Prevalence of the metabolic syndrome among Italian adults according to ATP III definition

BACKGROUND AND AIM: To evaluate the prevalence of the metabolic syndrome as defined by NCEP ATP III criteria in an Italian cohort of adult subjects. METHODS AND RESULTS: A total of 2100 subjects aged 19 years or more, were randomly selected from the general population of the Lucca area. Metabolic syndrome was defined by the clustering of three or more of the following abnormalities: waist circumference greater than 102 cm in men and 88 cm in women; serum triglycerides level of at least 150 mg/dl (1.69 mmol/l); high-density lipoprotein cholesterol less than 40 mg/dl (1.04 mmol/l) in men and 50 mg/dl (1.29 mmol/l) in women; blood pressure greater than 130/85 mmHg; or serum glucose greater than 110 mg/dl (6.1 mmol/l). The prevalence of the metabolic syndrome was 18% in women and 15% in men. The prevalence increased from 3% among subjects aged 20-29 years to 25% in subjects aged 70 years or older. Application of this estimated prevalence data to the Italian adult population suggests that 3.6 million women and 3 million men may have the metabolic syndrome. CONCLUSIONS: The prevalence of metabolic syndrome in a cohort likely representative of the Italian adult population is high. The recognition of the syndrome may represent an important challenge for physicians and healthcare and requires immediate strategies aimed to reduce level of individual metabolic traits.     

Prominent role of low HDL-cholesterol in explaining the high prevalence of the metabolic syndrome in polycystic ovary syndrome

Background and aimsThe main objective was to evaluate the prevalence of the metabolic syndrome in Caucasian women with PCOS, using either of the currently proposed definitions (NCEP/ATPIII, IDF and AHA/NHLBI) and, therefore, to estimate the concordance between these three classifications. Secondary objectives were to evaluate: i) which individual criterion of the metabolic syndrome is most strongly associated with PCOS; and ii) whether the severity of hyperandrogenemia, hyperinsulinemia and insulin resistance may influence the presence of the metabolic syndrome in PCOS women.Methods and resultsThe metabolic syndrome was assessed in 200 Caucasian women with PCOS and in 200 Caucasian controls, matched for age and BMI, considering the NCEP/ATPIII, IDF and AHA/NHLBI definitions. PCOS women had an increased prevalence of the metabolic syndrome compared with controls: 32 versus 23% with the NCEP/ATPIII, 39 versus 25% with the IDF and 37 versus 24% with the AHA/NHLBI, respectively (Cohen's Kappa index between the three classifications, P < 0.001). Multivariate logistic regressions revealed that among the individual criteria of the metabolic syndrome, only low HDL-cholesterol levels were significantly associated with PCOS (P < 0.001) which, in turn, are related to insulin_AUC (P = 0.029) but not to androgens.ConclusionThis case-control study indicates a high prevalence of the metabolic syndrome in Caucasian PCOS women that is independent of the diagnostic classification used. Furthermore, it shows that low HDL-cholesterol is the criterion which best explains the high prevalence of the metabolic syndrome in PCOS subjects which, in turn, is influenced by hyperinsulinemia, rather than by hyperandrogenemia.     

The metabolic syndrome in polycystic ovary syndrome

Much overlap is present between the polycystic ovary syndrome (PCOS) and the metabolic syndrome. This article reviews the existing data regarding the prevalence, characteristics, and treatment of the metabolic syndrome in women with PCOS. The prevalence of the metabolic syndrome in PCOS is approximately 43-47%, a rate 2-fold higher than that for women in the general population. High body mass index and low serum HDL cholesterol are the most frequently occurring components of the metabolic syndrome in PCOS. The pathogenic link between the metabolic syndrome and PCOS is most likely insulin resistance. Therefore, the presence of the metabolic syndrome in PCOS suggests a greater degree of insulin resistance compared to PCOS without the metabolic syndrome. Obesity, atherogenic dyslipidemia, hypertension, impaired fasting glucose/impaired glucose tolerance, and vascular abnormalities are all common metabolic abnormalities present in PCOS. Lifestyle modification has proven benefit and pharmacological therapy with insulin-sensitizing agents has potential benefit in the treatment of the metabolic syndrome in women with PCOS.     

