Polycystic ovarian syndrome (PCOS) is a common gynecological disorder with multifactorial pathogenic risk factors. Combination therapy with metformin and thiazolidinedione derivatives is frequently used, but its synergistic effects have not been thoroughly evaluated. This study aims to compare the therapeutic efficacy of low-dose spironolactone (LDS) at 0.25 mg/kg for 28 days, metformin at 500 mg/kg for 28 days, and a combination of LDS and metformin, against a letrozole (1 mg/kg/day) and 0.5 % carboxymethylcellulose (CMC)-induced PCOS rat model. The study involved five groups of laboratory animals: Group I (Healthy control), Group IIa (Disease control), Group IIb (Metformin), Group IIc (LDS), and Group IId (Metformin + LDS). Therapeutic efficacy was evaluated based on phenotypic, hormonal, and genotypic determinants. Letrozole successfully induced PCOS in the animals, evidenced by elevated levels of Sex Hormone Binding Globulin (SHBG), Follicle Stimulating Hormone (FSH), and progesterone, as well as the presence of multiple ovarian cysts. Hierarchical Cluster Analysis indicated that LDS was superior to metformin and the combination therapy in ameliorating PCOS symptoms. The findings suggest that there is little to no benefit in adding metformin to LDS for the clinical management of PCOS. Although these results are from preclinical studies, further case-controlled, randomized placebo studies on a larger patient sample are necessary to confirm these findings in clinical settings.

Sleep problems like obstructive sleep apnea (OSA) are common in polycystic ovary syndrome (PCOS), although the underlying mechanisms are not well understood. We aimed to determine the prevalence of sleep problems, synthesise and appraise studies analysing the associations between serum sex hormones, sex hormone-binding globulin (SHBG) and sleep problems in females with PCOS.

Systematic review and meta-analysis.

A systematic search using MEDLINE, Embase, PsycInfo, CINAHL, Scopus, and Google Scholar was performed till 3 August 2024. Studies that examined serum sex hormones, SHBG or hyperandrogenism with sleep disorders and/or sleep disturbances in PCOS were eligible. Random effects meta-analyses of sex hormones and SHBG among females with PCOS with compared to without OSA were conducted.

From 4487 screened studies, 24 were included, with nine suitable for meta-analyses. Among females with PCOS, 46.0% had OSA and 56.0% had other sleep disturbances. SHBG levels were significantly lower in women with PCOS and OSA compared to those without OSA (standardised mean difference = -0.62; 95% CI = -0.82 to -0.42; I2 = 0%; 179 participants; p < 0.00001), but no differences were seen in total and free testosterone, dehydroepiandrosterone sulfate, androstenedione, and oestradiol. No significant associations between serum sex hormones, SHBG or hyperandrogenism with sleep disturbances in PCOS were observed.

SHBG, rather than hyperandrogenism, may play a more important mechanistic role for OSA in PCOS, while other sleep disturbances exhibit a less severe SHBG profile. These findings enhance comprehension of underlying pathophysiology of sleep problems in PCOS. Further validation across PCOS populations is warranted.

There is a local renin-angiotensin system (RAS) in the ovary, which is involved in regulating many important physiological processes, but the specific mechanism remains unclear. Polycystic ovarian syndrome (PCOS) is the most frequently reported non-iatrogenic condition with abnormal RAS expression, characterized by overweight or obesity and insulin resistance (IR), both of which are significantly correlated with many long-term complications. These conditions are closely linked to circulatory or local RAS, serving as potential common regulatory nodes. The present study analyzed single-cell RNA sequencing (scRNA-seq) data from mouse ovaries during the reproductive period to obtain the expression levels and location information of RAS components in all cell clusters. It further analyzed the cyclical fluctuations of RAS and the differential gene sets during the estrous cycle. Protein-protein interaction analysis predicted the most closely interacting pathway with RAS, and preliminary evidence of crosstalk between angiotensin II (AngII) and the insulin signaling pathway was identified in the scRNA-seq data. A PCOS mouse model was constructed, replicating clinical reproductive and metabolic complications, and the crosstalk between AngII and IRS1/PI3K/AKT was verified. In conclusion, this study revealed the dynamic changes of the ovarian local RAS at the cellular level during the estrous cycle, and described the role of RAS in regulating ovarian function from a single-cell perspective. It also provided evidence that IR, caused by the crosstalk between AngII and IRS1/PI3K/AKT pathways, may be a potential underlying mechanism of PCOS.

Polycystic ovary syndrome (PCOS) is often linked with obesity, and weight management can improve endocrine and cardiometabolic features.

This work aimed to evaluate the effects of adding topiramate (TPM) to metformin (MTF) on weight control and hormonal and metabolic outcomes in women with PCOS.

In a randomized, double-blind, placebo-controlled trial, participants with PCOS and body mass index of 30 or greater, or 27 or greater associated with hypertension, type 2 diabetes, or dyslipidemia followed a 20 kcal/kg diet in addition to 850 mg of MTF or a previous MTF regimen. They were randomly assigned to receive either TPM or placebo (P) alongside MTF. Anthropometric measurements, blood pressure, modified Ferriman-Gallwey score (mFGS), and adverse events were assessed every 4 weeks for 6 months. The primary end point was the percentage change in body weight from baseline in both groups. Secondary end points included changes in clinical, cardiometabolic, and hormonal parameters and psychosocial features.

