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Published in: Reproductive Biology and Endocrinology 1/2016

Open Access 01-12-2016 | Review

Genetic, hormonal and metabolic aspects of PCOS: an update

Authors: V. De Leo, M. C. Musacchio, V. Cappelli, M. G. Massaro, G. Morgante, F. Petraglia

Published in: Reproductive Biology and Endocrinology | Issue 1/2016

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Abstract

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting 5–10 % of women of reproductive age. It generally manifests with oligo/anovulatory cycles, hirsutism and polycystic ovaries, together with a considerable prevalence of insulin resistance. Although the aetiology of the syndrome is not completely understood yet, PCOS is considered a multifactorial disorder with various genetic, endocrine and environmental abnormalities. Moreover, PCOS patients have a higher risk of metabolic and cardiovascular diseases and their related morbidity, if compared to the general population.
Literature
1.
go back to reference 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). Hum Reprod. 2004;19:41–7.CrossRef 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). Hum Reprod. 2004;19:41–7.CrossRef
2.
go back to reference Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine F, editors. Polycystic ovary syndrome. Boston: Blackwell Scientific; 1992. p. 377–84. Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine F, editors. Polycystic ovary syndrome. Boston: Blackwell Scientific; 1992. p. 377–84.
3.
go back to reference Azziz R, Carmina E, Dewailly D, et al. Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: An Androgen Excess guideline. J Clin Endocrinol Metab. 2006;91:4237–45.PubMedCrossRef Azziz R, Carmina E, Dewailly D, et al. Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: An Androgen Excess guideline. J Clin Endocrinol Metab. 2006;91:4237–45.PubMedCrossRef
4.
go back to reference Franks S, Mc Carthy M, Hardy K. Development of polycystic ovary syndrome: involvement of genetic and environmental factors. Int J Androl. 2006;29:278–85.PubMedCrossRef Franks S, Mc Carthy M, Hardy K. Development of polycystic ovary syndrome: involvement of genetic and environmental factors. Int J Androl. 2006;29:278–85.PubMedCrossRef
5.
go back to reference De Leo V, La Marca A. Petraglia F Insulin-lowering agents in the management of polycystic ovary syndrome. Endocr Rev. 2003;24:633–67.PubMedCrossRef De Leo V, La Marca A. Petraglia F Insulin-lowering agents in the management of polycystic ovary syndrome. Endocr Rev. 2003;24:633–67.PubMedCrossRef
6.
go back to reference Homburg R, Ray A, Bhide P, Gudi A, Shah A, Timms P, Grayson K. The relationship of serum anti-Mullerian hormone with polycystic ovarian morphology and polycystic ovary syndrome: a prospective cohort study. Hum Reprod. 2013;28:1077–83.PubMedCrossRef Homburg R, Ray A, Bhide P, Gudi A, Shah A, Timms P, Grayson K. The relationship of serum anti-Mullerian hormone with polycystic ovarian morphology and polycystic ovary syndrome: a prospective cohort study. Hum Reprod. 2013;28:1077–83.PubMedCrossRef
7.
go back to reference Lam PM, Raine-Fenning N. The role of three-dimensional ultrasonography in polycystic ovary syndrome. Hum Reprod. 2006;21:2209–15.PubMedCrossRef Lam PM, Raine-Fenning N. The role of three-dimensional ultrasonography in polycystic ovary syndrome. Hum Reprod. 2006;21:2209–15.PubMedCrossRef
8.
go back to reference Abbott DH, Dumesic DA, Franks S. Developmental origin of polycystic ovary syndrome-a hypothesis. J Endocrinol. 2002;174:1–5.PubMedCrossRef Abbott DH, Dumesic DA, Franks S. Developmental origin of polycystic ovary syndrome-a hypothesis. J Endocrinol. 2002;174:1–5.PubMedCrossRef
9.
go back to reference Maliqueo M, Lara HE, Sanchez F, Echiburu B, Crisosto N, Sir-Petermann T. Placental steroidogenesis in pregnant women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2013;166:151–5.PubMedCrossRef Maliqueo M, Lara HE, Sanchez F, Echiburu B, Crisosto N, Sir-Petermann T. Placental steroidogenesis in pregnant women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2013;166:151–5.PubMedCrossRef
10.
go back to reference Sir-Petermann T, Maliqueo M, Angel B, Lara HE, Perez-Bravo F, Recabarren SE. Maternal serum androgens in pregnant women with polycystic polycystic ovarian syndrome: possible implications in prenatal androgenization. Hum Reprod. 2002;17:2573–9.PubMedCrossRef Sir-Petermann T, Maliqueo M, Angel B, Lara HE, Perez-Bravo F, Recabarren SE. Maternal serum androgens in pregnant women with polycystic polycystic ovarian syndrome: possible implications in prenatal androgenization. Hum Reprod. 2002;17:2573–9.PubMedCrossRef
11.
go back to reference Jones ME, Boon WC, McInnes K, Maffei L, Carani C, Simpson ER. Recognizing rare disorders: aromatase deficiency. Nat Clin Pract Endocrinol Metab. 2007;3:414–21.PubMedCrossRef Jones ME, Boon WC, McInnes K, Maffei L, Carani C, Simpson ER. Recognizing rare disorders: aromatase deficiency. Nat Clin Pract Endocrinol Metab. 2007;3:414–21.PubMedCrossRef
12.
go back to reference Hertig A, Liere P, Chabbert-Buffet N, Fort J, Pianos A, Eychenne B, et al. Steroid profiling in preeclamptic women: evidence for aromatase deficiency. Am J Obstet Gynecol. 2010;203:477–9.PubMedCrossRef Hertig A, Liere P, Chabbert-Buffet N, Fort J, Pianos A, Eychenne B, et al. Steroid profiling in preeclamptic women: evidence for aromatase deficiency. Am J Obstet Gynecol. 2010;203:477–9.PubMedCrossRef
13.
go back to reference Jobe SO, Tyler CT, Magness RR. Aberrant synthesis, metabolism, and plasma accumulation of circulating estrogens and estrogen metabolites in preeclampsia implications for vascular dysfunction. Hypertension. 2013;61:480–7.PubMedPubMedCentralCrossRef Jobe SO, Tyler CT, Magness RR. Aberrant synthesis, metabolism, and plasma accumulation of circulating estrogens and estrogen metabolites in preeclampsia implications for vascular dysfunction. Hypertension. 2013;61:480–7.PubMedPubMedCentralCrossRef
14.