Body composition, fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome

The polycystic ovary syndrome (PCOS), characterized by chronic anovulation and hyperandrogenism, has many features of metabolic syndrome and can be considered a metabolic disease. Approximately 50% of patients with PCOS are overweight or obese with abdominal fat accumulation. Some metabolic alterations and abdominal fat distribution have also been reported in lean women with PCOS. The aim of this study was to evaluate the effect, if any, of obesity on metabolic features, body composition and fat distribution in patients with PCOS. Body composition and abdominal fat distribution (evaluated by DEXA), waist circumference, blood pressure, lipid profile, glucose tolerance and homeostasis model assessment index were determined in 23 lean [mean age 23 +/- 5 yr, mean body mass index (BMI) 22 +/- 2 kg/m2] and 27 overweight-obese (mean age 21 +/- 5 yr, mean BMI 32 +/- 5 kg/m2) patients with PCOS and in 20 age- and weight-matched eumenorrhoic women. Patients exhibited slight but non-significant differences in metabolic parameters, waist circumference, blood pressure and total and abdominal fat content compared with weight-matched controls. None of the lean subjects suffered from metabolic syndrome according to the National Cholesterol Education Program--Adult Treatment Panel III (NCEP-ATPIII) criteria as opposed to 10 overweight-obese patients and three overweight-obese control subjects (37% and 33.3% of each subgroup, respectively). Our data do not show significant metabolic alterations in lean PCOS women. Results indicate that obesity seems to underpin the metabolic alterations exhibited by the overweight-obese patients. However, since women with PCOS are at increased cardiovascular risk, further studies are needed to evaluate metabolic alterations and body composition in these patients.     

Prevalence of metabolic syndrome among Iranian women with polycystic ovary syndrome: A systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with an increased the risk of metabolic syndrome (MetS) and hence increased cardiovascular diseases in women. This systematic review and meta-analysis aimed at examining the prevalence of MetS in Iranian women with PCOS. This was a systematic review and meta-analysis of English and Persian studies, using the following keywords: Polycystic Ovary Syndrome, Hyperandrogenism, Metabolic Syndrome,“MetSyn”, X Syndrome, and Iran in several national and international databases (Scientific Information Database (SID), Magiran, Web of Science, Google Scholar, PubMed, and Scopus from inception to February 2019. Heterogeneity among the studies was assessed using the Cochran's Q test. The random effects model was then used to estimate the overall prevalence of MetS. ALL the analyses were performed using STATA, version 12. Overall, 10 studies were included in the study. The overall prevalence of MetS among Iranian women with PCOS was 26.6% (95% CI: 16.60–31.70). In addition, the mean body mass index (BMI) was 27.47 (95% CI: 25.46–29.48) and the mean waist circumference was 87.94 (95% CI: 84.28–91.60). According the meta-regression results, there were no significant associations between the prevalence of MetS and sample size, year of publication, waist circumference, BMI, and age. One-fourth of Iranian women with PCOS have MetS. Given the overlap between anthropometric and metabolic abnormalities in PCOS and the features of MetS, accurate identification of patients with MetS is important to ensure early diagnosis and subsequent interventions to effectively manage the condition.     

多囊卵巢综合征患者代谢综合征患病风险研究

目的 研究多囊卵巢综合征(PCOS)患者代谢综合征(MS)患病率,并探讨MS发生的危险因素.方法 比较348例年轻的PCOS患者及113名非PCOS正常女性的MS及其组分的患病率.结果 PCOS组MS的患病率为27.0%,明显高于正常对照组的10.6%(P<0.01),除甘油三酯外,其他MS组分在PCOS组均高于正常对照组(P<0.05或P<0.01),但校正年龄和体重指数(BMI)后,差异就不存在统计学意义(P=0.737).分层分析也显示PCOS非肥胖组和肥胖组的MS患病率与相应的正常对照组均无明显差异(均P>0.05).多元逐步回归分析显示稳态模型评估的胰岛素抵抗指数(HOMA-IR)和BMI是MS的独立预测因素(均P<0.01).结论 肥胖和胰岛素抵抗是MS的独立危险因素,PCOS单独并不增加MS的发生风险.     

