortality prevalence was similar in the two cohorts with similar body mass index.PubMedCrossRef
106.
Wang ET, Ku IA, Shah SJ, et al. Polycystic ovary syndrome is associated with higher left ventricular mass index: the CARDIA women's study. J Clin Endocrinol Metab. 2012;97(12):4656–62.PubMedCentralPubMedCrossRef
107.
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. Hum Reprod Update. 2011;17(4):495–500.PubMedCrossRef
Metadata
Title
Aspects of Cardiometabolic Risk in Women with Polycystic Ovary Syndrome
Authors
Thomas S. Paterakis
Evanthia Diamanti-Kandarakis
Publication date
01-12-2014
Publisher
Springer US
Published in
Current Obesity Reports / Issue 4/2014
Electronic ISSN: 2162-4968
DOI
https://doi.org/10.1007/s13679-014-0127-6

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Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

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A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

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