Thirty-one participants were in the MTF + P group and 30 in the MTF + TPM group. The MTF + TPM group showed greater mean weight loss at 3 months (-3.4% vs -1.6%; P = .03) and 6 months (-4.5% vs -1.4%; P = .03). Both groups had improved androgens, lipids, and psychosocial scores. Participants with 3% or greater weight loss at 6 months had improved mFGS (8.4 to 6.5; P = .026). Paresthesia was more common in the MTF + TPM group (23.3% vs 3.2%; P = .026).

Combining TPM with MTF and a low-calorie diet may be an effective, low-cost, easy-to-use, and safe strategy for weight management in women with PCOS, with mild adverse effects.

Women with polycystic ovary syndrome (PCOS) often experience infertility, potentially mediated by metabolic factors altered by elevated body mass index (BMI). While triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood sugar (FBS) are known mediators in the BMI-infertility relationship, the extent of their mediation effects remains unquantified in prior studies. This study quantifies the mediation effect of these metabolic factors. We conducted a cross-sectional study on 669 women diagnosed with PCOS at a tertiary hospital in Tehran, Iran, from 2021 to 2023. Data on BMI, TG, LDL, HDL, and FBS were collected, with infertility defined as the inability to conceive after 12 months of unprotected intercourse. Mediation analysis was performed using the Karlson Holm Breen (KHB) method, adjusting for age. Higher BMI was associated with increased levels of TG, LDL, and FBS and decreased HDL, all of which (except for LDL) were linked to infertility. Mediation analysis revealed that after adjusting for age, TG, HDL, and FBS significantly mediated the BMI-infertility association, accounting for 52.98%, 79.19%, and 49.7% of the effect, respectively. Our study identified TG, HDL, and FBS as significant mediators of the BMI-infertility link, with over half of the association mediated through these factors. Targeting metabolic improvements may help reduce infertility risk in this population.

To explore the impact of high body mass index (BMI) on the embryo quality and clinical outcomes of polycystic ovary syndrome (PCOS) patients, and the possible genes involved.

Patients who underwent in-vitro fertilization (IVF) treatment and embryo transfer in our center from November 2014 to September 2023, were divided into low BMI PCOS (LBP) group, high BMI PCOS (HBP) group, and high BMI control (HBC) group. Transcriptome sequencing was performed in eight PCOS patients' granulosa cells (GCs).

A total of 812 IVF/intracytoplasmic sperm injection (ICSI) cycles in the embryo part; and 489 fresh, 634 frozen-warmed embryo transfer (FET) cycles from the clinical part were included. The ICSI normal fertilization rate of HBP group was decreased compared to LBP and HBC groups (p = 0.013&0.008). The IVF blastocyst development rate in HBP group was lower than LBP group (p = 0.01). The preterm birth rate in HBP group was higher than in LBP (30.66% vs. 16.48%, p = 0.041) and HBC groups (30.66% vs. 11.34%, p = 0.002), the adjusted OR (AOR) of preterm birth and BMI was 1.124 (p = 0.023) in FET cycles. Transcriptome sequencing result of GCs showed that differentially expressed miRNAs/lncRNA/circRNA/mRNAs in two PCOS groups were 61, 450, 83, and 568, respectively. The hub genes analysis, enrichment analysis and competing endogenous RNA network revealed that cell cycle, oocyte maturation, systemic lupus erythematosus, oxidative phosphorylation, and mitogen-activated protein kinases (MAPK) signaling pathways had important roles in the embryo development and pregnancy process.

The combined effect of PCOS and obesity reduced oocyte quality and embryonic development potential, finally led to poorer clinical outcomes.

Polycystic ovary syndrome (PCOS) is a heterogeneous multifactorial endocrine disorder that affects one in five women around the globe. The pathology suggests a strong polygenic and epigenetic correlation, along with hormonal and metabolic dysfunction, but the exact etiology is still a mystery. The current diagnosis is mostly based on Rotterdam criteria, which resulted in a delayed diagnosis in most of the cases, leading to unbearable lifestyle complications and infertility. PCOS is not new; thus, constant efforts are made in the field of biomarker discovery and advanced diagnostic techniques. A plethora of research has enabled the identification of promising PCOS diagnostic biomarkers across hormonal, metabolic, genetic, and epigenetic domains. Not only biomarker identification, but the utilization of biosensing platforms also renders effective point-of-care diagnostic devices. Artificial intelligence also shows its power in modifying existing image-based analysis, even developing symptom-based prediction systems for the early diagnosis of this multifaceted disorder. This approach could affect the future management and treatment direction of PCOS, decreasing its severity and improving the reproductive life of women. The rationale of the current review is to identify the advancements in understanding the pathophysiology through biomarker discovery and the implementation of modern analytical techniques for the early diagnosis of PCOS.