Metabolic profile in sons of women with polycystic ovary syndrome

CONTEXT: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder with strong familial aggregation. It has been demonstrated that parents and brothers of PCOS women exhibit insulin resistance and related metabolic defects. However, metabolic phenotypes in sons of PCOS women have not been described. OBJECTIVE: Our objective was to assess the metabolic profiles in sons of women with PCOS during different stages of life: early infancy, childhood, and adulthood. DESIGN: Eighty sons of women with PCOS (PCOS(S)) and 56 sons of control women without hyperandrogenism (C(S)), matched for age, were studied. In early infancy, glucose and insulin were determined in the basal sample. In children and adults, a 2-h oral glucose tolerance test was performed with measurements of glucose and insulin. Adiponectin, leptin, C-reactive protein, SHBG, and serum lipids were determined in the basal sample during the three periods. RESULTS: During early infancy, PCOS(S) showed higher weight (P = 0.038) and weight sd score (P = 0.031) than C(S). During childhood, weight (P = 0.003), body mass index (BMI) (P < 0.001), BMI sd score (P < 0.001), waist circumference (P = 0.001), total cholesterol (P = 0.007), and low-density lipoprotein cholesterol (P = 0.022) were higher in PCOS(S) compared with C(S), but after adjusting for BMI, these differences were nonsignificant. During adulthood, PCOS(S) exhibited higher weight (P = 0.022), BMI (P = 0.046), and waist circumference (P = 0.028) than C(S). Fasting insulin (P = 0.030), homeostasis model assessment for insulin resistance (P = 0.034), total cholesterol (P = 0.043), low-density lipoprotein cholesterol (P = 0.034), and 2-h insulin (P = 0.006) were also significantly higher and insulin sensitivity index composite significantly lower in PCOS(S) than in C(S) (P = 0.003). After adjusting for BMI, only 2-h insulin and insulin sensitivity index composite remained significantly different. CONCLUSIONS: This study indicates that sons of PCOS women exhibit higher body weight from early infancy. In addition, insulin resistance became evident as the subjects got older, which may place them at risk for the development of type 2 diabetes and cardiovascular disease.     

Prevalence of the metabolic syndrome in German women with polycystic ovary syndrome.

The aim of our study was to evaluate the prevalence of the metabolic syndrome (MBS) according to the current International Diabetes Federation definition in German PCOS women. Four hundred and eleven PCOS patients (age 28+/-6.3 years) and 82 controls (age 28+/-7.5 years) were evaluated for anthropometric and metabolic parameters by physical examination, blood testing and a personal interview including family history. A subgroup analysis of controls with BMI-matched PCOS women (BMI 22.9+/-2.8 kg/m (2)) was performed to detect PCOS specific differences in metabolic variables between the groups. The MBS was found in 33.8% of PCOS women compared to 7.3% in the control group. Parameters of insulin resistance, lipid-and glucose metabolism, mean values of all criteria of the MBS as well as the prevalence of the MBS were significantly different between the entire PCOS cohort and controls, but did not differ between BMI-matched PCOS women and controls. In addition, the prevalence of the MBS increased with age. Moreover, in PCOS women an increase in BMI and insulin resistance was accompanied by a further significant increase in the severity of clinical and biochemical hyperandrogenism. In PCOS women, while one out of three PCOS women had the MBS, the presence of metabolic abnormalities did not appear to be associated with PCOS per se, but rather correlated with age and the degree of obesity.     