go back to reference Mehrabian F, Kelishadi R. Comparison of the metabolic parameters and androgen level of umbilical cord blood in newborns of mothers with polycystic ovary syndrome and controls. J Res Med Sci. 2012;17:207–11.PubMedPubMedCentral Mehrabian F, Kelishadi R. Comparison of the metabolic parameters and androgen level of umbilical cord blood in newborns of mothers with polycystic ovary syndrome and controls. J Res Med Sci. 2012;17:207–11.PubMedPubMedCentral
15.
go back to reference Barry JA, Kay AR, Navaratnarajah R, Iqbal S, Bamfo JE, David AL, et al. Umbilical vein testosterone in female infants born to mothers with polycystic ovary syndrome is elevated to male levels. J Obstet Gynaecol. 2010;30:444–6.PubMedCrossRef Barry JA, Kay AR, Navaratnarajah R, Iqbal S, Bamfo JE, David AL, et al. Umbilical vein testosterone in female infants born to mothers with polycystic ovary syndrome is elevated to male levels. J Obstet Gynaecol. 2010;30:444–6.PubMedCrossRef
16.
go back to reference Anderson H, Fogel N, Grebe SK, Singh RJ, Taylor RL, Dunaif A. Infants of women with polycystic ovary syndrome have lower cord blood androstenedione and estradiol levels. J Clin Endocrinol Metab. 2010;95:2180–6.PubMedPubMedCentralCrossRef Anderson H, Fogel N, Grebe SK, Singh RJ, Taylor RL, Dunaif A. Infants of women with polycystic ovary syndrome have lower cord blood androstenedione and estradiol levels. J Clin Endocrinol Metab. 2010;95:2180–6.PubMedPubMedCentralCrossRef
17.
go back to reference Hickey M, Sloboda DM, Atkinson HC, Doherty DA, Franks S, Norman RJ, et al. The relationship between maternal and umbilical cord androgen levels and polycystic ovary syndrome in adolescence: a prospective cohort study. J Clin Endocrinol Metab. 2009;94:3714–20.PubMedCrossRef Hickey M, Sloboda DM, Atkinson HC, Doherty DA, Franks S, Norman RJ, et al. The relationship between maternal and umbilical cord androgen levels and polycystic ovary syndrome in adolescence: a prospective cohort study. J Clin Endocrinol Metab. 2009;94:3714–20.PubMedCrossRef
18.
go back to reference Beck-Peccoz P, Padmanabhan V, Baggiani AM, Cortelazzi D, Buscaglia M, Medri G, et al. Maturation of hypothalamic-pituitary-gonadal function in normal human fetuses: circulating levels of gonadotropins, their common alpha-subunit and free testosterone, and discrepancy between immunological and biological activities of circulating follicle-stimulating hormone. J Clin Endocrinol Metab. 1991;73:525–32.PubMedCrossRef Beck-Peccoz P, Padmanabhan V, Baggiani AM, Cortelazzi D, Buscaglia M, Medri G, et al. Maturation of hypothalamic-pituitary-gonadal function in normal human fetuses: circulating levels of gonadotropins, their common alpha-subunit and free testosterone, and discrepancy between immunological and biological activities of circulating follicle-stimulating hormone. J Clin Endocrinol Metab. 1991;73:525–32.PubMedCrossRef
19.
go back to reference Cole B, Hensinger K, Maciel GA, Chang RJ, Erickson GF. Human fetal ovary development involves the spatiotemporal expression of p450c17 protein. J Clin Endocrinol Metab. 2006;91:3654–61.PubMedCrossRef Cole B, Hensinger K, Maciel GA, Chang RJ, Erickson GF. Human fetal ovary development involves the spatiotemporal expression of p450c17 protein. J Clin Endocrinol Metab. 2006;91:3654–61.PubMedCrossRef
20.
go back to reference Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, Sloboda DM. Serum antim€ullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94:1118–21.PubMedCrossRef Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, Sloboda DM. Serum antim€ullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94:1118–21.PubMedCrossRef
21.
go back to reference Sir-Petermann T, Codner E, Perez V, Echiburu B, Maliqueo M, Ladron de Guevara A, et al. Metabolic and reproductive features before and during puberty in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:1923–30.PubMedPubMedCentralCrossRef Sir-Petermann T, Codner E, Perez V, Echiburu B, Maliqueo M, Ladron de Guevara A, et al. Metabolic and reproductive features before and during puberty in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:1923–30.PubMedPubMedCentralCrossRef
22.
go back to reference Crisosto N, Echiburu B, Maliqueo M, Perez V, Ladron de Guevara A, Preisler J, et al. Improvement of hyperandrogenism and hyperinsulinemia during pregnancy in women with polycystic ovary syndrome: possible effect in the ovarian follicular mass of their daughters. Fertil Steril. 2012;97:218–24.PubMedCrossRef Crisosto N, Echiburu B, Maliqueo M, Perez V, Ladron de Guevara A, Preisler J, et al. Improvement of hyperandrogenism and hyperinsulinemia during pregnancy in women with polycystic ovary syndrome: possible effect in the ovarian follicular mass of their daughters. Fertil Steril. 2012;97:218–24.PubMedCrossRef
23.
go back to reference Sir-Petermann T, Ladron de Guevara A, Codner E, Preisler J, Crisosto N, Echiburu B, et al. Relationship between anti-Mullerian hormone (AMH) and insulin levels during different Tanner stages in daughters of women with polycystic ovary syndrome. Reprod Sci. 2012;19:383–90.PubMedCrossRef Sir-Petermann T, Ladron de Guevara A, Codner E, Preisler J, Crisosto N, Echiburu B, et al. Relationship between anti-Mullerian hormone (AMH) and insulin levels during different Tanner stages in daughters of women with polycystic ovary syndrome. Reprod Sci. 2012;19:383–90.PubMedCrossRef
24.
go back to reference Lewy VD, Danadian K, Witchel SF, Arslanian S. Early metabolic abnormalities in adolescent girls with polycystic ovarian syndrome. J Pediatr. 2001;138:38–44.PubMedCrossRef Lewy VD, Danadian K, Witchel SF, Arslanian S. Early metabolic abnormalities in adolescent girls with polycystic ovarian syndrome. J Pediatr. 2001;138:38–44.PubMedCrossRef
25.
go back to reference Maliqueo M, Sir-Petermann T, Perez V, Echiburu B, de Guevara AL, Galvez C, et al. Adrenal function during childhood and puberty in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:3282–8.PubMedCrossRef Maliqueo M, Sir-Petermann T, Perez V, Echiburu B, de Guevara AL, Galvez C, et al. Adrenal function during childhood and puberty in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:3282–8.PubMedCrossRef
26.
go back to reference Rosenfield RL. Polycystic ovary syndrome and insulin-resistant hyperinsulinemia. J Am Acad Dermatol. 2001;45:95–104.CrossRef Rosenfield RL. Polycystic ovary syndrome and insulin-resistant hyperinsulinemia. J Am Acad Dermatol. 2001;45:95–104.CrossRef
27.