Objective: To determine whether women with polycystic ovary syndrome (PCOS) were less likely to initiate breastfeeding or have shorter breastfeeding duration. Materials and Methods: Cross-sectional analysis was performed of the Pregnancy Risk Assessment Monitoring System dataset, a national questionnaire from the Centers for Disease Control and Prevention of postpartum women, from 2016 to 2018. Logistic regression assessed the odds of any breastfeeding initiation. Cox proportional hazards assessed duration of any breastfeeding. Results: Sample included 2,382,290 women (6.1% PCOS). In univariable analysis, PCOS was associated with increased odds of any breastfeeding initiation (89.9% versus 87.9%; odds ratio [OR]: 1.23 [95% confidence interval: 1.02, 1.47]; p = 0.03). This outcome remained significant after controlling for body mass index (BMI; ORadj: 1.3 [1.1, 1.6]; p = 0.005) but not after controlling for education and prior live births (ORadj: 1.10 [0.89, 1.37]; p = 0.37). With increasing BMI, the odds of any breastfeeding initiation decreased, with the lowest odds seen in women with class III obesity (ORadj: 0.74 [0.60, 0.9]; p = 0.003). In a subanalysis of racial/ethnic groups, PCOS did not impact any breastfeeding initiation in White or Black non-Hispanic groups but increased odds of any breastfeeding initiation in Hispanic women (ORadj: 2.0 [1.1, 3.7]; p = 0.03). In multivariable models, there was no difference in the duration of any breastfeeding in women with PCOS compared with those without. Conclusions: Understanding predictors of breastfeeding success is paramount. In this national survey measuring any breastfeeding, PCOS did not decrease breastfeeding initiation or duration, despite confirming the association between overweight/obesity and decreased breastfeeding. However, because the data did not distinguish between exclusive breastfeeding and supplementation, we cannot rule out the possibility that PCOS affects breastfeeding exclusivity or necessitates supplementation. This limitation suggests that important trends could be obscured, and therefore, our findings should be interpreted with caution regarding breastfeeding exclusivity. Interventions aimed at increasing breastfeeding should target populations that would benefit the most; our data support that PCOS-specific targeting is not needed. Additional prospective studies are necessary to fully understand the association between different PCOS phenotypes and breastfeeding.

Polycystic Ovary Syndrome (PCOS) is a prevalent yet under-researched endocrinologic disorder affecting females of reproductive age, characterized by menstrual dysfunction, infertility, hirsutism, acne, and obesity. Despite its global prevalence, with rates varying significantly among Asian communities, there is a notable lack of region-specific epidemiological data, particularly for urban areas in India. The aim of this study is to assess the prevalence of PCOS and associated sociodemographic risk factors among young adult females in Delhi and National Capital Region (NCR), India.

This study is comprised of two components: a cross-sectional survey and a systematic review. The cross-sectional survey involved 1,164 college-going females aged 18-25 years in Delhi NCR, with data collected through a structured interview schedule assessing sociodemographic variables and PCOS symptoms. PCOS diagnosis was based on the already diagnosed cases and cases diagnosed during the study (Rotterdam criteria, 2003), through symptoms and additional assessment through ultrasonography. The systematic review analysed prevalence studies from 2010 to 2024 across India, focusing on the similar age group.

The study found a high 17.40% prevalence rate of PCOS among the participants, with 70.30% already diagnosed and 29.70% newly diagnosed during the study. The prevalence is significantly higher compared to the pooled prevalence of 8.41% reported in previous studies across India. Sociodemographic factors such as age (20 years and above), higher education, ancestry (East India and immigrants), and nuclear family structure were associated with increased PCOS risk. Conversely, factors like belonging to the OBC category and lower middle class were linked to reduced risk.

The high prevalence of PCOS in Delhi NCR compared to other regions highlights the need for targeted epidemiological research and intervention strategies in urban settings. The association of PCOS with modern lifestyle factors and socioeconomic status underscores the importance of addressing these determinants in managing PCOS effectively. The study contributes valuable insights into the sociodemographic dimensions of PCOS and calls for more comprehensive studies to inform public health strategies.

Polycystic ovary syndrome (PCOS) is associated with obesity, insulin resistance (IR), metabolic syndrome (MetS), and abnormal fat distribution, especially fat excess in the upper body. Neck circumference (NC) reflects the adiposity accumulation in the upper body and may be a valuable and simple screening tool for metabolic risk among women with PCOS.

A systematic review was conducted using PubMed/Medline and Scopus based on the search terms "neck circumference" and "PCOS". Studies that examined associations of NC and anthropometric measurements, blood pressure (BP), lipid values, glucose metabolism, MetS, IR, or related disorders among women with PCOS were included. A meta-analysis was performed to compare NC values between women with PCOS and non-PCOS controls.

Of 139 publications, 13 full texts that met the selection criteria were included in the systematic review. Eight studies had non-PCOS controls and were thus eligible for the meta-analysis. Women with PCOS had significantly larger NC compared to non-PCOS controls (SMD: 0.78, 95% CI: 0.31-1.25, p = 0.0012). We found a positive association between larger NC and higher waist circumference, hip circumference, triglycerides, systolic BP, fasting insulin, and HOMA-IR or lower HOMA%S and higher prevalence of MetS or IR in the majority of the included studies. Neck circumference cut-off values for MetS varied from 33 cm to 34.25 cm and for IR 34.25 cm up to 42 cm among women with PCOS. Most of the studies were done with Asian populations thus limiting applicability of the study results to other ethnicities.

This meta-analysis demonstrated increased NC among women with PCOS compared to healthy controls. Women with PCOS and larger NC were more insulin resistant and had more MetS-related abnormalities when compared to women with smaller NC with or without PCOS. Data considering NC cut-off values for MetS and IR among women with PCOS are scarce, and further studies are needed, particularly among more varied ethnic populations.

Recent research on Polycystic Ovary Syndrome (PCOS) detection increasingly employs intelligent algorithms to assist gynecologists in more accurate and efficient diagnoses. However, intelligent PCOS detection faces notable challenges: absence of standardized feature taxonomies, limited research on available datasets, and insufficient understanding of existing detection tools' capabilities. This paper addresses these gaps by introducing a novel analytical framework for PCOS diagnostic research and developing a comprehensive taxonomy comprising 108 features across 8 categories. Furthermore, we analyzed available datasets and assessed current intelligent detection tools. Our findings reveal that 12 publicly accessible datasets cover only 54% of the 108 features identified in our taxonomy. These datasets frequently lack multimodal integration, regular updates, and clear license information-constraints that potentially limit detection tool development. Additionally, our analysis of 42 detection tools identifies several limitations: high computational resource requirements, inadequate multimodal data processing, insufficient longitudinal analysis capabilities, and limited clinical validation. Based on these observations, we highlight critical challenges and future research directions for advancing intelligent PCOS detection tools.

