Risk of Type 2 Diabetes Mellitus in Polycystic Ovarian Syndrome1

Safa M. Al-Ashou, Ruaa Nazar AL-Saraj

Volume 7, Issue 3 2023

Page: 1-8

Abstract

One of the most prevalent endocrine illnesses in women of reproductive age is polycystic ovary syndrome. 6% to 15% of the population are impacted. It is a multifactorial condition .Insulin resistance is a critical component that is important in the pathophysiology of the syndrome and is the main factor connected to the onset of type 2 diabetes mellitus in women with polycystic ovary syndrome, but it is not always a trait present in individuals with the condition. Between 44% and 70% of women with polycystic ovarian syndrome have insulin resistance. The objective of this study is to assess the risk of type 2 diabetes mellitus in individuals with polycystic ovarian syndrome and how the condition is managed.

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References

  • 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, 19– 25 .
  • Aboeldalyl S, James C, Seyam E, Ibrahim EM, Shawki HED, Amer S. The role of chronic inflammation in polycystic ovarian syndrome—a systematic review and meta-analysis. Int. J. Mol. Sci. 2021, 22, 2734 .
  • Conway G, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Franks S, Gambineri A, Kelestimur F, Macut D, Micic D, Pasquali R, Pfeifer M, Pignatelli D, Pugeat M, Yildiz BO; ESE PCOS Special Interest Group. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol 2014; 171: 1-29 .
  • Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, Lizneva D, Natterson-Horowtiz B, Teede HJ, Yildiz BO. Polycystic ovary syndrome. Nat Rev Dis Primers 2016; 2: 16057 .
  • Bednarska S, Siejka A. The pathogenesis and treatment of polycystic ovary syndrome: What's new?. Advances in Clinical and Experimental Medicine. 2017;26(2) .
  • Ganie MA, Vasudevan V, Wani IA, Baba MS, Arif T, Rashid A. Epidemiology, pathogenesis, genetics & management of polycystic ovary syndrome in India. The Indian journal of medical research. 2019 Oct;150(4):333 .
  • Glueck CJ, Goldenberg N. Characteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics. Metab. 2019, 92, 108–120 .
  • Damone AL, Joham AE, Loxton D, Earnest A, Teede HJ, Moran LJ. Depression, anxiety and perceived stress in women with and without PCOS: A community-based study. Psychol. Med. 2019, 49, 1510–1520 .
  • Walters KA, Gilchrist RB, Ledger WL, Teede HJ, Handelsman DJ, Campbell RE. New perspectives on the pathogenesis of PCOS: neuroendocrine origins Trends in Endocrinol. Metabol.2018;29(12)841-852.
  • Differential Diagnosis of PCOS. Available online: https://www.verywellhealth.com/what-is-the-differentialdiagnosis-of-pcos2616642 (accessed on 6 December 2021) .
  • Witchel SF, Burghard AC, Tao RH, Oberfield SE. The diagnosis and treatment of PCOS in adolescents. Curr. Opin. Pediatr. 2019, 31, 562–569 .
  • Polycystic Ovary Syndrome (PCOS). Available online: https://www.mayoclinic.org/diseasesconditions/pcos/diagnosistreatment/drc-20353443 (accessed on 6 December 2021) .
  • Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R: Criteria, prevalence, and phenotypes of polycystic ovary syndrome.FertilSteril.2016;106:6-15.
  • Jamil AS, Alalaf SK, Al-Tawil NG, Al-Shawaf T: Comparison of clinical and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Arch Gynecol Obstet. 2016, 293:447-56 .
  • Greenwood EA, Huddleston HG. Insulin resistance in polycystic ovary syndrome: Concept versus cutoff. Fertil. Steril. 2019, 112, 827–828 .