Prevalence of metabolic syndrome in an Indian urban population

OBJECTIVES: To determine prevalence of the metabolic syndrome using United States Adult Treatment Panel-3 (ATP-3) guidelines in an urban Indian population. METHODS: Randomly selected adults >20 years were studied using stratified sampling. Target study sample was 1800 with population proportionate distribution (men 960, women 840). Evaluation of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Subjects (1123; response 62.4%) were examined, fasting blood samples were available in 1091 (532 men, 559 women) and analysed for prevalence of metabolic syndrome. Atherosclerosis risk factors were determined using the current guidelines. Metabolic syndrome was diagnosed when any three of the following were present: central obesity, raised triglycerides >/=150 mg/dl (>/=1.7 mmol/l), low high-density lipoprotein (HDL) cholesterol, blood pressure >/=130/>/=85 mm Hg, and diabetes or fasting glucose >110 mg/dl (>6.1 mmol/l). Intergroup comparisons were performed using t-test or chi-square test. RESULTS: Metabolic syndrome was present in 345 (31.6%) subjects; prevalence was 122 (22.9%) in men and 223 (39.9%) in women (p<0.001); the age-adjusted prevalence was 24.9%, 18.4% in men and 30.9% in women. There was a significant age-related increase in its prevalence (Mantel-Haenzel chi(2) for trend p<0.05). Prevalence of components of metabolic syndrome in men and women was: central obesity (waist, men >102 cm, women >88 cm) in 116 (25.6%) and 246 (44.0%); low HDL cholesterol (men<40 mg/dl, <1.0 mmol/l), women<50 mg/dl, <1.3 mmol/l) in 292 (54.9%) and 504 (90.2%); high triglycerides >/=150 mg/dl (>/=1.7 mmol/l) in 172 (32.3%) and 160 (28.6%); and impaired fasting glucose or diabetes in 90 (16.9%) and 90 (16.1%). The prevalence of physical inactivity, hypertension, hypercholesterolemia (>/=200 mg/dl, >/=5.2 mmol/l) and high LDL cholesterol (>/=130 mg/dl, >/=3.4 mmol/l) was greater in the metabolic syndrome group in both men and women (p<0.05). CONCLUSIONS: There is a high prevalence of metabolic syndrome in an urban Indian population. Focus of cardiovascular prevention should be at this high-risk group.     

Abdominal obesity,insulin resistance,and metabolic syndrome in a southern European population

Background: Our objective was to investigate the relationship between abdominal obesity (AO), as measured by waist circumference (WC), insulin resistance (IR), and components of the metabolic syndrome (MS). Methods: A cross-sectional study was carried out with 283 subjects (130 males and 153 females aged 25-65 years) from a primary care outpatient clinic in Valencia (Spain) over a period of 1 year. Body mass index (BMI), waist circumference (WC), blood pressure (BP), total cholesterol, triglycerides, HDL-C, glucose, and insulin were measured by standard methods. IR was defined as HOMA-IR equal to or greater than 3.8. Results: The prevalence of IR was 39.6%. Subjects were divided into groups according to WC. A 'normal' WC was defined as below 88 cm in women and below 102 cm in men; 'AO' was defined as a WC equal to or above 88 cm in women and equal to or above 102 cm in men. The prevalence of IR was 31.7% in the group with normal WC and 54.6% in the AO group (P<0.001). The percentage of subjects with the MS (high BP, dyslipemia or abnormal glucose tolerance) significantly increased (P<0.001) in subjects with AO (48.4 vs. 18.8% in normal WC subjects). AO is an indicator of IR with an odds ratio of 2.59 (95% CI 1.55-4.29). Conclusions: AO, expressed as WC, appears to be a good indicator of risk for IR and the MS, particularly in non-obese subjects (BMI<30). The main independent parameters of risk for IR are WC and TG, whereas those for the MS are IR, WC, and age.     

Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance

CONTEXT: Adult women with polycystic ovary syndrome (PCOS) have an increased prevalence of the metabolic syndrome (MBS). The prevalence of MBS is also increasing in adolescents. OBJECTIVE: Our objective was to test the hypothesis that the prevalence of MBS is increased in adolescent girls with PCOS compared with the general population and to determine the factors associated with an increased risk of the MBS in PCOS. DESIGN AND SETTING: We conducted a cross-sectional case-control study at academic medical centers with general clinical research centers. PARTICIPANTS: Participants included 49 adolescent girls with PCOS and 165 girls from the Third National Health and Nutrition Examination Survey (NHANES III) adolescent population of similar age and ethnic background. MAIN OUTCOME MEASURE: We assessed the prevalence of MBS according to currently proposed adolescent MBS criteria. RESULTS: Thirty-seven percent of adolescent girls with PCOS had MBS compared with 5% of NHANES III girls (P < 0.0001). None of the girls of normal body mass index (BMI) had MBS, whereas 11% of overweight and 63% of obese girls with PCOS had MBS compared with 0 and 32% of NHANES III girls, respectively. Girls with PCOS were 4.5 times more likely to have MBS than age-matched NHANES III girls after adjusting for BMI (odds ratio, 4.5; 95% confidence interval, 1.1-17.7; P = 0.03). The odds of having the MBS were 3.8 times higher for every quartile increase in bioavailable testosterone in girls with PCOS after adjusting for BMI and insulin resistance (odds ratio, 3.8; 95% confidence interval, 1.4-10.2; P = 0.008). CONCLUSIONS: Adolescent girls with PCOS have a higher prevalence of MBS than the general adolescent population. Hyperandrogenemia is a risk factor for MBS independent of obesity and insulin resistance.     