go back to reference Jabbar M, Pugliese M, Fort P, Recker B, Lifshitz F. Excess weight and precocious pubarche in children: alterations of the adrenocortical hormones. J Am Coll Nutr. 1991;10:289–96.PubMedCrossRef Jabbar M, Pugliese M, Fort P, Recker B, Lifshitz F. Excess weight and precocious pubarche in children: alterations of the adrenocortical hormones. J Am Coll Nutr. 1991;10:289–96.PubMedCrossRef
28.
go back to reference Apter D, Butzow T, Laughlin GA, Yen SS. Metabolic features of polycystic ovary syndrome are found in adolescent girls with hyperandrogenism. J Clin Endocrinol Metab. 1995;80:2966–73.PubMed Apter D, Butzow T, Laughlin GA, Yen SS. Metabolic features of polycystic ovary syndrome are found in adolescent girls with hyperandrogenism. J Clin Endocrinol Metab. 1995;80:2966–73.PubMed
29.
go back to reference McCartney CR, Prendergast KA, Blank SK, Helm KD, Chhabra S, Marshall JC. Maturation of luteinizing hormone (gonadotropin-releasing hormone) secretion across puberty: evidence for altered regulation in obese peripubertal girls. J Clin Endocrinol Metab. 2009;94:56–66.PubMedCrossRef McCartney CR, Prendergast KA, Blank SK, Helm KD, Chhabra S, Marshall JC. Maturation of luteinizing hormone (gonadotropin-releasing hormone) secretion across puberty: evidence for altered regulation in obese peripubertal girls. J Clin Endocrinol Metab. 2009;94:56–66.PubMedCrossRef
30.
go back to reference Rosenfield RL, Bordini B. Evidence that obesity and androgens have independent and opposing effects on gonadotropin production from puberty to maturity. Brain Res. 2010;1364:186–97.PubMedPubMedCentralCrossRef Rosenfield RL, Bordini B. Evidence that obesity and androgens have independent and opposing effects on gonadotropin production from puberty to maturity. Brain Res. 2010;1364:186–97.PubMedPubMedCentralCrossRef
31.
go back to reference Burt Solorzano CM, McCartney CR, Blank SK, Knudsen KL, Marshall JC. Hyperandrogenaemia in adolescent girls: origins of abnormal gonadotropinreleasing hormone secretion. BJOG. 2010;117:143–9.PubMedPubMedCentralCrossRef Burt Solorzano CM, McCartney CR, Blank SK, Knudsen KL, Marshall JC. Hyperandrogenaemia in adolescent girls: origins of abnormal gonadotropinreleasing hormone secretion. BJOG. 2010;117:143–9.PubMedPubMedCentralCrossRef
32.
go back to reference Blank SK, McCartney CR, Chhabra S, Helm KD, Eagleson CA, Chang RJ, et al. Modulation of gonadotropin-releasing hormone pulse generator sensitivity to progesterone inhibition in hyperandrogenic adolescent girls-implications for regulation of pubertal maturation. J Clin Endocrinol Metab. 2009;94:2360–6.PubMedPubMedCentralCrossRef Blank SK, McCartney CR, Chhabra S, Helm KD, Eagleson CA, Chang RJ, et al. Modulation of gonadotropin-releasing hormone pulse generator sensitivity to progesterone inhibition in hyperandrogenic adolescent girls-implications for regulation of pubertal maturation. J Clin Endocrinol Metab. 2009;94:2360–6.PubMedPubMedCentralCrossRef
33.
go back to reference Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM. Type 2 (noninsulin- dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993;36:62–7.PubMedCrossRef Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM. Type 2 (noninsulin- dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993;36:62–7.PubMedCrossRef
35.
go back to reference Jaquet D, Leger J, Czernichow P, Levy-Marchal C. The effect of in-utero undernutrition on the insulin resistance syndrome. Curr Diabetes Rep. 2002;2:77–82.CrossRef Jaquet D, Leger J, Czernichow P, Levy-Marchal C. The effect of in-utero undernutrition on the insulin resistance syndrome. Curr Diabetes Rep. 2002;2:77–82.CrossRef
36.
go back to reference Leger J, Levy-Marchal C, Bloch J, Pinet A, Chevenne D, Porquet D, et al. Reduced final height and indications for insulin resistance in 20 year olds born small for gestational age: regional cohort study. BMJ. 1997;315:341–7.PubMedPubMedCentralCrossRef Leger J, Levy-Marchal C, Bloch J, Pinet A, Chevenne D, Porquet D, et al. Reduced final height and indications for insulin resistance in 20 year olds born small for gestational age: regional cohort study. BMJ. 1997;315:341–7.PubMedPubMedCentralCrossRef
37.
go back to reference Jaquet D, Tregouet DA, Godefroy T, Nicaud V, Chevenne D, Tiret L, et al. Combined effects of genetic and environmental factors on insulin resistance associated with reduced fetal growth. Diabetes. 2002;51:3473–8.PubMedCrossRef Jaquet D, Tregouet DA, Godefroy T, Nicaud V, Chevenne D, Tiret L, et al. Combined effects of genetic and environmental factors on insulin resistance associated with reduced fetal growth. Diabetes. 2002;51:3473–8.PubMedCrossRef
38.
go back to reference Silverman BL, Metzger BE, Cho NH, Loeb CA. Impaired glucose tolerance in adolescent offspring of diabetic mothers. Relationship to fetal hyperinsulinism. Diabetes Care. 1995;18:611–7.PubMedCrossRef Silverman BL, Metzger BE, Cho NH, Loeb CA. Impaired glucose tolerance in adolescent offspring of diabetic mothers. Relationship to fetal hyperinsulinism. Diabetes Care. 1995;18:611–7.PubMedCrossRef
39.
go back to reference Silverman BL, Rizzo TA, Cho NH, Metzger BE. Northwestern University Diabetes in Pregnancy Center. Long-term effects of the intrauterine environment. Diabetes Care. 1998;21:142–9. Silverman BL, Rizzo TA, Cho NH, Metzger BE. Northwestern University Diabetes in Pregnancy Center. Long-term effects of the intrauterine environment. Diabetes Care. 1998;21:142–9.