  • Ibrahim DK, Al- Thanoon ZA. The Relationship Between Magnesium Supplementation and Glycemic Control in Diabetic Patients: A Review. Irq J Pharm 2021:18(1);57-66 .
  • Pani A, Gironi I, Di Vieste G, Mion E, Bertuzzi F, Pintaudi B. From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management. Int J Endocrinol 2020; 2020: 6276187 .
  • Hurd WW, Abdel-Rahman MY, Ismail SA, Abdellah MA, Schmotzer CL, Sood A. “Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome,” Fertility and Sterility2011; 96(4): 1043–1047 .
  • Moran L, Teede H: Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod Update. 2009,
  • Ibáñez L, Oberfield SE, Witchel S, Auchus RJ, Chang RJ, Codner E, Dabadghao P, Darendeliler F, Elbarbary NS, Gambineri A, Garcia Rudaz C. An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Hormone research in paediatrics. 2017 Jun 1;88(6):371-95.
  • Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocr. Rev. 2016:37; 467–520 .
  • Andersen M, Glintborg D: Diagnosis and follow-up of type 2 diabetes in women with PCOS: a role for OGTT?. Eur J Endocrinol. 2018, 179:D1-D14.
  • American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013; 36:67- 74 ..
  • 4. Lim SS, Davies MJ, Norman RJ, Moran LJ: Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618-37 .
  • Huebschmann AG, Huxley RR, Kohrt WM, Zeitler P, Regensteiner JG, Reusch JEB. Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course. Diabetologia 2019; 62: 1761-1772
  • Anagnostis P, Tarlatzis BC, Kauffman RP:Polycystic ovarian syndrome (PCOS): long-term metabolic consequences. Metabolism. 2018, 86:33-43.
  • Pelanis R, Mellembakken JR, Sundström-Poromaa I, Ravn P, Morin-Papunen L, Tapanainen JS, Piltonen T, Puurunen J, Hirschberg AL, Fedorcsak P, Andersen M. The prevalence of Type 2 diabetes is not increased in normal-weight women with PCOS. Human reproduction. 2017 Nov 1;32(11):2279-86.
  • Goverde AJ, Van Koert AJ, Eijkemans MJ, Knauff EA, Westerveld HE, Fauser BC, Broekmans FJ. Indicators for metabolic disturbances in anovulatory women with polycystic ovary syndrome diagnosed according to the Rotterdam consensus criteria. Human Reproduction. 2009 Mar 1;24(3):710-7 .
  • Gassar S, Misso ML, Hopkins WG, Shaw CS, Teede HJ, Stepto NK. Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic-hyperinsulinaemic clamp studies. Hum Reprod 2016; 31: 2619-2631
  • Tsilchorozidou T, Overton C, Conway GS: The Pathophysiology of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2004; 60:1–17 .
  • Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2006; 295: 1288-1299
  • Oh JY, Barrett-Connor E, Wedick NM, Wingard DL; Rancho Bernardo Study. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo study. Diabetes Care 2002; 25: 55-60.
  • Muka T, Nano J, Jaspers L, Meun C, Bramer WM, Hofman A, Dehghan A, Kavousi M, Laven JS, Franco OH. Associations of Steroid Sex Hormones and Sex Hormone-Binding Globulin With the Risk of Type 2 Diabetes in Women: A Population-Based Cohort Study and Meta-analysis. Diabetes 2017; 66: 577-586
  • Barber TM, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2021; 95: 531-541 .
  • Forslund M, Landin-Wilhelmsen K, Trimpou P, Schmidt J, Brännström M, Dahlgren E. Type 2 diabetes mellitus in women with polycystic ovary syndrome during a 24-year period: importance of obesity and abdominal fat distribution. Hum Reprod Open 2020; 2020: hoz042 [PMID: 31976382 DOI: 10.1093/hropen/hoz042]