Polycystic ovary syndrome (PCOS) is a heterogeneous familial disorder affecting up to one in five women. The aetiology remains unclear, but available evidence suggests it is a polygenic disorder with epigenetic, developmental, and environmental components. The diagnostic criteria for PCOS are based on reproductive features, and the syndrome is categorized into several phenotypes that can vary by race and ethnicity. Insulin resistance and metabolic dysfunction have a crucial role in the pathogenesis of the syndrome and contribute to many adverse metabolic outcomes that place a substantial burden on the health of women with PCOS across their lifespan. Metabolic abnormalities like those identified in women with PCOS are also present in their female and male first-degree relatives. Overall, more emphasis is required on defining PCOS as a metabolic disorder in addition to a reproductive one. This approach could affect the management and future treatment options for the syndrome. The rationale of the current review is to identify and analyse existing evidence for PCOS as a metabolic, as well as a reproductive, disease.

Physical activity (PA) is recommended for the management of women with polycystic ovary syndrome (PCOS). However, it is not known whether PA modulates the risk of components of PCOS diagnostic criteria during adolescence.

We included participants from the Avon Longitudinal Study of Parents and Children prospective cohort with objective measurement of PA and sedentary behavior using accelerometry between ages 11 and 15 years, biochemical and clinical measures of hyperandrogenism (serum total testosterone level at 15 years and self-reported hirsutism at 19 years), and self-reported menstrual regularity at 17 years. Two-stage regression models evaluated the association of repeated measures of PA and sedentary behavior with components of PCOS diagnostic criteria.

Among 1,526 singleton girls with accelerometer data and testosterone samples, time spent in light PA was inversely associated with total testosterone (ß = -0.070, 95% CI -0.114, -0.025; nmol/L, per 60 minutes) and continuous hirsutism score (ß = -0.756, 95% CI -1.41, -0.103; per 60 minutes). Conversely, time spent sedentary was associated with higher total testosterone level (ß = 0.052, 95% CI 0.013, 0.090; per 60 minutes) and hirsutism score (ß = 0.668, 95% CI 0.103, 1.23; per 60 minutes). Associations were independent of adiposity, but results for hirsutism were attenuated following adjustment for age at menarche and after stratification by hormonal contraceptive use. No associations were observed with menstrual irregularity, for other PA intensity components, or among users of hormonal contraceptives.

More time spent in light intensity physical activity and less time spent sedentary during early adolescence is associated with lower testosterone concentrations and lower hirsutism scores in late adolescence.

Polycystic ovary syndrome (PCOS) is linked to non-alcoholic fatty liver disease (NAFLD). Biochemical, sex hormonal, and anthropometric indicators have been explored for screening NAFLD in PCOS patients. However, the accuracy of NAFLD screening using these indicators in PCOS patients remains uncertain. This study aimed to identify biochemical, sex hormonal, and anthropometric indicators associated with NAFLD in overweight and obese PCOS patients and assess the diagnostic efficacy of combined indicators.

This cross-sectional study (Clinical trial number ChiCTR1900020986; Registration date January 24th, 2019) involved 87 overweight or obese women with PCOS (mean age 29 ± 4 years). Measurements included anthropometric indices, biochemistry, sex hormone levels, and liver proton density fat fraction (PDFF). Correlation analysis, intergroup comparisons, and logistic regression analysis were used to identify risk factors for NAFLD (PDFF > 5.1%). The receiver operating characteristic curve, area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predictive value were used to determine cut-off values and evaluate diagnostic accuracy.

Liver PDFF was 7.69% (3.93%, 14.80%) in overweight and obese PCOS patients, with 67.8% diagnosed with NAFLD. NAFLD was associated with increased body mass index (BMI), abdominal circumference (AC), and triglyceride, total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), glucose, insulin, and free testosterone (FT) levels, and with decreased high-density lipoprotein-cholesterol (HDL-C) and sex hormone-binding globulin (SHBG) levels (P < 0.05). Risk factors for NAFLD in PCOS included BMI > 26.8 kg/m2, AC > 88.3 cm, triglyceride > 1.57 mmol/L, TC > 4.67 mmol/L, LDL-C > 3.31 mmol/L, glucose > 4.83 mmol/L, insulin > 111.35 pmol/L, FT > 7.6 pg/mL and SHBG < 25 nmol/L (β = 1.411-2.667, P < 0.005). A multi-indicator model including triglycerides, LDL-C, glucose, insulin, and SHBG showed higher diagnostic accuracy (AUC = 0.899, P < 0.001) for screening NAFLD in PCOS patients than single indicators (AUC = 0.667-0.761, P < 0.05).

Overweight and obese PCOS patients have higher incidences of liver PDFF and NAFLD. A multi-indicator model including triglycerides > 1.57 mmol/L, LDL-C > 3.31 mmol/L, glucose > 4.83 mmol/L, insulin > 111.35 pmol/L, and SHBG < 25 nmol/L is highly accurate for screening NAFLD in overweight and obese PCOS patients.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often leading to anovulatory infertility. Obesity exacerbates the reproductive, metabolic and psychological features of PCOS, making fertility treatment and patient satisfaction difficult. Despite guidelines from the European Society of Human Reproduction and Embryology (ESHRE) emphasizing lifestyle modifications and specific treatments, there remains a significant gap in adherence to these guidelines by both healthcare providers and patients.