40.
go back to reference Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, et al. Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships. Diabetes. 2000;49:2208–11.PubMedCrossRef Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, et al. Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships. Diabetes. 2000;49:2208–11.PubMedCrossRef
41.
go back to reference Poretsky L, Cataldo NA, Rosenwaks Z, Giudice LC. The insulin-related ovarian regulatory system in health and disease. Endocr Rev. 1999;20:535–82.PubMedCrossRef Poretsky L, Cataldo NA, Rosenwaks Z, Giudice LC. The insulin-related ovarian regulatory system in health and disease. Endocr Rev. 1999;20:535–82.PubMedCrossRef
42.
go back to reference Moghetti P, Castello R, Negri C, Tosi F, Spiazzi GG, Brun E, et al. Insulin infusion amplifies 17 alpha-hydroxycorticosteroid intermediates response to adrenocorticotropin in hyperandrogenic women: apparent relative impairment of 17,20-lyase activity. J Clin Endocrinol Metab. 1996;81:881–6.PubMed Moghetti P, Castello R, Negri C, Tosi F, Spiazzi GG, Brun E, et al. Insulin infusion amplifies 17 alpha-hydroxycorticosteroid intermediates response to adrenocorticotropin in hyperandrogenic women: apparent relative impairment of 17,20-lyase activity. J Clin Endocrinol Metab. 1996;81:881–6.PubMed
43.
go back to reference Franks S, McCarthy M. Genetics of ovarian disorders: polycystic ovary syndrome. Rev Endocr Metab Disord. 2004;5:69–76.PubMedCrossRef Franks S, McCarthy M. Genetics of ovarian disorders: polycystic ovary syndrome. Rev Endocr Metab Disord. 2004;5:69–76.PubMedCrossRef
44.
go back to reference Chen ZJ, Zhao H, He L, Shi Y, Qin Y, Shi Y, et al. Genome-wide association study identifies susceptibility loci for polycystic ovary syndrome on chromosome 2p16.3, 2p21 and 9q33.3. Nat Genet. 2011;43:55–9.PubMedCrossRef Chen ZJ, Zhao H, He L, Shi Y, Qin Y, Shi Y, et al. Genome-wide association study identifies susceptibility loci for polycystic ovary syndrome on chromosome 2p16.3, 2p21 and 9q33.3. Nat Genet. 2011;43:55–9.PubMedCrossRef
45.
go back to reference Goodarzi MO, Jones MR, Li X, Chua AK, Garcia OA, Chen YD, et al. Replication of association of DENND1A and THADA variants with polycystic ovary syndrome in European cohorts. J Med Genet. 2012;49:90–5.PubMedCrossRef Goodarzi MO, Jones MR, Li X, Chua AK, Garcia OA, Chen YD, et al. Replication of association of DENND1A and THADA variants with polycystic ovary syndrome in European cohorts. J Med Genet. 2012;49:90–5.PubMedCrossRef
46.
go back to reference Welt CK, Styrkarsdottir U, Ehrmann DA, Thorleifsson G, Arason G, Gudmundsson JA, et al. Variants in DENND1A are associated with polycystic ovary syndrome in women of European ancestry. J Clin Endocrinol Metab. 2012;97:1342–7.CrossRef Welt CK, Styrkarsdottir U, Ehrmann DA, Thorleifsson G, Arason G, Gudmundsson JA, et al. Variants in DENND1A are associated with polycystic ovary syndrome in women of European ancestry. J Clin Endocrinol Metab. 2012;97:1342–7.CrossRef
47.
go back to reference Xie GB, Xu P, Che YN, Xia YJ, Cao YX, Wang WJ, et al. Microsatellite polymorphism in the fibrillin 3 gene and susceptibility to PCOS: a case–control study and meta-analysis. Reprod Biomed Online. 2013;26:168–74.PubMedCrossRef Xie GB, Xu P, Che YN, Xia YJ, Cao YX, Wang WJ, et al. Microsatellite polymorphism in the fibrillin 3 gene and susceptibility to PCOS: a case–control study and meta-analysis. Reprod Biomed Online. 2013;26:168–74.PubMedCrossRef
48.
go back to reference Capalbo A, Sagnella F, Apa R, Fulghesu AM, Lanzone A, Morciano A, et al. The 312N variant of the luteinizing hormone/choriogonadotropin receptor gene (LHCGR) confers up to 2.7-fold increased risk of polycystic ovary syndrome in a Sardinian population. Clin Endocrinol (Oxf). 2012;77:113–9.CrossRef Capalbo A, Sagnella F, Apa R, Fulghesu AM, Lanzone A, Morciano A, et al. The 312N variant of the luteinizing hormone/choriogonadotropin receptor gene (LHCGR) confers up to 2.7-fold increased risk of polycystic ovary syndrome in a Sardinian population. Clin Endocrinol (Oxf). 2012;77:113–9.CrossRef
49.
go back to reference Mutharasan P, Galdones E. Pe~nalver Bernabe B, Garcia OA, Jafari N, Shea LD, et al. Evidence for chromosome 2p16.3 polycystic ovary syndrome susceptibility locus in affected women of European ancestry. J Clin Endocrinol Metab. 2013;98:E185–90.PubMedCrossRef Mutharasan P, Galdones E. Pe~nalver Bernabe B, Garcia OA, Jafari N, Shea LD, et al. Evidence for chromosome 2p16.3 polycystic ovary syndrome susceptibility locus in affected women of European ancestry. J Clin Endocrinol Metab. 2013;98:E185–90.PubMedCrossRef
50.
go back to reference Urbanek M, Sam S, Legro RS, Dunaif A. Identification of a polycystic ovary syndrome susceptibility variant in fibrillin-3 and association with a metabolic phenotype. J Clin Endocrinol Metab. 2007;92:4191–8.PubMedCrossRef Urbanek M, Sam S, Legro RS, Dunaif A. Identification of a polycystic ovary syndrome susceptibility variant in fibrillin-3 and association with a metabolic phenotype. J Clin Endocrinol Metab. 2007;92:4191–8.PubMedCrossRef
51.
go back to reference Hatzirodos N, Bayne RA, Irving-Rodgers HF, Hummitzsch K, Sabatier L, Lee S, et al. Linkage of regulators of TGF-b activity in the fetal ovary to polycystic ovary syndrome. FASEB J. 2011;25:2256–65.PubMedPubMedCentralCrossRef Hatzirodos N, Bayne RA, Irving-Rodgers HF, Hummitzsch K, Sabatier L, Lee S, et al. Linkage of regulators of TGF-b activity in the fetal ovary to polycystic ovary syndrome. FASEB J. 2011;25:2256–65.PubMedPubMedCentralCrossRef
52.
go back to reference Sabatier L, Miosge N, Hubmacher D, Lin G, Davis EC, Reinhardt DP. Fibrillin-3 expression in human development. Matrix Biol. 2011;30:43–52.PubMedCrossRef Sabatier L, Miosge N, Hubmacher D, Lin G, Davis EC, Reinhardt DP. Fibrillin-3 expression in human development. Matrix Biol. 2011;30:43–52.PubMedCrossRef
53.