  • Gambineri A, Patton L, Altieri P, Pagotto U, Pizzi C, Manzoli L, Pasquali R. Polycystic ovary syndrome is a risk factor for type 2 diabetes: results from a long-term prospective study. Diabetes 2012; 61: 2369-2374.
  • Zhu T, Cui J, Goodarzi MO. Polycystic Ovary Syndrome and Risk of Type 2 Diabetes, Coronary Heart Disease, and Stroke. Diabetes 2021; 70: 627-637.
  • Lee H, Oh JY, Sung YA, Chung H, Cho WY. The prevalence and risk factors for glucose intolerance in young Korean women with polycystic ovary syndrome. Endocrine 2009; 36: 326-332
  • Wei HJ, Young R, Kuo IL, Liaw CM, Chiang HS, Yeh CY. Prevalence of insulin resistance and determination of risk factors for glucose intolerance in polycystic ovary syndrome: a cross-sectional study of Chinese infertility patients. Fertil Steril 2009; 91: 1864-1868 .
  • Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, Lobo R, Norman RJ, Talbott E, Dumesic DA. 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. The Journal of Clinical Endocrinology & Metabolism. 2010 May 1;95(5):2038-49.
  • Livadas S, Anagnostis P, Bosdou JK, Bantouna D, Paparodis R. Polycystic ovary syndrome and type 2 diabetes mellitus: A state-of-the-art review. World journal of diabetes. 2022 Jan 1;13(1):5 .
  • Livadas S, Kollias A, Panidis D, Diamanti-Kandarakis E. Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome. Eur J Endocrinol 2014; 171: 301-309
  • Livadas S, Macut D, Bothou C, Kuliczkowska-PÅ‚aksej J, Vryonidou A, Bjekic-Macut J, Mouslech Z, Milewicz A, Panidis D. Insulin resistance, androgens, and lipids are gradually improved in an age-dependent manner in lean women with polycystic ovary syndrome: insights from a large Caucasian cohort. Hormones (Athens) 2020; 19: 531-539
  • Celik C, Tasdemir N, Abali R, Bastu E, Yilmaz M. Progression to impaired glucose tolerance or type 2 diabetes mellitus in polycystic ovary syndrome: a controlled follow-up study. Fertil Steril 2014; 101: 1123-8.e1
  • Rubin KH, Glintborg D, Nybo M, Abrahamsen B, Andersen M. Development and Risk Factors of Type 2 Diabetes in a Nationwide Population of Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2017; 102: 3848-3857.
  • Lindheim L, Bashir M, Münzker J, Trummer C, Zachhuber V, Leber B, Horvath A, Pieber TR, Gorkiewicz G, Stadlbauer V, Obermayer-Pietsch B. Alterations in gut microbiome composition and barrier function are associated with reproductive and metabolic defects in women with polycystic ovary syndrome (PCOS): a pilot study. PloS one. 2017 Jan 3;12(1):e0168390.
  • Arianna Pani, Ilaria Gironi, Giacoma Di Vieste, Elena Mion, Federico Bertuzzi, and Basilio Pintaudi.International Journal of Endocrinology Volume 2020, Article ID 6276187, 10 pages.
  • Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabet. Med.2007 24(5), 451–463 .
  • Shang Y, Zhou H, Hu M, Feng H. Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2020; 105 .
  • . Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd-Jones D, McEvoy JW, Michos ED. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e596-646.
  • Domecq JP, Prutsky G, Mullan RJ, Hazem A, Sundaresh V, Elamin MB, Phung OJ, Wang A, Hoeger K, Pasquali R, Erwin P. Lifestyle modification programs in polycystic ovary syndrome: systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 2013 Dec 1;98(12):4655-63.
  • Moran LJ, Ko H, Misso M, Marsh K, Noakes M, Talbot M, Frearson M, Thondan M, Stepto N, Teede HJ. Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. Journal of the Academy of Nutrition and Dietetics. 2013 Apr 1;113(4):520-45
