Prevalence of Metabolic Syndrome in Four Phenotypes of PCOS and Its Relationship with Androgenic Components Among Iranian Women: A Cross-sectional Study

Overview

Journal Int J Reprod Biomed

Specialty Reproductive Medicine

Date 2020 Jun 5

PMID 32494764

Citations 6

Authors

Narges Zaeemzadeh

Shahideh Jahanian Sadatmahalleh

Saeideh Ziaei

Anoshirvan Kazemnejad

Azadeh Mottaghi

Neda Mohamadzadeh

Maryam Movahedinejad

Affiliations

Soon will be listed here.

Abstract

Background: Polycystic ovary syndrome (PCOS) increases the risk of metabolic syndrome (MetS). Insulin resistance (IR) plays a major role in the pathophysiology of both PCOS and MetS.

Objective: This study was designed to compare the prevalence of MetS among different phenotypes of PCOS and its relationship with androgenic components.

Materials And Methods: 182 participants eligible for this five-group comparative study were selected by convenience sampling method. They were classified according to the Rotterdam criteria: clinical and/or biochemical hyperandrogenism (H) + PCOS on ultrasound (P) + ovulation disorders (O) (n = 41), clinical and/or biochemical H + PCOS on P (n = 33), PCOS on P + O (n = 40), clinical and/or biochemical H + O (n = 37), and control (without PCOS) (n = 31). MetS was measured based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Androgenic components included free-androgen-index (FAI), total-testosterone (TT) level and sex-hormone-binding-globulin (SHBG).

Results: A significant difference was observed between the study groups in terms of MetS prevalence (p = 0.01). In phenotype H+P+O, there was a statistically significant positive association between TG and TT, and a significant negative association between SBP and DBP with SHBG. In phenotype O+P, WC was inversely associated with SHBG. In phenotype H+O, FBS and TG were positively associated with FAI but HDL was inversely associated with FAI. Moreover, WC and DBP were positively associated with TT in phenotype H+O. No associations were detected between MetS parameters and androgenic components in other PCOS subjects (phenotype H+P) and in the control group. TT was significantly higher in the PCOS group suffering from MetS (p = 0.04).

Conclusion: According to the research results, hyperandrogenic components are potent predictors of metabolic disorders. Thus, we suggest that MetS screening is required for the prevention of MetS and its related complications in PCOS women.

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References

Grundy S, Cleeman J, Daniels S, Donato K, Eckel R, Franklin B . Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol. 2008; 4(4):198-203. DOI: 10.1097/00132577-200512000-00018. View

Sharma S, Majumdar A . Prevalence of metabolic syndrome in relation to body mass index and polycystic ovarian syndrome in Indian women. J Hum Reprod Sci. 2016; 8(4):202-8. PMC: 4691971. DOI: 10.4103/0974-1208.170394. View

Lazic M, Aird F, Levine J, Dunaif A . Prenatal androgen treatment alters body composition and glucose homeostasis in male rats. J Endocrinol. 2010; 208(3):293-300. PMC: 3039067. DOI: 10.1677/JOE-10-0263. View

Alberti K, Eckel R, Grundy S, Zimmet P, Cleeman J, Donato K . Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation;.... Circulation. 2009; 120(16):1640-5. DOI: 10.1161/CIRCULATIONAHA.109.192644. View

. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2003; 19(1):41-7. DOI: 10.1093/humrep/deh098. View

Jamil A, Alalaf S, Al-Tawil N, Al-Shawaf T . A case-control observational study of insulin resistance and metabolic syndrome among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. Reprod Health. 2015; 12:7. PMC: 4417246. DOI: 10.1186/1742-4755-12-7. View

Fruzzetti F, Perini D, Lazzarini V, Parrini D, Genazzani A . Hyperandrogenemia influences the prevalence of the metabolic syndrome abnormalities in adolescents with the polycystic ovary syndrome. Gynecol Endocrinol. 2009; 25(5):335-43. DOI: 10.1080/09513590802630146. View

Kavardzhikova S, Pechlivanov B . [Clinical, hormonal and metabolic characteristics of different phenotypes of polycystic ovary syndrome, in Bulgarian population]. Akush Ginekol (Sofiia). 2010; 49(4):32-7. View

Nandi A, Chen Z, Patel R, Poretsky L . Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 2014; 43(1):123-47. DOI: 10.1016/j.ecl.2013.10.003. View

10.

Diamanti-Kandarakis E, Christakou C, Kandarakis H . Polycystic ovarian syndrome: the commonest cause of hyperandrogenemia in women as a risk factor for metabolic syndrome. Minerva Endocrinol. 2007; 32(1):35-47. View

11.

Fruzzetti F, Perini D, Lazzarini V, Parrini D, Genazzani A . Adolescent girls with polycystic ovary syndrome showing different phenotypes have a different metabolic profile associated with increasing androgen levels. Fertil Steril. 2008; 92(2):626-34. DOI: 10.1016/j.fertnstert.2008.06.004. View

12.

Goverde A, van Koert A, Eijkemans M, Knauff E, Westerveld H, Fauser B . Indicators for metabolic disturbances in anovulatory women with polycystic ovary syndrome diagnosed according to the Rotterdam consensus criteria. Hum Reprod. 2008; 24(3):710-7. DOI: 10.1093/humrep/den433. View

13.

Vaggopoulos V, Trakakis E, Chrelias C, Panagopoulos P, Basios G, Makridima S . Comparing classic and newer phenotypes in Greek PCOS women: the prevalence of metabolic syndrome and their association with insulin resistance. J Endocrinol Invest. 2012; 36(7):478-84. DOI: 10.3275/8771. View

14.

Demirel F, Bideci A, Cinaz P, Camurdan M, Biberoglu G, Yesilkaya E . Serum leptin, oxidized low density lipoprotein and plasma asymmetric dimethylarginine levels and their relationship with dyslipidaemia in adolescent girls with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2007; 67(1):129-34. DOI: 10.1111/j.1365-2265.2007.02849.x. View

15.

Ferriman D, GALLWEY J . Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961; 21:1440-7. DOI: 10.1210/jcem-21-11-1440. View

16.

Madani T, Hosseini R, Ramezanali F, Khalili G, Jahangiri N, Ahmadi J . Metabolic syndrome in infertile women with polycystic ovarian syndrome. Arch Endocrinol Metab. 2016; 60(3):199-204. PMC: 10522304. DOI: 10.1590/2359-3997000000135. View

17.

Hashemi S, Ramezani Tehrani F, Noroozzadeh M, Azizi F . Normal cut-off values for hyperandrogenaemia in Iranian women of reproductive age. Eur J Obstet Gynecol Reprod Biol. 2013; 172:51-5. DOI: 10.1016/j.ejogrb.2013.09.029. View

18.

Sung Y, Oh J, Chung H, Lee H . Hyperandrogenemia is implicated in both the metabolic and reproductive morbidities of polycystic ovary syndrome. Fertil Steril. 2014; 101(3):840-5. DOI: 10.1016/j.fertnstert.2013.11.027. View

19.

Azizi F, Khalili D, Aghajani H, Esteghamati A, Hosseinpanah F, Delavari A . Appropriate waist circumference cut-off points among Iranian adults: the first report of the Iranian National Committee of Obesity. Arch Iran Med. 2010; 13(3):243-4. View

20.

Zahiri Z, Sharami S, Milani F, Mohammadi F, Kazemnejad E, Ebrahimi H . Metabolic Syndrome in Patients with Polycystic Ovary Syndrome in Iran. Int J Fertil Steril. 2016; 9(4):490-6. PMC: 4793169. DOI: 10.22074/ijfs.2015.4607. View