go back to reference Xu N, Kwon S, Abbott DH, Geller DH, Dumesic DA, Azziz R, et al. Epigenetic mechanism underlying the development of polycystic ovary syndrome (PCOS)–like phenotypes in prenatally androgenized rhesus monkeys. PLoS One. 2011;6:e27286.PubMedPubMedCentralCrossRef Xu N, Kwon S, Abbott DH, Geller DH, Dumesic DA, Azziz R, et al. Epigenetic mechanism underlying the development of polycystic ovary syndrome (PCOS)–like phenotypes in prenatally androgenized rhesus monkeys. PLoS One. 2011;6:e27286.PubMedPubMedCentralCrossRef
54.
go back to reference Massam-Wu T, Chiu M, Choudhury R, Chaudhry SS, Baldwin AK, McGovern A, et al. Assembly of fibrillin microfibrils governs extracellular deposition of latent TGF beta. J Cell Sci. 2010;123:3006–18.PubMedPubMedCentralCrossRef Massam-Wu T, Chiu M, Choudhury R, Chaudhry SS, Baldwin AK, McGovern A, et al. Assembly of fibrillin microfibrils governs extracellular deposition of latent TGF beta. J Cell Sci. 2010;123:3006–18.PubMedPubMedCentralCrossRef
55.
go back to reference Sengle G, Ono RN, Sasaki T, Sakai LY. Prodomains of transforming growth factor beta (TGFbeta) superfamily members specify different functions: extracellular matrix interactions and growth factor bioavailability. J Biol Chem. 2011;286:5087–99.PubMedCrossRef Sengle G, Ono RN, Sasaki T, Sakai LY. Prodomains of transforming growth factor beta (TGFbeta) superfamily members specify different functions: extracellular matrix interactions and growth factor bioavailability. J Biol Chem. 2011;286:5087–99.PubMedCrossRef
56.
go back to reference Dickinson RE, Stewart AJ, Myers M, Millar RP, Duncan WC. Differential expression and functional Characterization of luteinizing hormone receptor splice variants in human luteal cells:implications for luteolysis. Endocrinology. 2009;150(6):2873–81.PubMedCrossRef Dickinson RE, Stewart AJ, Myers M, Millar RP, Duncan WC. Differential expression and functional Characterization of luteinizing hormone receptor splice variants in human luteal cells:implications for luteolysis. Endocrinology. 2009;150(6):2873–81.PubMedCrossRef
57.
go back to reference Dos Santos E, Dievdonnè MN, Leneveu MC, Pecquery R, Serazin V, Giudicelli Y. In vitro effects of chorionic gonadotrophin hormone on human adipose development. J Endocrinol. 2007;194(2):313–25.PubMedCrossRef Dos Santos E, Dievdonnè MN, Leneveu MC, Pecquery R, Serazin V, Giudicelli Y. In vitro effects of chorionic gonadotrophin hormone on human adipose development. J Endocrinol. 2007;194(2):313–25.PubMedCrossRef
58.
go back to reference Escobar-Morreale HF, Luque-Ramírez M, San Millán JL. The molecular-genetic basis of functional hyperandrogenism and the polycystic ovary syndrome. Endocr Rev. 2005;26:251–82.PubMedCrossRef Escobar-Morreale HF, Luque-Ramírez M, San Millán JL. The molecular-genetic basis of functional hyperandrogenism and the polycystic ovary syndrome. Endocr Rev. 2005;26:251–82.PubMedCrossRef
59.
go back to reference Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Hum Reprod Update. 2011;17:17–33.PubMedCrossRef Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Hum Reprod Update. 2011;17:17–33.PubMedCrossRef
60.
go back to reference Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79:820–5.PubMed Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79:820–5.PubMed
61.
go back to reference THOMSON RL, SPEDDING S, BUCKLEY JD. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol. 2012;77:343–50.CrossRef THOMSON RL, SPEDDING S, BUCKLEY JD. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol. 2012;77:343–50.CrossRef
62.
go back to reference Yildizhan R, Kurdoglu M, Adali E, Kolusari A, Yildizhan B, Sahin HG, Kamaci M. Serum 25-hydroxy vitamin D concentrations in obese and non-obese women with polycystic ovary syndrome. Arch Gynecol Obstet. 2009;280:559–63.PubMedCrossRef Yildizhan R, Kurdoglu M, Adali E, Kolusari A, Yildizhan B, Sahin HG, Kamaci M. Serum 25-hydroxy vitamin D concentrations in obese and non-obese women with polycystic ovary syndrome. Arch Gynecol Obstet. 2009;280:559–63.PubMedCrossRef
63.
go back to reference Kalro BN, Loucks TL, Berga SL. Neuromodulation in polycystic ovary syndrome. Obstet Gynecol Clin North Am. 2001;28:35–62.PubMedCrossRef Kalro BN, Loucks TL, Berga SL. Neuromodulation in polycystic ovary syndrome. Obstet Gynecol Clin North Am. 2001;28:35–62.PubMedCrossRef
64.
go back to reference Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update. 2008;14:367–78.PubMedCrossRef Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update. 2008;14:367–78.PubMedCrossRef
66.
go back to reference D’Anglemont de Tassigny X, Colledge WH. The role of kisspeptin signaling in reproduction. Physiology (Bethesda). 2010;25:207–17.CrossRef D’Anglemont de Tassigny X, Colledge WH. The role of kisspeptin signaling in reproduction. Physiology (Bethesda). 2010;25:207–17.CrossRef
67.
go back to reference Navarro VM, Tena-Sempere M. Neuroendocrine control by kisspeptins: role in metabolic regulation of fertility. Nat Rev Endocrinol. 2012;8:40–53.CrossRef Navarro VM, Tena-Sempere M. Neuroendocrine control by kisspeptins: role in metabolic regulation of fertility. Nat Rev Endocrinol. 2012;8:40–53.CrossRef
68.
go back to reference Pinilla L, Aguilar E, Dieguez C, Millar RP, Tena-Sempere M. Kisspeptins and reproduction: physiological roles and regulatory mechanisms. Physiol Rev. 2012;92:1235–316.PubMedCrossRef Pinilla L, Aguilar E, Dieguez C, Millar RP, Tena-Sempere M. Kisspeptins and reproduction: physiological roles and regulatory mechanisms. Physiol Rev. 2012;92:1235–316.PubMedCrossRef
69.