The metabolic syndrome in young Korean women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and consequent hyperinsulinemia. Insulin resistance also plays an important role in the metabolic syndrome (MS). We conducted a cross-sectional study to determine the prevalence of the MS in young Korean women with PCOS and whether it is associated insulin resistance. One hundred and seventeen young women with PCOS (age: 26+/-5, 16-39 years) were evaluated for the frequency of MS according to the modified Adult Treatment Panel III. Total testosterone (T), free T, androstenedione, dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were measured, and insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp technique. The prevalence of MS in women with PCOS was 14.5%, nearly 3.5-fold higher than in age-matched women in Korean urban population (4.3%) [J.-Y. Oh, Y.-A. Sung, Y.S. Hong, E. Barrett-Conner, Prevalence and factor analysis of metabolic syndrome in an urban Korean population, Diabetes Care 27 (2004) 2027-2032]. The most frequently occurring component of MS was low HDL cholesterol (45%), and the least frequent was high fasting serum glucose level (0.9%). PCOS women with MS had significantly higher free T, and lower SHBG compared with those without MS. And women with MS showed significantly lower M-value and higher fasting/post-glucose load insulin levels. M-value was still significantly lower in women with MS even after the adjustment for BMI. MS is frequent in young Korean women with PCOS and it reflects more severe insulin resistance. These results suggest the importance of early and regular screening of metabolic disturbance in even young women with PCOS.     

Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS), a common endocrine disorder of reproductive-aged women, is associated with multiple risk factors for coronary heart disease (CHD), such as diabetes mellitus, dyslipidemia, visceral obesity, and hypertension. However, premature coronary atherosclerosis has not been demonstrated in PCOS women. Electron beam computed tomography (EBCT) noninvasively measures coronary artery calcium (CAC), a marker for coronary atherosclerosis. We measured CAC by EBCT in 30- to 45-yr-old premenopausal PCOS women and compared the results to CAC in 1) recruited normal ovulatory volunteers matched for age and weight to the PCOS cohort, and 2) community-dwelling women of similar age in an extant coronary calcium database. Healthy, community-dwelling, ovulatory controls (n = 71) were matched by age and body mass index (BMI) to PCOS women (n = 36). Women with diabetes or known CHD were excluded. Subjects underwent EBCT scanning, oral glucose tolerance testing, and CHD risk factor assessment. PCOS women had significantly higher levels of serum total and low density lipoprotein cholesterol and testosterone levels than matched controls. PCOS and control women were obese and had a greater mean BMI than community-dwelling women (33 kg/m(2) for PCOS vs. 31 kg/m(2) for control; P < 0.001). CAC was more prevalent in PCOS women (39%) than in matched controls (21%; odds ratio, 2.4; P = 0.05) or community-dwelling women (9.9%; odds ratio, 5.9; P < 0.001). BMI, waist circumference, and total and low density lipoprotein cholesterol levels predicted CAC prevalence after adjustment for BMI. CAC is more prevalent in PCOS women than in obese or nonobese women of similar age. PCOS women are at increased risk for atherosclerosis and should be targeted for primary prevention of CHD.     

