About this Journal Submit a Manuscript Table of Contents
International Journal of Endocrinology
Volume 2012 (2012), Article ID 317241, 7 pages
http://dx.doi.org/10.1155/2012/317241
Review Article

Obesity Differentially Affects Phenotypes of Polycystic Ovary Syndrome

1Direction of Health Research and Training, Medical Unit of High Specialty, Gynecology and Obstetrics Hospital No. 4 Luis Castelazo Ayala, Mexican Institute of Social Security, Mexico City, DF 01090, Mexico
2Health Research Council, Mexican Institute of Social Security, Mexico City, DF 06725, Mexico
3General Hospital of Zone No. 8, Mexican Institute of Social Security, Mexico City, DF 01090, Mexico

Received 29 September 2011; Revised 13 February 2012; Accepted 17 April 2012

Academic Editor: Faustino R. Pérez-López

Copyright © 2012 Carlos Moran et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. O. Lunde, P. Magnus, L. Sandvik, and S. Hoglo, “Familial clustering in the polycystic ovarian syndrome,” Gynecologic and Obstetric Investigation, vol. 28, no. 1, pp. 23–30, 1989. View at Scopus
  2. A. Govind, M. S. Obhrai, and R. N. Clayton, “Polycystic ovaries are inherited as an autosomal dominant trait: analysis of 29 polycystic ovary syndrome and 10 control families,” Journal of Clinical Endocrinology and Metabolism, vol. 84, no. 1, pp. 38–43, 1999. View at Publisher · View at Google Scholar · View at Scopus
  3. J. M. Vink, S. Sadrzadeh, C. B. Lambalk, and D. I. Boomsma, “Heritability of polycystic ovary syndrome in a Dutch twin-family study,” Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 6, pp. 2100–2104, 2006. View at Publisher · View at Google Scholar · View at Scopus
  4. J. R. Wood, V. L. Nelson, C. Ho et al., “The molecular phenotype of polycystic ovary syndrome (PCOS) theca cells and new candidate PCOS genes defined by microarray analysis,” Journal of Biological Chemistry, vol. 278, no. 29, pp. 26380–26390, 2003. View at Publisher · View at Google Scholar · View at Scopus
  5. D. H. Abbott, D. A. Dumesic, and S. Franks, “Developmental origin of polycystic ovary syndrome—a hypothesis,” Journal of Endocrinology, vol. 174, no. 1, pp. 1–5, 2002. View at Publisher · View at Google Scholar · View at Scopus
  6. E. Diamanti-Kandarakis, C. Christakou, E. Palioura, E. Kandaraki, and S. Livadas, “Does polycystic ovary syndrome start in childhood?” Pediatric Endocrinology Reviews, vol. 5, no. 4, pp. 904–911, 2008. View at Scopus
  7. C. Moran, C. M. Del Tapia, E. Hernandez, G. Vazquez, E. Garcia-Hernandez, and J. A. Bermudez, “Etiological review of hirsutism in 250 patients,” Archives of Medical Research, vol. 25, no. 3, pp. 311–314, 1994. View at Scopus
  8. R. Azziz, L. A. Sanchez, E. S. Knochenhauer et al., “Androgen excess in women: experience with over 1000 consecutive patients,” Journal of Clinical Endocrinology and Metabolism, vol. 89, no. 2, pp. 453–462, 2004. View at Publisher · View at Google Scholar · View at Scopus
  9. E. Carmina, F. Rosato, A. Jannì, M. Rizzo, and R. A. Longo, “Relative prevalence of different androgen excess disorders in 950 women referred because of clinical hyperandrogenism,” Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 1, pp. 2–6, 2006. View at Publisher · View at Google Scholar · View at Scopus
  10. J. K. Zawadzki and A. Dunaif, “Diagnostic criteria for polycystic ovary syndrome: towards a rational approach,” in Polycystic Ovary Syndrome, A. Dunaif, J. R. Givens, F. P. Haseltine, and G. R. Merriam, Eds., chapter 32, pp. 377–384, Blackwell, Boston, Mass, USA, 1992.
