Reproductive and Metabolic Consequences of the Polycystic Ovarian Syndrome

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Hudecova, Miriam,1971-Uppsala universitet,Institutionen för kvinnors och barns hälsa (författare)

Reproductive and Metabolic Consequences of the Polycystic Ovarian Syndrome

BokEngelska2010

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Uppsala :Acta Universitatis Upsaliensis,2010
73 s.
electronicrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:uu-123248
ISBN:9789155478261
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-123248URI

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Språk:engelska
Sammanfattning på:engelska

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Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine,1651-6206 ;570

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Polycystic ovary syndrome (PCOS) is a complex clinical condition characterized by hyperandrogenism and chronic oligo/anovulation. Infrequent ovulation and metabolic alterations in women with PCOS are associated with subfertility and probably increased miscarriage rates compared with normal fertile women. The overall risk of developing type 2 diabetes and impaired glucose tolerance (IGT) is three- to sevenfold higher in PCOS women, and the onset of glucose intolerance seems to occur at an earlier age than in healthy controls. Women with PCOS also have several risk factors for cardiovascular disease, although it is unclear whether they actually experience more cardiovascular events than other women. Very few studies assessing the long-term reproductive and metabolic consequences in older women with previously confirmed PCOS have been conducted. In this long-term follow-up of women with PCOS, 84 women with a diagnosis of PCOS between 1987 and 1995 and age at the follow-up > 35 years and an age-matched population-based group of control women participated. Data on reproductive outcome, ovarian reserve, endothelial function, insulin sensitivity and beta-cell function were collected. According to our results most women with PCOS had given birth and the rate of spontaneous pregnancies was relatively high. The rate of miscarriages was not increased in PCOS patients and the ultrasound findings together with increased levels of anti-müllerian hormone suggested that their ovarian reserve is superior to women of similar age. PCOS women displayed signs of endothelial dysfunction, but this was largely due to the increased prevalence of independent risk factors for cardiovascular disease such as increased BMI, triglycerides and blood pressures. IGT and type 2 diabetes occurred more often in PCOS women. Free androgen levels and beta-cell function decreased over time whereas insulin sensitivity remained unchanged. Obesity at young age and progressive weight-gain rendered them more prone to be insulin resistant at the follow-up. Beta-cell function was increased in PCOS women in comparison with control subjects but declined over time. Independent of PCOS phenotype at the index assessment and persistence of PCOS symptoms at the follow-up investigation, premenopausal women with PCOS had lower insulin sensitivity and increased beta cell function in comparison with control subjects. Conclusion: The long-term reproductive outcomes of PCOS are similar compared to women with normal ovaries. Although symptoms and androgen levels are normalized over time, women with PCOS continue to display reduced insulin sensitivity and increased beta-cell function and they also have an increased risk of IGT and type 2 diabetes.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
polycystic ovarian syndrome
long-term follow-up
ovarian reserve
anti-Müllerian hormone
insulin sensitivity
early insuline response
impaired glucose tolerance
diabetes
endothelial function
endothelial-dependent vasodilation
Obstetrics and gynaecology
Obstetrik och gynekologi
Obstetrik och gynekologi
Obstetrics and Gynaecology

Biuppslag (personer, institutioner, konferenser, titlar ...)

Sundström Poromaa, Inger,Prof.Uppsala universitet,Institutionen för kvinnors och barns hälsa (preses)
Holte, Jan,M.D., Ph.D.Uppsala universitet,Institutionen för kvinnors och barns hälsa (preses)
Olovsson, Matts,Ass.Prof.Uppsala universitet,Institutionen för kvinnors och barns hälsa (preses)
Janson, Per Olof,Prof.Sahlgrenska University Hospital, Gothenburg, Sweden (opponent)
Uppsala universitetInstitutionen för kvinnors och barns hälsa (creator_code:org_t)

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Av författaren/redakt...: Hudecova, Miriam ...; Sundström Poroma ...; Holte, Jan, M.D. ...; Olovsson, Matts, ...; Janson, Per Olof ...

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