Evaluation of insulin sensitivity status in polycystic ovarian syndrome

ObjectiveTo identify the risk arising from polycystic ovarian syndrome (PCOS) which would help the clinician to make early interventions.MethodsFasting and postprandial serum glucose and serum insulin levels were estimated in 26 cases of PCOS and 26 healthy women were selected as controls. Calculation of quantitative insulin sensitivity check index (QUICKI) in all the subjects was utilized to analyze its sensitivity and reliability. Also body mass index and waist circumference in all these subjects were measured as obesity plays a key role in the pathogenesis of PCOS.ResultsHyperglycemia was observed in 11% of the cases and hyperinsulinemia was a consistent feature in 46% of the patients. The postprandial insulin levels in cases were statistically significant (P=0.006). Sensitivity to insulin as indicated by QUICKI in the postprandial state was less in cases than in controls (P=0.13). The BMI was markedly raised in 15% and moderately raised in about 38% of the cases (P=0.024). Waist circumference was significantly raised in about 61% of the cases (>80 cm) (P<0.001).ConclusionsOur study indicates that QUICKI, BMI and waist circumference are simple, quick and may act as early markers in identifying the risks of developing metabolic syndrome. Obesity, being a consistent finding in most cases suggested its key role in the pathogenesis of PCOS.     

Insulin resistance, obesity, and metabolic syndrome among non-diabetic pre- and post-menopausal women in North Taiwan

OBJECTIVE: To investigate the relationship between the metabolic syndrome and its related factors among non-diabetic pre- and post-menopausal women in North Taiwan. DESIGN: A cross-sectional study in a medical center in North Taiwan. SUBJECTS: Five hundred and ninety-four, non-diabetic middle-aged women (age range=40-64 years, mean=48.9+/-5.4 years) were recruited. MEASUREMENTS: The fasting plasma glucose, insulin, lipids levels and anthropometric indices were measured. The homeostasis model assessment was applied to estimate the degree of insulin resistance (HOMA-IR). Metabolic syndrome was defined by using the National Cholesterol Education Panel (NCEP) criteria and modified NCEP criteria (waist circumference >80 cm). RESULTS: The prevalence of metabolic syndrome was 6.2% using NCEP criteria, and 8.9% using modified NCEP criteria. Post-menopausal women had a higher prevalence of metabolic syndrome and its individual components compared to pre-menopausal women except hyperglycemia and low HDL-C. In multiple logistic regression analysis with adjustment for age and menopausal status, both BMI and HOMA-IR were independently associated with the metabolic syndrome. CONCLUSION: The prevalence of metabolic syndrome was higher in post-menopausal than pre-menopausal women. Both obesity and insulin resistance may play an important role in the development of metabolic syndrome among the middle-aged women in North Taiwan.     

Association of mitochondrial deoxyribonucleic acid 16189 variant (T->C transition) with metabolic syndrome in Chinese adults

OBJECTIVE: A common variant in mitochondrial DNA (mtDNA) at bp 16189 (T-->C transition) has been associated with small birth size, adulthood hyperglycemia, and insulin resistance in Caucasians. In this study, we investigated whether mtDNA 16189 variant is associated with metabolic syndrome in Chinese subjects. METHODS: Six hundred fifteen Chinese adults, aged 40 yr or older, were recruited in this study. The 16189 variant of mtDNA was detected using PCR and restriction enzyme digestion. Metabolic syndrome was diagnosed on modified National Cholesterol Education Program Adult Treatment Panel III guidelines, using body mass index (BMI) instead of waist circumference. An association study was performed with chi2 test and logistic regression analysis. RESULTS: The prevalence of the 16189 variant was higher in patients with metabolic syndrome than in those without: 44% (125 of 284) vs. 33.2% (110 of 331) (P = 0.006). The association between this 16189 variant of mtDNA and metabolic syndrome (P = 0.021) remained significant even after correcting for age and BMI. As to the individual traits, the prevalence of fasting plasma glucose of at least 110 mg/dl (> or =6.1 mmol/liter) [(51.5% (121 of 235) vs. 42.1% (160 of 380); P = 0.023], type 2 diabetes mellitus [48.1% (113 of 235) vs. 39.2% (149 of 380); P = 0.031], and hypertriglyceridemia [44.3% (104 of 235) vs. 35.8% (136 of 380); P = 0.037] were significantly higher in subjects harboring the 16189 variant of mtDNA than those with the wild type. However, the prevalence of hypertension [53.2% (125 of 235) vs. 47.6% (181 of 380); P = 0.180], BMI greater than 25 kg/m2 [48.5% (114 of 235) vs. 43.9% (167 of 380); P = 0.270], and low high-density lipoprotein cholesterol [61.3% (144 of 235) vs. 54.7% (208 of 380); P = 0.111] did not reach a significant difference between the two groups. Furthermore, there was a trend of increasing frequency of occurrence of the 16189 variant in individuals having an increasing number of components of metabolic syndrome (Ptrend < 0.005). CONCLUSION: Our data strongly suggest that mtDNA 16189 variant underlies susceptibility to metabolic syndrome in the Chinese population.     