  11. B. C. J. M. Fauser, “Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome,” Fertility and Sterility, vol. 81, no. 1, pp. 19–24, 2004. View at Publisher · View at Google Scholar · View at Scopus
  12. R. Azziz, E. Carmina, D. Dewailly et al., “Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an androgen excess society guideline,” Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 11, pp. 4237–4245, 2006. View at Publisher · View at Google Scholar · View at Scopus
  13. K. G. Ewens, M. R. Jones, W. Ankener et al., “FTO and MC4R gene variants are associated with obesity in polycystic ovary syndrome,” PLoS One, vol. 6, no. 1, Article ID e16390, 2011. View at Publisher · View at Google Scholar · View at Scopus
  14. E. Guastella, R. A. Longo, and E. Carmina, “Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes,” Fertility and Sterility, vol. 94, no. 6, pp. 2197–2201, 2010. View at Publisher · View at Google Scholar · View at Scopus
  15. M. Yilmaz, U. Isaoglu, I. B. Delibas, and S. Kadanali, “Anthropometric, clinical and laboratory comparison of four phenotypes of polycystic ovary syndrome based on Rotterdam criteria,” Journal of Obstetrics and Gynaecology Research, vol. 37, no. 8, pp. 1020–1026, 2011. View at Publisher · View at Google Scholar
  16. A. S. Melo, C. S. Vieira, L. G. Romano, R. A. Ferriani, and P. A. Navarro, “The frequency of metabolic syndrome is higher among PCOS Brazilian women with menstrual irregularity plus hyperandrogenism,” Reproductive Sciences, vol. 18, no. 12, pp. 1230–1236, 2011. View at Publisher · View at Google Scholar
  17. C. Moran, M. Arriaga, G. Rodriguez, and S. Moran, “Obesity in polycystic ovary syndrome,” in Polycystic Ovary Syndrome, S. Mukherjee, Ed., chapter 5, pp. 77–92, In Tech, Rijeka, Croatia, 2012.
  18. C. Moran, G. Tena, S. Moran, P. Ruiz, R. Reyna, and X. Duque, “Prevalence of polycystic ovary syndrome and related disorders in Mexican women,” Gynecologic and Obstetric Investigation, vol. 69, no. 4, pp. 274–280, 2010. View at Publisher · View at Google Scholar · View at Scopus
  19. E. S. Knochenhauer, T. J. Key, M. Kahsar-Miller, W. Waggoner, L. R. Boots, and R. Azziz, “Prevalence of the polycystic ovary syndrome in unselected black and white women of the Southeastern United States: a prospective study,” Journal of Clinical Endocrinology and Metabolism, vol. 83, no. 9, pp. 3078–3082, 1998. View at Publisher · View at Google Scholar · View at Scopus
  20. E. Diamanti-Kandarakis, C. R. Kouli, A. T. Bergiele et al., “A survey of the polycystic ovary syndrome in the Greek Island of Lesbos: hormonal and metabolic profile,” Journal of Clinical Endocrinology and Metabolism, vol. 84, no. 11, pp. 4006–4011, 1999. View at Scopus
  21. M. Asunción, R. M. Calvo, J. L. San Millán, J. Sancho, S. Avila, and H. F. Escobar-Morreale, “A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain,” Journal of Clinical Endocrinology and Metabolism, vol. 85, no. 7, pp. 2434–2438, 2000. View at Publisher · View at Google Scholar · View at Scopus
  22. D. S. Kiddy, P. S. Sharp, D. M. White et al., “Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: an analysis of 263 consecutive cases,” Clinical Endocrinology, vol. 32, no. 2, pp. 213–220, 1990. View at Scopus
  23. K. B. Singh, D. K. Mahajan, and J. Wortsman, “Effect of obesity on the clinical and hormonal characteristics of the polycystic ovary syndrome,” Journal of Reproductive Medicine, vol. 39, no. 10, pp. 805–808, 1994. View at Scopus
