Update on PCOS: Consequences, Challenges, and Guiding Treatment

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2020, Volume and Issue: 106(3), P. e1071 - e1083

Published: Nov. 19, 2020

Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine disorders in women and despite this, diagnostic challenges, delayed diagnosis, less-than-optimal treatment regimens plague condition. The International PCOS network, consisting geographically diverse international experts as well consumers, engaged a multi-year evidence-based guideline development process that was jointly sponsored by European Society for Human Reproduction Embryology (ESHRE) American Reproductive Medicine (ASRM). published 2018 endorsed more than 40 societies involved PCOS. Translation this to medical practice consumer groups remains priority. However, there remain many challenges both understanding diagnosis Evidence suggests clinicians consumers are not satisfied with timeliness options. This review summarizes important findings from guidelines expands on recent developments literature since its publication. Special attention at ends spectrum discussed remaining areas controversy noted. Additionally, highlights some management help guide investigators perplexing

Language: Английский

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Obesity as a multisystem disease: Trends in obesity rates and obesity‐related complications

Diabetes Obesity and Metabolism, Journal Year: 2021, Volume and Issue: 23(S1), P. 3 - 16

Published: Feb. 1, 2021

Abstract Obesity is a chronic multisystem disease associated with increased morbidity and mortality. The increasing prevalence of obesity makes it major healthcare challenge across both developed developing countries. Traditional measures such as body mass index do not always identify individuals at risk comorbidities, yet continue to be used in deciding who qualifies for weight loss treatment. A better understanding how particular non‐metabolic conditions, needed order prioritize For metabolic disorders type 2 diabetes (T2D), can prevent T2D prediabetes. It improve reverse if achieved early the course disease. However, access effective treatments significant barrier improved health people obesity. In present paper, we review rising why should classed We will discuss potential mechanisms underlying its association various comorbidities these respond treatment, focus on cardiometabolic disease, malignancy mental health.

Language: Английский

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Deconstructing a Syndrome: Genomic Insights Into PCOS Causal Mechanisms and Classification

Endocrine Reviews, Journal Year: 2022, Volume and Issue: 43(6), P. 927 - 965

Published: Jan. 13, 2022

Polycystic ovary syndrome (PCOS) is among the most common disorders in women of reproductive age, affecting up to 15% worldwide, depending on diagnostic criteria. PCOS characterized by a constellation interrelated abnormalities, including disordered gonadotropin secretion, increased androgen production, chronic anovulation, and polycystic ovarian morphology. It frequently associated with insulin resistance obesity. These metabolic derangements cause major morbidities across lifespan, anovulatory infertility type 2 diabetes (T2D). Despite decades investigative effort, etiology remains unknown. Familial clustering cases has indicated genetic contribution PCOS. There are rare Mendelian forms extreme phenotypes, but typically follows non-Mendelian pattern inheritance consistent complex architecture, analogous T2D obesity, that reflects interaction susceptibility genes environmental factors. Genomic studies have provided important insights into disease pathways current criteria do not capture underlying differences biology different We provide state-of-the-science review analyses PCOS, an overview genomic methodologies aimed at general audience non-geneticists clinicians. Applications will be discussed, strengths limitations each study. The contributions factors, developmental origins, reviewed. Insights pathogenesis architecture summarized. Future directions for outlined.

Language: Английский

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Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(8), P. 4110 - 4110

Published: April 8, 2022

Polycystic ovary syndrome (PCOS) is a heterogeneous and extremely common disease with symptoms that vary the age of patient, typically characterized by hyperandrogenism, chronic oligo-anovulation, and/or several metabolic disorders. The includes various phenotypes, pathogenesis multifactorial, often involving insulin resistance. This feature closely related to ovarian dysfunction, inflammation, disorders, which characterize complicate syndrome. Therapy currently considers both lifestyle improvements medications, must be tailored on case-by-case basis. To date, published studies have not arrived at definition most suitable therapy for each individual case many drugs used are still off-label. In this review, we discuss some controversial diagnostic therapeutic aspects PCOS, such as role resistance, hyperandrogenism. We also evaluated advantages disadvantages contraceptive antiandrogens.