The lack of association between polycystic ovary syndrome and metabolic syndrome: Iranian PCOS prevalence study

Objective This study was designed to evaluate the prevalence of the metabolic syndrome (MetS) and insulin resistance (IR) in a large population‐based study in Iran. Research design and methods Anthropometric measurements, biochemical parameters and IR were compared between 136 polycystic ovary syndrome (PCOS) subjects and 423 healthy controls recruited from among 1126 reproductive aged women (18–45 year). PCOS and MetS were diagnosed using the Rotterdam criteria and Joint Interim Statement, respectively. IR was defined using the homeostatic model assessment‐IR). Results Among the PCOS subjects, the mean ± SD age, body mass index (BMI) and waist circumference were 31 ± 7·7 years, 26·4 ± 5·8 kg/m² and 84 ± 13·3 cm, respectively; corresponding values among healthy controls were 36 ± 7·5 years, 26·4 ± 5·0 kg/m² and 85 ± 11·9 cm, respectively. Age and BMI adjusted prevalences of MetS in PCOS subjects and controls were 18·5% (CI 95%, 15·3–21·7%) and 18·3% (CI 95%, 15·1–21·5%), respectively [P = not significant (NS)]. Age and BMI adjusted prevalences of IR in PCOS and healthy controls were 27·2% (CI 95%, 23·5–30·9%) and 24·2% (CI 95%, 20·6–27·8%), respectively (P < 0·01). Conclusions Metabolic syndrome was no more frequent in a representative sample of PCOS Iranian population than in healthy controls. However, the prevalence of IR in PCOS appears to be higher than in controls. It seems that the association between PCOS and MetS needs more consideration.     

Serum adiponectin in women with polycystic ovarian syndrome and its relation to clinical, metabolic and endocrine parameters

Several studies have demonstrated that low levels of serum adiponectin are present in obesity, insulin resistance, hypertension and hyperlipidemias. The aim of our study was to determine whether serum adiponectin level is different between patients with polycystic ovarian syndrome (PCOS) and control subjects. We also investigated relationships between various cardiovascular risk factors, levels of serum adiponectin and other hormones, such as androstendione, testosterone, estradiol, DHEAS, sex hormone binding globulin (SHBG), and leptin. We also analysed the correlation between serum adiponectin and free androgen index. Ninety-one women with clinical diagnosed PCOS and 53 healthy control subjects, carefully matched by body mass index (BMI) and age, were enrolled in the study. The fasting blood samples were obtained and all participants underwent an oral 75 g glucose tolerance test. The prevalences of impaired glucose tolerance (IGT), hypertension and hypertriglyceridemia were higher in the PCOS group. PCOS women had increased androgen concentrations and higher free androgen index and decreased level of serum SHBG. Lower serum adiponectin concentrations were observed among cases than in controls (median 13.7 microg/ml vs 17.8 microg/ml, p<0.001) despite being matched by BMI. In the PCOS group adiponectin levels correlated significantly with: BMI (r=-0.32, p=0.002), waist circumference (r=-0.32, p=0.003), waist-to-hip ratio (WHR, r=-0.38, p=0.001), triglycerides (r=-0.31, p=0.007), SHBG (r=0.30, p=0.003) and free androgen index (r=-0.29, p=0.02). In contrast, the adiponectin level does not appear to be related to total testosterone, DHEAS and leptin levels. The adiponectin and SHBG levels were found to be decreased in PCOS women with IGT compared to PCOS women with normal glucose tolerance, but after adjustment by BMI or WHR, the differences were no longer statistically significant. To exclude a possible confounding effect due to a higher prevalence of IGT in the PCOS group, this comparison was repeated for the subgroup of 58 PCOS women and 48 control women after excluding those with IGT. Neither adiponectin nor SHBG were significantly different between those subgroups. Multiple regression analysis revealed that serum adiponectin concentrations were best predicted by WHR, free androgen index and presence of IGT when all patients were considered. In PCOS subjects, the only independent predictor of adiponectin concentrations was glucose tolerance status. CONCLUSIONS: Lower adiponectin levels were observed in PCOS group than in control women, and these differences were probably due to higher prevalence of IGT in these cases.     

Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome

OBJECTIVE: Application of the newly introduced Rotterdam criteria for polycystic ovary syndrome (PCOS) generates four phenotypic subgroups, defined by the presence/absence of three diagnostic elements: polycystic ovarian (PCO) morphology (P); hyperandrogenism (H); and oligo-amenorrhoea (O). Whilst PCOS is associated with adverse metabolic features, the strength of the association within individual subgroups is not established. We characterized the metabolic and endocrine profiles of PCOS women who are oligomenorrhoeic but normoandrogenaemic, and compared these to other PCOS women and controls. DESIGN: Retrospective dataset analyses. PATIENTS: A total of 309 Europid PCOS women, all with PCO morphology, of whom 191 were also hyperandrogenaemic and oligomenorrhoeic (PHO), 76 hyperandrogenaemic with normal menses (PH) and 42 oligomenorrhoeic but normoandrogenaemic (PO); plus 76 Europid control women without PCOS. MEASUREMENTS: Metabolic parameters: fasting insulin, lipids, homeostasis model assessment (HOMA) measures of insulin sensitivity; endocrine variables: LH, FSH; prevalence of metabolic syndrome. RESULTS: Insulin sensitivity: PO women were indistinguishable from controls, and markedly less insulin-resistant than PHO women (vs. controls, P = 0.38 after adjustment for BMI and age; vs. PHO, P = 0.003). Metabolic syndrome: the prevalence in PO women (7.1%) was similar to that in controls (3.9%), and lower than in PHO women (29.3%, P < 0.0001). LH levels: PO women were intermediate between controls (vs. controls, P = 0.008) and PHO women (vs. PHO, P = 0.06). CONCLUSIONS: Normoandrogenaemic, oligomenorrhoeic women with PCOS are metabolically similar to control women with significantly fewer metabolic features than PCOS women who are also hyperandrogenaemic. However, higher than normal LH and lower sex hormone-binding globulin (SHBG) concentrations in the PO women support the view that they form part of the spectrum of PCOS.     

Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS)

OBJECTIVE: To determine the prevalence of adrenal androgen (AA) excess in the polycystic ovary syndrome (PCOS) using age- and race-specific normative values. DESIGN: Cross-sectional observational study. PATIENTS: One hundred and eight-two (88 Black and 94 White) age-matched healthy eumenorrhoeic nonhirsute women (controls) and 213 (27 Black and 186 White) women with PCOS were recruited. MEASUREMENTS: Total testosterone (T), free T, androstenedione (A4), dehydroepiandrosterone sulfate (DHEAS) and SHBG, as well as fasting insulin and glucose, were measured in plasma. RESULTS: The mean total T, free T, A4, DHEAS and body mass index (BMI) were higher in women with PCOS than in control women. DHEAS levels were significantly lower in Black controls than White controls, whereas fasting insulin and BMI were higher in Black controls. In control and Black PCOS women, DHEAS levels did not correlate with BMI, waist-to-hip ratio (WHR) or fasting insulin. Among White women with PCOS, DHEAS levels correlated negatively with BMI and fasting insulin. DHEAS levels decreased similarly with age in control and PCOS women of either race. For each race and age group the upper 95% normative values for log DHEAS was calculated, and the number of PCOS subjects with log DHEAS values above this level were assessed. The prevalence of supranormal DHEAS levels was 33.3% and 19.9%, respectively, among Black and White women with PCOS. CONCLUSIONS: The prevalence of DHEAS excess is approximately 20% among White and 30% among Black PCOS patients, when using age- and race-adjusted normative values. This study also indicates that the age-associated decline in DHEAS levels is observable and similar in both control and PCOS women, regardless of race. While BMI and fasting insulin had little impact on circulating DHEAS levels in healthy women, among White PCOS patients these parameters were negatively associated with circulating DHEAS levels.