  24. C. Moran, E. Garcia-Hernandez, E. Barahona, S. Gonzalez, and J. A. Bermudez, “Relationship between insulin resistance and gonadotropin dissociation in obese and nonobese women with polycystic ovary syndrome,” Fertility and Sterility, vol. 80, no. 6, pp. 1466–1472, 2003. View at Publisher · View at Google Scholar · View at Scopus
  25. P. O. Dale, T. Tanbo, S. Vaaler, and T. Abyholm, “Body weight, hyperinsulinemia, and gonadotropin levels in the polycystic ovarian syndrome: evidence of two distinct populations,” Fertility and Sterility, vol. 58, no. 3, pp. 487–491, 1992. View at Scopus
  26. A. M. Fulghesu, F. Cucinelli, V. Pavone et al., “Changes in luteinizing hormone and insulin secretion in polycystic ovarian syndrome,” Human Reproduction, vol. 14, no. 3, pp. 611–617, 1999. View at Scopus
  27. R. J. Chang, R. M. Nakamura, H. L. Judd, and S. A. Kaplan, “Insulin resistance in nonobese patients with polycystic ovarian disease,” Journal of Clinical Endocrinology and Metabolism, vol. 57, no. 2, pp. 356–359, 1983. View at Scopus
  28. M. Matteini, G. Cotrozzi, G. N. Bufalini, P. Relli, and T. Lazzari, “Hyperinsulinism and insulinresistance in polycystic ovarian syndrome studied by tolbutamide test,” Bollettino della Societa Italiana di Biologia Sperimentale, vol. 58, no. 22, pp. 1455–1460, 1982. View at Scopus
  29. D. Shoupe, D. D. Kumar, and R. A. Lobo, “Insulin resistance in polycystic ovary syndrome,” American Journal of Obstetrics and Gynecology, vol. 147, no. 5, pp. 588–592, 1983. View at Scopus
  30. R. Pasquali, F. Casimirri, S. Venturoli, et al., “Insulin resistance in patients with polycystic ovaries: its relationship to body weight and androgen levels,” Acta Endocrinologica, vol. 104, no. 1, pp. 110–116, 1983. View at Scopus
  31. R. S. Legro, A. R. Kunselman, W. C. Dodson, and A. Dunaif, “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,” Journal of Clinical Endocrinology and Metabolism, vol. 84, no. 1, pp. 165–169, 1999. View at Publisher · View at Google Scholar · View at Scopus
  32. D. A. Ehrmann, M. K. Cavaghan, R. B. Barnes, J. Imperial, and R. L. Rosenfield, “Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome,” Diabetes Care, vol. 22, no. 1, pp. 141–146, 1999. View at Publisher · View at Google Scholar · View at Scopus
  33. A. Dunaif, K. R. Segal, W. Futterweit, and A. Dobrjansky, “Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome,” Diabetes, vol. 38, no. 9, pp. 1165–1174, 1989. View at Scopus
  34. C. Morán, E. Hernández, J. E. Ruíz, M. E. Fonseca, J. A. Bermúdez, and A. Zárate, “Upper body obesity and hyperinsulinemia are associated with anovulation,” Gynecologic and Obstetric Investigation, vol. 47, no. 1, pp. 1–5, 1999. View at Publisher · View at Google Scholar · View at Scopus
  35. G. Tena, C. Moran, R. Romero, and S. Moran, “Ovarian morphology and endocrine function in polycystic ovary syndrome,” Archives of Gynecology and Obstetrics, vol. 284, no. 6, pp. 1443–1448, 2011. View at Publisher · View at Google Scholar · View at Scopus
  36. R. S. Legro, P. Chiu, A. R. Kunselman, C. M. Bentley, W. C. Dodson, and A. Dunaif, “Polycystic ovaries are common in women with hyperandrogenic chronic anovulation but do not predict metabolic or reproductive phenotype,” Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 5, pp. 2571–2579, 2005. View at Publisher · View at Google Scholar · View at Scopus