go back to reference Castellano JM, Gaytan M, Roa J, Vigo E, Navarro VM, Bellido C, et al. Expression of Kiss-1 in rat ovary: putative local regulator of ovulation? Endocrinology. 2006;147:4852–62.PubMedCrossRef Castellano JM, Gaytan M, Roa J, Vigo E, Navarro VM, Bellido C, et al. Expression of Kiss-1 in rat ovary: putative local regulator of ovulation? Endocrinology. 2006;147:4852–62.PubMedCrossRef
70.
go back to reference Gaytan F, Gaytan M, Castellano JM, Romero M, Roa J, Aparicio B, et al. Kiss-1 in the mammalian ovary: distribution of kisspeptin in human and marmoset and alterations in Kiss-1 mRNA levels in a rat model of ovulatory dysfunction. Am J Physiol Endocrinol Metab. 2009;296:5520–31. Gaytan F, Gaytan M, Castellano JM, Romero M, Roa J, Aparicio B, et al. Kiss-1 in the mammalian ovary: distribution of kisspeptin in human and marmoset and alterations in Kiss-1 mRNA levels in a rat model of ovulatory dysfunction. Am J Physiol Endocrinol Metab. 2009;296:5520–31.
71.
go back to reference Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Rev Mol Med. 2008;10:1–21.CrossRef Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Rev Mol Med. 2008;10:1–21.CrossRef
72.
go back to reference La Marca A, Egbe TO, Morgante G, Paglia T, Cianci A, De Leo V. Metformin treatment reduces ovarian cytochrome P-450c17 response to human chorionic gonadotrophin in women with insulin resistance-related polycystic ovary syndrome. Hum Reprod. 2000;15:21–3.PubMedCrossRef La Marca A, Egbe TO, Morgante G, Paglia T, Cianci A, De Leo V. Metformin treatment reduces ovarian cytochrome P-450c17 response to human chorionic gonadotrophin in women with insulin resistance-related polycystic ovary syndrome. Hum Reprod. 2000;15:21–3.PubMedCrossRef
73.
go back to reference Bremer AA, Miller WL. The serine phosphorylation hypothesis of polycystic ovary syndrome: a unifying mechanism of hyperandrogenemia and insulin resistance. Fertil Steril. 2008;89:1039–48.PubMedCrossRef Bremer AA, Miller WL. The serine phosphorylation hypothesis of polycystic ovary syndrome: a unifying mechanism of hyperandrogenemia and insulin resistance. Fertil Steril. 2008;89:1039–48.PubMedCrossRef
74.
go back to reference Diamanti-Kandarakis E, Argyrakopolou G, Economou F, et al. Defects in insulin signaling pathways in ovarian steroidogenesis and other tissues in polycystic ovary syndrome. J Steroid Biochem an Molecular Bio. 2008;109:242–6.CrossRef Diamanti-Kandarakis E, Argyrakopolou G, Economou F, et al. Defects in insulin signaling pathways in ovarian steroidogenesis and other tissues in polycystic ovary syndrome. J Steroid Biochem an Molecular Bio. 2008;109:242–6.CrossRef
75.
go back to reference Nestler JE, Jakubowicz DJ, de Vargas AF, Brik C, Quintero N, Medina F. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab. 1998;83:2001–5.PubMed Nestler JE, Jakubowicz DJ, de Vargas AF, Brik C, Quintero N, Medina F. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab. 1998;83:2001–5.PubMed
76.
go back to reference Baillargeon JP, Nestler JE, Ostlund RE, Apridonidze T, Diamanti-Kandarakis E. Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositol metabolism. Hum Reprod. 2008;23:1439–46.PubMedPubMedCentralCrossRef Baillargeon JP, Nestler JE, Ostlund RE, Apridonidze T, Diamanti-Kandarakis E. Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositol metabolism. Hum Reprod. 2008;23:1439–46.PubMedPubMedCentralCrossRef
77.
go back to reference De Leo V, La Marca A, Orvieto R, Morgante G. Effect of metformin on insulin-like growth factor (IGF) I and IGF-binding protein I in polycystic ovary syndrome. J Clin Endocrinol Metab. 2000;85:1598–600.PubMedCrossRef De Leo V, La Marca A, Orvieto R, Morgante G. Effect of metformin on insulin-like growth factor (IGF) I and IGF-binding protein I in polycystic ovary syndrome. J Clin Endocrinol Metab. 2000;85:1598–600.PubMedCrossRef
78.
go back to reference Artini PG, Monteleone P, Toldin MRP, Matteucci C, Ruggiero M, Cela V, Genazzani AR. Growth factors and folliculogenesis in polycystic ovary patients. Expert Rev Endocrinol Metab. 2007;2:215–23.CrossRef Artini PG, Monteleone P, Toldin MRP, Matteucci C, Ruggiero M, Cela V, Genazzani AR. Growth factors and folliculogenesis in polycystic ovary patients. Expert Rev Endocrinol Metab. 2007;2:215–23.CrossRef
79.
go back to reference Dumesic DA, Abbott DH. Implications of polycystic ovary syndrome on oocyte development. Seminar Reprod Med. 2008;26:53–61.CrossRef Dumesic DA, Abbott DH. Implications of polycystic ovary syndrome on oocyte development. Seminar Reprod Med. 2008;26:53–61.CrossRef
80.
go back to reference La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2009;16:113–30.PubMedCrossRef La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2009;16:113–30.PubMedCrossRef
81.
go back to reference Corton M, Botella-Carretero JI, Lopez JA, Camafeita E, San Millan JL, Escobar- Morreale HF, Peral B. Proteomic analysis of human omental adipose tissue in the polycystic ovary syndrome using two-dimensional difference gel electrophoresis and mass spectrometry. Hum Reprod. 2008;23:651–61.PubMedCrossRef Corton M, Botella-Carretero JI, Lopez JA, Camafeita E, San Millan JL, Escobar- Morreale HF, Peral B. Proteomic analysis of human omental adipose tissue in the polycystic ovary syndrome using two-dimensional difference gel electrophoresis and mass spectrometry. Hum Reprod. 2008;23:651–61.PubMedCrossRef
82.
go back to reference Ma X, Fan L, Meng Y, Hou Z, Mao YD, Wang W, Ding W, Liu JY. Proteomic analysis of human ovaries from normal and polycystic ovarian syndrome. Mol Hum Reprod. 2007;13:527–35.PubMedCrossRef Ma X, Fan L, Meng Y, Hou Z, Mao YD, Wang W, Ding W, Liu JY. Proteomic analysis of human ovaries from normal and polycystic ovarian syndrome. Mol Hum Reprod. 2007;13:527–35.PubMedCrossRef
83.