Language: Английский

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Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment

Journal of Ovarian Research, Journal Year: 2023, Volume and Issue: 16(1)

Published: Jan. 11, 2023

Abstract Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic ovulation dysfunction and overabundance of androgens; it affects 6–20% women reproductive age. PCOS involves various pathophysiological factors, affected usually have significant insulin resistance (IR), which major cause PCOS. IR compensatory hyperinsulinaemia differing pathogeneses in tissues, varies among different phenotypes. Genetic epigenetic changes, hyperandrogenaemia, obesity aggravate IR. Insulin sensitization drugs are new treatment modality for We searched PubMed, Google Scholar, Elsevier, UpToDate databases this review, focused on the pathogenesis with pathophysiology tissues. In addition, review provides comprehensive overview current progress efficacy therapy management PCOS, providing latest evidence clinical

Language: Английский

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Epigenetic inheritance of polycystic ovary syndrome — challenges and opportunities for treatment

Nature Reviews Endocrinology, Journal Year: 2021, Volume and Issue: 17(9), P. 521 - 533

Published: July 7, 2021

Language: Английский

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Polycystic ovary syndrome

Nature Reviews Disease Primers, Journal Year: 2024, Volume and Issue: 10(1)

Published: April 18, 2024

Language: Английский

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A Review of Machine Learning Algorithms for Biomedical Applications

Annals of Biomedical Engineering, Journal Year: 2024, Volume and Issue: 52(5), P. 1159 - 1183

Published: Feb. 21, 2024

Language: Английский

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When one size does not fit all: Reconsidering PCOS etiology, diagnosis, clinical subgroups, and subgroup-specific treatments

Endocrine and Metabolic Science, Journal Year: 2024, Volume and Issue: 14, P. 100159 - 100159

Published: Jan. 21, 2024

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects large proportion of women. Due to its heterogeneity, the best diagnostic strategy has been matter contention. Since 1990 scientific societies in field human reproduction have tried define pivotal criteria for diagnosis PCOS. The consensus Rotterdam included presence hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology (PCOM), now updated evidence based 2018 2023 International Guideline endorsed by 39 internationally. Within Criteria, at least two out three above-mentioned features are required be present diagnose PCOS, resulting four phenotypes being identified: phenotype A, characterized all features, B, exhibiting hyperandrogenism oligo-anovulation, C, presenting as PCOM finally D oligo-anovulation PCOM, lacking hyperandrogenic component. However, it hypothesis EGOI group C different underlying causality D. Recent studies highlighted strong correlation between insulin resistance role these factors driving alterations, such follicular functional cyst formation. This new understanding PCOS pathogenesis led authors endocrine-metabolic syndromes with metabolic clinical onset. Conversely, absence disturbances suggests origin this condition, point towards novel pathophysiological mechanisms; however, still not fully understood. Further questions raised regarding suitability "phenotypes" described Criteria publication recent GWAS studies, which demonstrated should considered subtypes they reflected genetic picture. Hence, capturing heterogeneity disorder, current may benefit from reassessment evaluation additional parameters endometrial thickness, purpose only improving their accuracy but also assigning an appropriate personalized treatment. In framework, overview aims analyze currently recognized community assess application practice light newly emerging evidence.

Language: Английский

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Sex Hormone-Binding Globulin (SHBG) as an Early Biomarker and Therapeutic Target in Polycystic Ovary Syndrome

International Journal of Molecular Sciences, Journal Year: 2020, Volume and Issue: 21(21), P. 8191 - 8191

Published: Nov. 1, 2020

Human sex hormone-binding globulin (SHBG) is a glycoprotein produced by the liver that binds steroids with high affinity and specificity. Clinical observations reports in literature have suggested negative correlation between circulating SHBG levels markers of non-alcoholic fatty disease (NAFLD) insulin resistance. Decreased increase bioavailability androgens, which turn leads to progression ovarian pathology, anovulation phenotypic characteristics polycystic syndrome (PCOS). This review will use case report illustrate inter-relationships SHBG, NAFLD PCOS. In particular, we evidence low hepatic production may be key step pathogenesis Furthermore, there emerging serum useful as diagnostic biomarker therapeutic target for managing women

Language: Английский

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