A cross-sectional online survey was conducted from 1 January to 14 March 2021 among PCOS patients in Germany, Austria and Switzerland. A non-standardized, non-validated questionnaire covering several aspects of reproductive health was distributed via online channels. Data were analyzed using descriptive statistics, chi-squared tests, Student's t-tests and Jonckheere-Terpstra tests, with significance set at p < 0.05.

Out of 2029 participants, 1902 completed the fertility questionnaire. Of these, 73.9% perceived their fertility to be impaired, with this perception being higher in obese women (80.8% vs. 67.4%, p < 0.001). The analysis focused on 564 childless women with a current desire to have children, 67.0% of whom met WHO criteria for infertility. Obese women (BMI ≥ 30 kg/m2) reported lower satisfaction with fertility treatment (40.9 vs. 47.8, p = 0.009) and were less likely to receive fertility treatment (56.7% vs. 75.8%, p < 0.001). Despite recommendations, only 34.1% reported lifestyle changes as part of their treatment. Letrozole, the recommended first-line treatment, was underused (14.6%) and clomiphene citrate was more commonly prescribed (35.4%). Obese women reported fewer current pregnancies (4% vs. 13.9%, p < 0.001) and were more likely to be infertile for more than one year (77.0% vs. 53.0%, p < 0.001). They also expressed a greater desire for possibilities to ask more questions about PCOS and fertility and to undergo more infertility tests. (56.1% vs. 45.3%, p = 0.013; 69.4% vs. 59.8%, p = 0.020).

Fertility management in PCOS patients, especially in obese patients, shows significant gaps in adherence to recommended guidelines, highlighting the need for improved patient education, professional training and individualized treatment strategies. Improved health care is essential to address reproductive concerns and improve outcomes in this population.

Polycystic ovary syndrome (PCOS) is a prevalent metabolic and endocrine disorder affecting women of reproductive age, particularly those with obesity. This syndrome is characterized by clinical/biochemical hyperandrogenism and/or ovulatory dysfunction, which can result in infertility.

To investigate the prevalence of PCOS in candidates for bariatric surgery and to examine the correlation between PCOS and sex hormones in women with obesity.

A retrospective study analyzed 577 bariatric surgery candidates from 2015 to 2021 using RStudio. Normally distributed data were expressed as x ± s and compared with ANOVA or T-test, while the Kruskal-Wallis test was used for non-normal data. Count data, presented as M [Q1, Q3], were analyzed with the Chi-square test. Logistic regression identified influencing factors, with P < 0.05 indicating statistical significance.

The findings of our study reveal that the prevalence of PCOS among bariatric surgery candidates stands at 14.04%. Conversely, high-density lipoprotein cholesterol (HDL-C) levels tended to decrease with higher BMI categories (P = 0.02). Compared to the non-PCOS group, the PCOS group exhibits lower age and HDL-C levels. Still, they showed significantly elevated HOMA-IR, fasting blood glucose (FBG), luteinizing hormone (LH), total testosterone (TT), and luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio (P < 0.05). The logistic regression analysis of PCOS indicates that, compared to the control group, those with FBG levels exceeding 7 mmol/L (OR = 2.28, 95% CI 1.19 to 4.37, P = 0.01) and individuals with TT levels greater than 2.01 ng/ml (OR = 2.36, 95% CI 1.23 to 4.71, P = 0.01) exhibited an increased risk of PCOS.

PCOS is highly prevalent among female bariatric surgery candidates. It is significantly associated with younger age, lower HDL, higher FBG, and elevated TT levels. These factors may also serve as indicators for evaluating PCOS improvement and assessing surgical outcomes postoperatively.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dual GLP-1/glucose-dependent insulinotropic peptide (GIP) or glucagon receptor agonists have emerged as promising agents to treat metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH). Although the beneficial effects of GLP-1RAs on glycemic control and weight are well-established, clinicians may be unfamiliar with other potential benefits of this class.

We examined the pleiotropic effects of GLP-1RAs and how they relate to gastroenterologists for MASLD/MASH treatment. Our narrative review of English articles included four GLP-1RAs (subcutaneous semaglutide, liraglutide, dulaglutide, and efpeglenatide), a dual GLP-1/GIP agonist (tirzepatide), a dual GLP-1/glucagon receptor agonist (survodutide), MASLD/MASH, related disorders, clinical management, treatment outcomes and landscape.

In Phase I - III trials, GLP-1RAs are associated with clinically relevant hepatic improvements including MASH resolution, liver fat reduction, and preventing worsening fibrosis. Effects on cardiometabolic parameters align with type 2 diabetes/obesity Phase III data, comprising substantial improvements in glycemic, weight, and cardiovascular outcomes. Promising data also suggest benefits in common comorbidities, including obstructive sleep apnea, polycystic ovary syndrome, chronic kidney disease, and heart failure with preserved ejection fraction.GLP-1RAs represent a valuable pharmacotherapeutic option for gastroenterologists managing individuals with MASLD/MASH and cardiometabolic comorbid conditions.

