Cardiometabolic aspects of the polycystic ovary syndrome

master's thesis

• Author: Roya Leila Saadia Susan Ougouag
• Mentor: Dinka Pavičić-Baldani (mentor)
• Committee member: Marina Šprem Goldštajn (predsjednik povjerenstva)
• Committee member: Tomislav Čanić (član povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder amongst
women of reproductive age. Although PCOS is diagnosed exclusively based on reproductive
criteria (clinical/biochemical hyperandrogenism, an/oligo-ovulation, and/or polycystic ovaries
(PCO) on ultrasound), it is also a metabolic disorder. Insulin resistance, impaired glucose
tolerance, type 2 diabetes mellitus, obesity and dyslipidemia are more common in women with
PCOS than in age-comparable women without PCOS. Many of the metabolic abnormalities that
manifest in PCOS, such as insulin resistance, impaired glucose tolerance, type 2 diabetes
mellitus, and dyslipidemia are worsened by the concurrent incidence of obesity. However, some
of these metabolic perturbations occur even in lean women with PCOS and therefore are
rightfully recognized as intrinsic to PCOS. The intrinsic factors that produce these metabolic
disturbances are reviewed in this thesis paper. Regarding obesity as both an amplifying factor for
other disturbances and as a PCOS-induced disturbance is legitimate, as obesity exacerbates the
other PCOS-induced disturbances yet, it is itself an intrinsic PCOS-induced disturbance since it
arises more frequently in PCOS women than in control cohorts. The consequences of obesity and
the other metabolic aberrations are also discussed. Most importantly, these metabolic
perturbations lead to chronic low grade inflammation and to cardiovascular impairments that
heighten the risk of having cardiovascular disease. Following a review of cardiovascular
impairments and cardiovascular events that have been reported in studies on women with PCOS,
this paper then proceeds to discuss therapies currently implemented to minimize these
cardiovascular risks. Therapies such as oral contraceptives and anti-androgenic medications used
to manage the reproductive manifestations of PCOS may themselves be a cause of metabolic
perturbations. Therefore, factors influencing the cardiometabolic side effects arising during the
treatment of the non-metabolic manifestations of PCOS (hirsutism/anovulation) will also be
discussed in an effort to minimize the overall cardiometabolic risk.

• Keywords: Insulin resistance; Metabolic Syndrome; Cardiovascular Disease; Cardiovascular Risk Factors
• Language: english
• URN:NBN: urn:nbn:hr:105:168343
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-20 10:01:27