go back to reference Choi DH, Lee WS, Won M, Park M, Park HO, Kim E, Lee KA, Bae J. The apolipoprotein A-I level is downregulated in the granulosa cells of patients with polycystic ovary syndrome and affects steroidogenesis. J Proteome Res. 2010;9:4329–36.PubMedCrossRef Choi DH, Lee WS, Won M, Park M, Park HO, Kim E, Lee KA, Bae J. The apolipoprotein A-I level is downregulated in the granulosa cells of patients with polycystic ovary syndrome and affects steroidogenesis. J Proteome Res. 2010;9:4329–36.PubMedCrossRef
84.
go back to reference Huang S, Qiao J, Li R, Wang L, Li M. Can serum apolipoprotein C–I demonstrate metabolic abnormality early in women with polycystic ovary syndrome? Fertil Steril. 2010;9:205–10.CrossRef Huang S, Qiao J, Li R, Wang L, Li M. Can serum apolipoprotein C–I demonstrate metabolic abnormality early in women with polycystic ovary syndrome? Fertil Steril. 2010;9:205–10.CrossRef
85.
go back to reference Ilhan A, Gartner W, Nabokikh A, Daneva T, Majdic O, Cohen G, Bohmig GA, Base W, Horl WH, Wagner L. Localization and characterization of the novel protein encoded by C20orf3. Biochem J. 2008;414:485–95.PubMedCrossRef Ilhan A, Gartner W, Nabokikh A, Daneva T, Majdic O, Cohen G, Bohmig GA, Base W, Horl WH, Wagner L. Localization and characterization of the novel protein encoded by C20orf3. Biochem J. 2008;414:485–95.PubMedCrossRef
86.
go back to reference Murri M, Luque-Ramirez M, Insenser M, Ojeda-Ojeda M, Escobar-Morreale HF. Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): a systematic review and meta-analysis. Hum Reprod Update. 2013;19:268-88. Murri M, Luque-Ramirez M, Insenser M, Ojeda-Ojeda M, Escobar-Morreale HF. Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): a systematic review and meta-analysis. Hum Reprod Update. 2013;19:268-88.
87.
go back to reference Bi X, Haque TS, Zhou J, Skillman AG, Lin B, Lee CE, Kuntz ID, Ellman JA, Lynch G. Novel cathepsin D inhibitors block the formation of hyperphosphorylated tau fragments in hippocampus. J Neurochem. 2000;74:1469–77.PubMedCrossRef Bi X, Haque TS, Zhou J, Skillman AG, Lin B, Lee CE, Kuntz ID, Ellman JA, Lynch G. Novel cathepsin D inhibitors block the formation of hyperphosphorylated tau fragments in hippocampus. J Neurochem. 2000;74:1469–77.PubMedCrossRef
88.
go back to reference Vashishta A, Ohri SS, Vetvicka V. Pleiotropic effects of cathepsin D. Endocr Metab Immune Disord Drug Targets. 2009;9:385–91.PubMedCrossRef Vashishta A, Ohri SS, Vetvicka V. Pleiotropic effects of cathepsin D. Endocr Metab Immune Disord Drug Targets. 2009;9:385–91.PubMedCrossRef
89.
go back to reference Misiti S, Stigliano A, Borro M, Gentile G, Michienzi S, Cerquetti L, Bucci B, Argese N, Brunetti E, Simmaco M, Toscano V. Proteomic profiles in hyperandrogenic syndromes. J Endocrinol Invest. 2010;33:156–64.PubMedCrossRef Misiti S, Stigliano A, Borro M, Gentile G, Michienzi S, Cerquetti L, Bucci B, Argese N, Brunetti E, Simmaco M, Toscano V. Proteomic profiles in hyperandrogenic syndromes. J Endocrinol Invest. 2010;33:156–64.PubMedCrossRef
90.
go back to reference Fan L, Ling J, Ma X, Cui YG, Liu JY. Involvement of HSP10 during the ovarian follicular development of polycystic ovary syndrome: Study in both human ovaries and cultured mouse follicles. Gynecol Endocrinol. 2009;25:392–7.PubMedCrossRef Fan L, Ling J, Ma X, Cui YG, Liu JY. Involvement of HSP10 during the ovarian follicular development of polycystic ovary syndrome: Study in both human ovaries and cultured mouse follicles. Gynecol Endocrinol. 2009;25:392–7.PubMedCrossRef
91.
go back to reference Chazenbalk G, Chen YH, Heneidi S, Lee JM, Pall M, Chen YD, Azziz R. Abnormal expression of genes involved in inflammation, lipid metabolism, and Wnt signaling in the adipose tissue of polycystic ovary syndrome. J Clin Endocrinol Metab. 2012;97:E765–70.PubMedPubMedCentralCrossRef Chazenbalk G, Chen YH, Heneidi S, Lee JM, Pall M, Chen YD, Azziz R. Abnormal expression of genes involved in inflammation, lipid metabolism, and Wnt signaling in the adipose tissue of polycystic ovary syndrome. J Clin Endocrinol Metab. 2012;97:E765–70.PubMedPubMedCentralCrossRef
92.
go back to reference Insenser M, Martinez-Garcia MA, Montes R, San-Millan JL, Escobar-Morreale HF. Proteomic analysis of plasma in the polycystic ovary syndrome identifies novel markers involved in iron metabolism, acute-phase response, and inflammation. J Clin Endocrinol Metab. 2010;95:3863–70.PubMedCrossRef Insenser M, Martinez-Garcia MA, Montes R, San-Millan JL, Escobar-Morreale HF. Proteomic analysis of plasma in the polycystic ovary syndrome identifies novel markers involved in iron metabolism, acute-phase response, and inflammation. J Clin Endocrinol Metab. 2010;95:3863–70.PubMedCrossRef
93.
go back to reference Escobar-Morreale HF. Iron metabolism and the polycystic ovary syndrome. Trends Endocrinol Metab. 2012;23:509–15.PubMedCrossRef Escobar-Morreale HF. Iron metabolism and the polycystic ovary syndrome. Trends Endocrinol Metab. 2012;23:509–15.PubMedCrossRef
94.
go back to reference Luque-Ramirez M, Alvarez-Blasco F, Alpanes M, Escobar-Morreale HF. Role of decreased circulating hepcidin concentrations in the iron excess of women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 2011;96:846–52.PubMedCrossRef Luque-Ramirez M, Alvarez-Blasco F, Alpanes M, Escobar-Morreale HF. Role of decreased circulating hepcidin concentrations in the iron excess of women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 2011;96:846–52.PubMedCrossRef
95.