  • Harrison CL, Lombard CB, Moran LJ, Teede HJ. Exercise therapy in polycystic ovary syndrome: a systematic review. Human reproduction update. 2011 Mar 1;17(2):171-83
  • Jensterle M, Kravos NA, Ferjan S, Goricar K, Dolzan V, Janez A. Long-term efficacy of metformin in overweight-obese PCOS: longitudinal follow-up of retrospective cohort. Endocrine Connections. 2020 Jan 1;9(1):44-54 .
  • Pasquali R. Metformin in women with PCOS, pros. Endocrine 2015; 48: 422–426.
  • Harborne LR, Sattar N, Norman JE, Fleming R. Metformin and weight loss in obese women with polycystic ovary syndrome: comparison of doses. The Journal of Clinical Endocrinology & Metabolism. 2005 Aug 1;90(8):4593-8
  • Spiegelman BM. PPAR-gamma: adipogenic regulator and thiazolidinedione receptor. Diabetes 1998; 47: 507– 514 .
  • Jearath V, Vashisht R, Rustagi V, Raina S, Sharma R. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction. Journal of Pharmacology and Pharmacotherapeutics. 2016 Mar;7(1):41-3
  • Cefalu WT. The physiologic role of incretin hormones: clinical applications. J Am Osteopath Assoc 2010; 110(Suppl. 2): S8–S14 .
  • Pontikis C, Yavropoulou MP, Toulis KA, Kotsa K, Kazakos K, Papazisi A, Gotzamani-Psarakou A, Yovos JG. The incretin effect and secretion in obese and lean women with polycystic ovary syndrome: a pilot study. Journal of women's health. 2011 Jun 1;20(6):971-6
  • Olansky L, Reasner C, Seck TL, Williams‐Herman DE, Chen M, Terranella L, Mehta A, Kaufman KD, Goldstein BJ. A treatment strategy implementing combination therapy with sitagliptin and metformin results in superior glycaemic control versus metformin monotherapy due to a low rate of addition of antihyperglycaemic agents. Diabetes, Obesity and Metabolism. 2011 Sep;13(9):841-9.
  • Zinman B, Gerich J, Buse JB, Lewin A, Schwartz S, Raskin P, Hale PM, Zdravkovic M, Blonde L, LEAD-4 Study Investigators. Efficacy and safety of the human glucagon-like peptide-1 analog liraglutide in combination with metformin and thiazolidinedione in patients with type 2 diabetes (LEAD-4 Met+ TZD). Diabetes care. 2009 Jul 1;32(7):1224-30
  • . Vella A. Mechanism of action of DPP-4 inhibitors–new insights. J Clin Endocrinol Metab 2012; 97: 2626–2628 .
  • Thornberry NA, Gallwitz B. Mechanism of action of inhibitors of dipeptidyl-peptidase-4 (DPP-4). Best Pract Res Clin Endocrinol Metab 2009; 23: 479–486 .
  • Chao EC. SGLT-2 inhibitors: a new mechanism for glycemic control. Clin Diabetes 2014; 32: 4–11 .
  • Yaribeygi H, Sathyapalan T, Maleki M, Jamialahmadi T, Sahebkar A. Molecular mechanisms by which SGLT2 inhibitors can induce insulin sensitivity in diabetic milieu: A mechanistic review. Life sciences. 2020 Jan 1;240:117090
  • Ostlund Jr RE, McGill JB, Herskowitz I, Kipnis DM, Santiago JV, Sherman WR. D-chiro-inositol metabolism in diabetes mellitus. Proceedings of the National Academy of Sciences. 1993 Nov 1;90(21):9988-92. .
  • Corrado F, D’anna R, Di Vieste G, Giordano D, Pintaudi B, Santamaria A, Di Benedetto A. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabetic medicine. 2011 Aug;28(8):972-5 .
  • Hong JH, Jang HW, Kang YE, Lee JH, Kim KS, Kim HJ, Park KR, Ku BJ. Urinary chiro-and myo-inositol levels as a biological marker for type 2 diabetes mellitus. Disease markers. 2012 Jan 1;33(4):193-9
  • Genazzani AD, Lanzoni C, Ricchieri F, Jasonni VM. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecological Endocrinology. 2008 Jan 1;24(3):139-44.

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