Polycystic ovary syndrome (PCOS) is a complex multifactorial endocrinopathy affecting reproductive aged women globally, whose presentation is strongly influenced by genetic makeup, ethnic, and geographic diversity leaving these affected women substantially predisposed to reproductive and metabolic perturbations. Sophisticated techniques spanning genomics, proteomics, epigenomics, and transcriptomics have been harnessed to comprehensively understand the enigmatic pathophysiology of PCOS, however, conclusive markers for PCOS are still lacking today. Metabolomics represents a paradigm shift in biotechnological advances enabling the simultaneous identification and quantification of metabolites and the use of this approach has added yet another dimension to help unravel the strong metabolic component of PCOS. Reports dissecting the metabolic signature of PCOS have revealed disparate levels of metabolites such as pyruvate, lactate, triglycerides, free fatty acids, carnitines, branched chain and essential amino acids, and steroid intermediates in major biological compartments. These metabolites have been shown to be altered in women with PCOS overall, after phenotypic subgrouping, in animal models of PCOS, and also following therapeutic intervention. This review seeks to supplement previous reviews by highlighting the aforementioned aspects and to provide easy, coherent and elementary access to significant findings and emerging trends. This will in turn help to delineate the metabolic plot in women with PCOS in various biological compartments including plasma, urine, follicular microenvironment, and gut. This may pave the way to design additional studies on the quest of unraveling the etiology of PCOS and delving into novel biomarkers for its diagnosis, prognosis and management.

Are empirically derived adolescent overweight/obesity phenotypes differentially associated with polycystic ovary syndrome (PCOS) in young adulthood?

Self-reported PCOS diagnosis risk in young adulthood varied by empirically derived adolescent overweight/obesity phenotypes, with the highest risk observed among those in the 'mothers with obesity' and 'early puberty' phenotypes.

Overweight and obesity during puberty are postulated to promote the development of PCOS. Much of the prior literature in this area is cross-sectional and defines weight status based solely on BMI, yet emerging research suggests that not all people with overweight/obesity have the same risk for chronic health conditions, including PCOS.

Data came from 4838 female participants in the Growing Up Today Study (GUTS), an ongoing prospective cohort study in the USA that has followed children aged 9-14 into young adulthood (ages 31-37, with 16 waves of data collection between 1996 and 2019).

We previously used latent class analysis to empirically derive obesity phenotypes among 2038 female participants aged 14-19 years with overweight/obesity in the sample, as determined by participants' self-reported height and weight status. Indicators in the latent class analysis were participants' maternal weight status, disordered eating behaviors, body image and weight concerns, depressive symptoms and pubertal timing. The derived obesity phenotypes included 'mothers with obesity', 'early puberty', 'high weight concerns', and 'mixed'. Among these participants and female participants without adolescent overweight/obesity, we used logistic regression with generalized estimating equations to examine associations of adolescent obesity phenotypes with self-reported PCOS diagnosis after age 19. Analyses were adjusted for potential confounders.

Participants in all four obesity phenotypes were more likely than participants without overweight/obesity to report a PCOS diagnosis ('mothers with obesity' phenotype: odds ratio (OR) = 4.50, 95% CI = 2.61, 7.77; 'early puberty' phenotype: OR = 2.51, 95% CI = 1.59, 3.97; 'high weight concerns' phenotype: OR = 2.01, 95% CI = 1.24, 3.24; 'mixed' phenotype: OR = 1.94, 95% CI = 1.33, 2.82). Individuals in the 'mothers with obesity' phenotype had a significantly greater risk of PCOS diagnosis compared to those in the 'mixed' and 'high weight concerns' phenotypes (P < 0.05).

Participants self-reported PCOS diagnosis, which may underestimate new-onset PCOS and limit our ability to establish a temporal order between overweight/obesity and PCOS development. Residual confounding may also explain some of the observed associations in our analysis. Despite the fact that participants were from all regions across the USA, the results may not be generalizable to non-White and socioeconomically diverse populations.

Among females, the risk of PCOS in young adulthood varied by distinct adolescent obesity phenotypes. Those in the 'mothers with obesity' and 'early puberty' phenotypes had higher risks of PCOS, which suggests a potential underlying biological component. It may be beneficial to tailor PCOS surveillance according to these high-risk adolescent obesity phenotypes.

This project was funded by research grants from the National Institutes of Health (R01 DK127585, U01 HL145386, and U01 CA176726). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no competing interests to disclose.

N/A.

Polycystic ovary syndrome (PCOS) is one of the commonest gyneco-endocrine disorders amongst women of reproductive age. Whether PCOS and cardiometabolic traits in PCOS patients are associated with shortened telomere length (TL) or relative leukocyte telomere length (rLTL) remains unclear.

214 women with PCOS and 214 age-matched women were recruited. rLTL was measured with an updated quantitative real-time PCR protocol and reported as ΔΔCt between telomere and a single-copy gene encoding β-globin relative to a normalisation control. A two-way Mendelian randomization analysis using the UK Biobank Resource was performed to assess the causal relationship between rLTL and PCOS.

Women with PCOS had significantly shortened rLTL (PCOS: 0.5 ± 0.7; control: 0.8 ± 0.6; p < 0.001). Longer rLTL was associated with a lower risk of PCOS after adjusting for age, history of smoking and other cardiometabolic traits (OR: 0.503; 95% CI: 0.342-0.730; p < 0.001). Longer rLTL was associated with reduced risk of dyslidpidemia (OR: 0.563; 95% CI: 0.450-0.968; p = 0.042) in PCOS patients. PCOS subjects with rLTL shorter than mean of the rLTL of control subjects had an elevated risk of dysglycemia (OR: 2.09; 95% CI: 1.04-4.29; p = 0.040). No causal relationships were found between rLTL and PCOS in the Mendelian randomization study.