  37. E. Carmina, M. C. Chu, C. Moran et al., “Subcutaneous and omental fat expression of adiponectin and leptin in women with polycystic ovary syndrome,” Fertility and Sterility, vol. 89, no. 3, pp. 642–648, 2008. View at Publisher · View at Google Scholar · View at Scopus
  38. M. Olszanecka-Glinianowicz, D. Kuglin, A. Dbkowska-Huć, and P. Skałba, “Serum adiponectin and resistin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome,” European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 154, no. 1, pp. 51–56, 2011. View at Publisher · View at Google Scholar · View at Scopus
  39. A. Dokras, M. Bochner, E. Hollinrake, S. Markham, B. VanVoorhis, and D. H. Jagasia, “Screening women with polycystic ovary syndrome for metabolic syndrome,” Obstetrics and Gynecology, vol. 106, no. 1, pp. 131–137, 2005. View at Scopus
  40. J. Holte, T. Bergh, C. Berne, and H. Lithell, “Serum lipoprotein lipid profile in women with the polycystic ovary syndrome: relation to anthropometric, endocrine and metabolic variables,” Clinical Endocrinology, vol. 41, no. 4, pp. 463–471, 1994. View at Scopus
  41. M. Kravariti, K. K. Naka, S. N. Kalantaridou et al., “Predictors of endothelial dysfunction in young women with polycystic ovary syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 9, pp. 5088–5095, 2005. View at Publisher · View at Google Scholar · View at Scopus
  42. S. Rajendran, S. R. Willoughby, W. P. A. Chan et al., “Polycystic ovary syndrome is associated with severe platelet and endothelial dysfunction in both obese and lean subjects,” Atherosclerosis, vol. 204, no. 2, pp. 509–514, 2009. View at Publisher · View at Google Scholar · View at Scopus
  43. N. Samy, M. Hashim, M. Sayed, and M. Said, “Clinical significance of inflammatory markers in polycystic ovary syndrome: their relationship to insulin resistance and body mass index,” Disease Markers, vol. 26, no. 4, pp. 163–170, 2009. View at Publisher · View at Google Scholar · View at Scopus
  44. R. C. W. Ma, K. H. Liu, P. M. Lam et al., “Sonographic measurement of mesenteric fat predicts presence of fatty liver among subjects with polycystic ovary syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 3, pp. 799–807, 2011. View at Publisher · View at Google Scholar · View at Scopus
  45. A. Repaci, A. Gambineri, and R. Pasquali, “The role of low-grade inflammation in the polycystic ovary syndrome,” Molecular and Cellular Endocrinology, vol. 335, no. 1, pp. 30–41, 2011. View at Publisher · View at Google Scholar · View at Scopus
  46. R. M. Dos Reis, M. C. Foss, M. Dias de Moura, R. A. Ferriani, and M. F. Silva de Sa, “Insulin secretion in obese and non-obese women with polycystic ovary syndrome and its relationship with hyperandrogenism,” Gynecological Endocrinology, vol. 9, no. 1, pp. 45–50, 1995. View at Scopus
  47. F. Quereda, E. Villarroya, J. A. López-Fernández, and R. Alfayate, “Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders,” Fertility and Sterility, vol. 72, no. 1, pp. 32–40, 1999. View at Publisher · View at Google Scholar · View at Scopus
  48. C. Moran, J. L. Renteria, S. Moran, J. Herrera, S. Gonzalez, and J. A. Bermudez, “Obesity differentially affects serum levels of androstenedione and testosterone in polycystic ovary syndrome,” Fertility and Sterility, vol. 90, no. 6, pp. 2310–2317, 2008. View at Publisher · View at Google Scholar · View at Scopus