go back to reference Victor VM, Rocha M, Banuls C, Alvarez A, de Pablo C, Sanchez-Serrano M, Gomez M, Hernandez-Mijares A. Induction of oxidative stress and human leukocyte/endothelial cell interactions in polycystic ovary syndrome patients with insulin resistance. J Clin Endocrinol Metab. 2011;96:3115–22.PubMedCrossRef Victor VM, Rocha M, Banuls C, Alvarez A, de Pablo C, Sanchez-Serrano M, Gomez M, Hernandez-Mijares A. Induction of oxidative stress and human leukocyte/endothelial cell interactions in polycystic ovary syndrome patients with insulin resistance. J Clin Endocrinol Metab. 2011;96:3115–22.PubMedCrossRef
96.
go back to reference Gonzalez F, Rote NS, Minium J, Kirwan JP. Reactive oxygen speciesinduced oxidative stress in the development of insulin resistance and hyperandrogenism in polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:336–40.PubMedCrossRef Gonzalez F, Rote NS, Minium J, Kirwan JP. Reactive oxygen speciesinduced oxidative stress in the development of insulin resistance and hyperandrogenism in polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:336–40.PubMedCrossRef
97.
go back to reference Costello MF, Shrestha B, Eden J, Johnson NP, Sjoblom P. Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review. Hum Reprod. 2007;22:1200–9.PubMedCrossRef Costello MF, Shrestha B, Eden J, Johnson NP, Sjoblom P. Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review. Hum Reprod. 2007;22:1200–9.PubMedCrossRef
98.
go back to reference Elting MW, Korsen TJ, Rekers-Mombarg LT, Schoemaker J. Women with polycystic ovary syndrome gain regular menstrual cycles when ageing. Hum Reprod. 2000;15:24–8.PubMedCrossRef Elting MW, Korsen TJ, Rekers-Mombarg LT, Schoemaker J. Women with polycystic ovary syndrome gain regular menstrual cycles when ageing. Hum Reprod. 2000;15:24–8.PubMedCrossRef
99.
go back to reference Bekx MT, Connor EC, Allen DB. Characteristics of adolescents presenting to a multidisciplinary clinic for polycystic ovarian syndrome. J Pediatr Adolesc Gynecol. 2010;23:7–10.PubMedCrossRef Bekx MT, Connor EC, Allen DB. Characteristics of adolescents presenting to a multidisciplinary clinic for polycystic ovarian syndrome. J Pediatr Adolesc Gynecol. 2010;23:7–10.PubMedCrossRef
100.
go back to reference Ardaens Y, Robert Y, Lemaitre L, Fossati P, Dewailly D. Polycystic ovary disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis. Fertil Steril. 1991;55:1062–8.PubMedCrossRef Ardaens Y, Robert Y, Lemaitre L, Fossati P, Dewailly D. Polycystic ovary disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis. Fertil Steril. 1991;55:1062–8.PubMedCrossRef
101.
go back to reference Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–7.PubMedCrossRef Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–7.PubMedCrossRef
102.
go back to reference Deplewski D, Rosenfield RL. Role of hormones in pilosebaceous unit development. Endocr Rev. 2000;21:363–92.PubMedCrossRef Deplewski D, Rosenfield RL. Role of hormones in pilosebaceous unit development. Endocr Rev. 2000;21:363–92.PubMedCrossRef
103.
go back to reference Carmina E, Oberfeld S, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol. 2010;203:201.e1-5. Carmina E, Oberfeld S, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol. 2010;203:201.e1-5.
104.
go back to reference Hudecova M, Holte J, Olovsson M, Sundstrom PI. Long-term follow-up of patients with polycystic ovary syndrome: reproductive outcome and ovarian reserve. Hum Reprod. 2009;24:1176–83.PubMedCrossRef Hudecova M, Holte J, Olovsson M, Sundstrom PI. Long-term follow-up of patients with polycystic ovary syndrome: reproductive outcome and ovarian reserve. Hum Reprod. 2009;24:1176–83.PubMedCrossRef
105.
go back to reference Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): arguably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrinol Metab. 1999;84:1897–9.PubMedCrossRef Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): arguably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrinol Metab. 1999;84:1897–9.PubMedCrossRef
106.
go back to reference Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2007;66:513–7. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2007;66:513–7.
107.
go back to reference Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycyatic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2014;20:748–58.PubMedPubMedCentralCrossRef Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycyatic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2014;20:748–58.PubMedPubMedCentralCrossRef
108.
go back to reference Boosma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12:673–83.CrossRef Boosma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12:673–83.CrossRef
109.
go back to reference Abbott DH, Barnett DK, Bruns CM, Dumesic DA. Androgen excess fetal programming of female reproduction: a developmental aetiology for polycystic ovary syndrome. Hum Reprod Update. 2005;11:357–74.PubMedCrossRef Abbott DH, Barnett DK, Bruns CM, Dumesic DA. Androgen excess fetal programming of female reproduction: a developmental aetiology for polycystic ovary syndrome. Hum Reprod Update. 2005;11:357–74.PubMedCrossRef
110.
go back to reference Xita N, Tsatsoulis A. Review: fetal programming of polycystic ovary syndrome by androgen excess: evidence from experimental, clinical and genetic association studies. J Clin Endocrinol Metab. 2006;91:1660–6.PubMedCrossRef Xita N, Tsatsoulis A. Review: fetal programming of polycystic ovary syndrome by androgen excess: evidence from experimental, clinical and genetic association studies. J Clin Endocrinol Metab. 2006;91:1660–6.PubMedCrossRef
111.
go back to reference Giudice LC. Endometrium in PCOS: Implantation and predisposition to endocrine CA. Best Pract Res Clin Endocrinol Metab. 2006;20:235–44.PubMedCrossRef Giudice LC. Endometrium in PCOS: Implantation and predisposition to endocrine CA. Best Pract Res Clin Endocrinol Metab. 2006;20:235–44.PubMedCrossRef
112.
go back to reference Denison FC, Roberts KA, Barr SM, Norman JE. Obesity, pregnancy, inflammation and vascular function. Reproduction. 2010;24:112–45. Denison FC, Roberts KA, Barr SM, Norman JE. Obesity, pregnancy, inflammation and vascular function. Reproduction. 2010;24:112–45.
113.
go back to reference Fauser BC, Devroey P, Macklon NS. Multiple birth resulting from ovarian stimulation for subfertility treatment. Lancet. 2005;365:1807–16.PubMedCrossRef Fauser BC, Devroey P, Macklon NS. Multiple birth resulting from ovarian stimulation for subfertility treatment. Lancet. 2005;365:1807–16.PubMedCrossRef
Metadata
Title
Genetic, hormonal and metabolic aspects of PCOS: an update
Authors
V. De Leo
M. C. Musacchio
V. Cappelli
M. G. Massaro
G. Morgante
F. Petraglia
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Reproductive Biology and Endocrinology / Issue 1/2016
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/s12958-016-0173-x

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