Women with PCOS have significantly reduced rLTL and shorter LTL may be associated with cardiometabolic risk factors in PCOS subjects. There are no causal relationship between genetically determined PCOS and TL or vice versa.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder with significant metabolic and hormonal dysregulation. Marjoram (Origanum majorana L.), known for its medicinal properties, has potential in managing PCOS through various bioactive compounds.

This study aims to evaluate the effects of marjoram on PCOS symptoms using serum pharmacochemistry, network pharmacology, and molecular docking in a DHEA-induced rat model.

Polycystic Ovary Syndrome (PCOS) was induced in rats using dehydroepiandrosterone (DHEA). Marjoram's therapeutic effects were evaluated by analyzing oxidative stress biomarkers, hormone levels, and ovarian histopathology. Untargeted serum metabolomics, conducted with ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC TQD-MS/MS), identified key bioactive compounds. These compounds were then examined through network pharmacology to map their interactions with PCOS-related pathways, with findings validated via molecular docking.

Marjoram treatment significantly reduced oxidative stress by decreasing nitric oxide (NO) and increasing total antioxidant capacity (TAC). Hormonal analysis revealed that high-dose marjoram (100 mg/kg) normalized progesterone, estradiol, testosterone and FSH levels. Body weight gain was also reduced with marjoram treatment, especially at the higher dose. Histopathological evaluation showed fewer ovarian cysts and improved follicular structure with marjoram administration. Network pharmacology analysis highlighted the steroid hormone biosynthesis and estrogen signaling pathways as critical targets, with apigenin and oleic acid identified as active compounds. Molecular docking confirmed strong interactions of these compounds with core PCOS-associated proteins, further supporting marjoram's potential in modulating PCOS symptoms.

This study reveals that marjoram contains a diverse range of active compounds that can modulate crucial biochemical and histological markers related to PCOS. By combining serum pharmacochemistry with network pharmacology, the research highlights marjoram's potential as a natural supplement to help alleviate PCOS symptoms and slow the syndrome's progression. These findings support further investigation into marjoram's role as a complementary therapy for managing PCOS.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that causes cardiometabolic and reproductive disorders in women of reproductive age. Women with PCOS are more likely to have obesity, type 2 diabetes mellitus, and cardiovascular disease. There is an inconclusive consensus on which dietary modification could be most effective in PCOS prevention and treatment. This review aimed to examine the effects of diverse dietary patterns on PCOS in women according to randomized controlled trials (RCTs) with and without an isocaloric dietary design. A literature search was performed in the PubMed®®/MEDLINE®® database up to 14 November 2024. A total of 21 RCTs were reviewed after screening the records, including 15 RCTs with a calorie-restricted dietary design and 6 RCTs with a non-calorie-restricted dietary design. This review found beneficial effects of the calorie-restricted Dietary Approaches to Stop Hypertension (DASH) diet on weight loss and glucose control in women with PCOS in four RCTs with an isocaloric dietary design. The calorie-restricted low-glycemic index (GI) diets from three RCTs and high-protein diets from four RCTs with an isocaloric dietary design showed no significant differences in anthropometric parameters, glucose control, lipids, and gonadal parameters compared with the control diet in women with PCOS. Non-calorie-restricted low-carbohydrate diets from four RCTs with an isocaloric dietary design showed similar results to the calorie-restricted low-GI diets and high-protein diets. However, the existing number of RCTs is insufficient to conclude the association between dietary patterns and PCOS in women. Further, well-designed dietary intervention studies are needed to assess the role of dietary patterns in PCOS beyond calorie restriction.

The dual burden of malnutrition is characterised by the coexistence of undernutrition alongside overweight/obesity and diet-related noncommunicable diseases. It is a paradox which disproportionately affects women and is applicable to those who become pregnant after weight loss surgery. Obesity before and during pregnancy is associated with increased risk of adverse perinatal outcomes in both mother and child. Overall lifestyle interventions targeting weight loss in the preconception period have not proven effective, with people, and women in particular, increasingly seeking weight loss surgery. In women with severe obesity, surgery may normalise hormonal abnormalities and improve fertility. In those who become pregnant after surgery, evidence suggests a better overall obstetric outcome compared to those with severe obesity managed conservatively; however, there is heightened risk of maternal nutritional deficiencies and infants born small for gestational age. Specifically, pregnancy soon after surgery, in the catabolic phase when rapid weight loss is occurring, has the potential for poor outcomes. Lifelong micronutrient supplementation is required, and there is considerable risk of malnutrition if nutritional aftercare guidelines are not adhered to. It is therefore recommended that pregnancy is delayed until a stable weight is achieved and is supported by individualised advice from a multidisciplinary team. Further research is required to better understand how weight loss surgery affects the chances of having a healthy pregnancy and to ultimately improve nutritional management and patient care. In this review, we aim to summarise the evidence and guidance around nutrition during pregnancy after weight loss surgery.

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10-13% of reproductive-aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed-methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed-methods studies were narratively synthesized and all studies were thematically analyzed. Sixty-eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS-specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight-centric care are necessary for long-term sustainable changes and improvements in health outcomes in people with PCOS.

Within normal variation, higher hemoglobin (Hb) levels are associated with poorer metabolic profile in population cohorts, underlying the link between oxygen delivery and cell metabolism. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women and is commonly accompanied by metabolic derangements. In this study we sought to investigate Hb levels, and their metabolic associations, in women with PCOS.

We used data from Northern Finland Birth Cohort 1966 to evaluate Hb levels in women with or without PCOS at the ages of 31 and 46 years. Linear regression models were used to investigate associations between Hb levels and essential metabolic parameters in both groups.