  49. R. L. Rosenfield, E. N. Ehrlich, and R. E. Cleary, “Adrenal and ovarian contributions to the elevated free plasma androgen levels in hirsute women,” Journal of Clinical Endocrinology and Metabolism, vol. 34, no. 1, pp. 92–98, 1972. View at Scopus
  50. C. Morán, E. Knochenhauer, L. R. Boots, and R. Azziz, “Adrenal androgen excess in hyperandrogenism: relation to age and body mass,” Fertility and Sterility, vol. 71, no. 4, pp. 671–674, 1999. View at Publisher · View at Google Scholar · View at Scopus
  51. E. Carmina, T. Koyama, L. Chang, F. Z. Stanczyk, and R. A. Lobo, “Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome?” American Journal of Obstetrics and Gynecology, vol. 167, no. 6, pp. 1807–1812, 1992. View at Scopus
  52. R. Pasquali, A. Gambineri, and U. Pagotto, “The impact of obesity on reproduction in women with polycystic ovary syndrome,” An International Journal of Obstetrics and Gynaecology, vol. 113, no. 10, pp. 1148–1159, 2006. View at Publisher · View at Google Scholar · View at Scopus
  53. R. Pasquali, D. Antenucci, F. Casimirri et al., “Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss,” Journal of Clinical Endocrinology and Metabolism, vol. 68, no. 1, pp. 173–179, 1989. View at Scopus
  54. D. S. Kiddy, D. Hamilton-Fairley, A. Bush et al., “Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome,” Clinical Endocrinology, vol. 36, no. 1, pp. 105–111, 1992. View at Scopus
  55. D. S. Guzick, R. Wing, D. Smith, S. L. Berga, and S. J. Winters, “Endocrine consequences of weight loss in obese, hyperandrogenic, anovulatory women,” Fertility and Sterility, vol. 61, no. 4, pp. 598–604, 1994. View at Scopus
  56. J. Holte, T. Bergh, C. Berne, L. Wide, and H. Lithell, “Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 80, no. 9, pp. 2586–2593, 1995. View at Scopus
  57. C. E. Wright, J. V. Zborowski, E. O. Talbott, K. McHugh-Pemu, and A. Youk, “Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome,” International Journal of Obesity, vol. 28, no. 8, pp. 1026–1032, 2004. View at Publisher · View at Google Scholar · View at Scopus
  58. K. M. Hoeger, “Exercise therapy in polycystic ovary syndrome,” Seminars in Reproductive Medicine, vol. 26, no. 1, pp. 93–100, 2008. View at Publisher · View at Google Scholar · View at Scopus
  59. L. J. Moran, G. Brinkworth, M. Noakes, and R. J. Norman, “Effects of lifestyle modification in polycystic ovarian syndrome,” Reproductive BioMedicine Online, vol. 12, no. 5, article no. 2166, pp. 569–578, 2006. View at Scopus
  60. V. Jayagopal, E. S. Kilpatrick, S. Holding, P. E. Jennings, and S. L. Atkin, “Orlistat is as beneficial as metformin in the treatment of polycystic ovarian syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 2, pp. 729–733, 2005. View at Publisher · View at Google Scholar · View at Scopus
  61. T. Sabuncu, M. Harma, M. Harma, Y. Nazligul, and F. Kilic, “Sibutramine has a positive effect on clinical and metabolic parameters in obese patients with polycystic ovary syndrome,” Fertility and Sterility, vol. 80, no. 5, pp. 1199–1204, 2003. View at Publisher · View at Google Scholar · View at Scopus
  62. H. F. Escobar-Morreale, J. I. Botella-Carretero, F. Álvarez-Blasco, J. Sancho, and J. L. San Millán, “The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery,” Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 12, pp. 6364–6369, 2005. View at Publisher · View at Google Scholar · View at Scopus