Women with PCOS had higher Hb levels than controls at the age of 31 years but not at the age of 46 years. Hb levels were associated positively with most of the metabolic parameters tested (body mass index, waist circumference, fasting insulin, homeostatic model assessment-insulin resistance (HOMA-IR), blood pressure, inflammatory markers, and blood lipids), with stronger associations in women with PCOS than in non-PCOS controls. There were fewer associations at the age of 46 than at 31 years, and body mass index seemed to explain many, though not all, differences between the PCOS and non-PCOS groups.

Women with PCOS have higher Hb levels at the age of 31 years. In both women with and without PCOS, Hb levels associate with poorer metabolic profile.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder and the primary cause of anovulatory infertility among women aged 15-49 years. Despite its significance, it has been largely overlooked in global health discussions, with persistently high prevalence and incidence rates. This public health challenge necessitates attention both domestically and internationally. Between 1990 and 2017, the age-standardized prevalence of female infertility and associated DALYs rose by 0.70% and 0.396%, respectively. Economically, addressing women's endocrine and metabolic health can bolster the overall well-being of the female population using existing resources. For judicious utilization of available resources, data regarding the burden of PCOS is pivotal for comprehending women's health status and for devising and refining policies related to women's endocrine health. Consequently, this study scrutinizes and assesses the age-standardized PCOS incidence rate and DALYs for 1990 and 2019, traces the trends of these metrics from 1990 to 2019, examines the composition of various populations and diseases, and offers international comparisons. This aims to furnish critical insights for future health policy development and adjustments in the realm of female endocrine and metabolic health.

This study employed the Global Health Data Exchange to obtain PCOS burden data based on GBD 2019. It collected incidence, DALYs, and age-standardized rates (ASRs) from 1990 to 2019 across global, regional, national, and SDI quintile levels, spanning 21 regions and 204 countries. To analyze trends, ASRs and estimated annual percentage changes (EAPCs) were calculated, with standardization crucial for comparability. EAPC was derived using a generalized linear model with a Gaussian distribution.

The global burden of PCOS increased significantly from 1990 to 2019, with estimated annual percentage change (EAPCs) of 0.56 for incidence and 0.83 for DALYs. The highest incidence rates were observed in the High-income Asia Pacific region, particularly in Japan and New Zealand, while the lowest rates were in Central Europe. Equatorial Guinea and Qatar exhibited the most pronounced increases in incidence and DALYs, attributed to urbanization and enhanced healthcare infrastructure. The incidence and DALYs of PCOS showed variation across SDI quintiles, with the greatest burden found in the middle-SDI quintile. Women between the ages of 20-29 years had the highest incidence and DALYs, emphasizing the importance of targeted interventions during this critical period. In contrast, regions with lower SDI levels, such as Central and Eastern Europe, reported the lowest burdens of PCOS, likely due to underdiagnosis and limited healthcare resources.

From 1990 to 2019, there was a significant increase in the global burden of PCOS, with variations seen across regions and SDI quintiles. Countries such as Italy, Japan, New Zealand, and Australia had the highest burdens, while Central and Eastern Europe had the lowest. The age group most affected was women aged 20-29 years, emphasizing the necessity for targeted interventions.

The beneficial effect of probiotics on the improvement of carbohydrate and lipid metabolism, as well as body mass index (BMI), has been demonstrated in various patient groups. We aimed to investigate the effect of a multi-strain probiotic on the hormonal balance of women with PCOS. Ethical approval was obtained from the Bioethical Committee.

The study was designed as a 12-week, randomized, double-blind, placebo-controlled clinical study. The probiotic SanProbi® Barrier capsules, which contain a unique composition of nine probiotic bacteria strains (Lactobacillus and Biffidobacterium), were used in the study. The mean age of the study participants was a mean of 28.42 ± 5.62 years. A total of 50 women with PCOS, diagnosed based on Rotterdam ESHRE criteria, were included in the study. Among them, 25 women were randomized to a placebo group, and 25 to a probiotic group.

A comparison of changes in individual hormone levels between groups confirmed statistically significant differences for TSH, androstenedione, SHBG, and BMI. In the case of LH, the statistical significance of the difference in delta change in the probiotic group was demonstrated with the use of a one-tailed test.

Probiotic supplementation may serve as an alternative supporting treatment, especially in the phenotype of women with a high FAI index. Probiotic therapy is also effective in reducing BMI in overweight women with PCOS.

Background/Objectives: Hirsutism is excessive male-patterned hair in postpubertal women with multifactorial etiology and is an indicator of hyperandrogenism associated with polycystic ovary syndrome (PCOS). Indeed, it can be caused by the enhanced peripheral conversion of androgen precursors to testosterone, as in idiopathic hirsutism (IH). Moreover, hirsutism can be caused by hirsutism-related hyperandrogenic syndromes like non-classic congenital adrenal hyperplasia (NCAH) and idiopathic hyperandrogenism (IHA). Methods: In this study, we characterized a large cohort of Portuguese women referred for hirsutism and estimated the prevalence of PCOS, NCAH, IHA, and IH. The levels of androgens and gonadotropins and body mass index (BMI) were measured and compared with controls. The correlation between each variable was calculated. Results: In the cohort, we found a prevalence of PCOS of 56.2%, IH of 20.2%, IHA of 17.3%, and NCAH of 6.2%. Subjects with PCOS were the only ones showing a significant difference in BMI compared to the controls and had the lowest levels of sex hormone-binding globulin (SHBG). Those with NCAH were younger and more hirsute with higher levels of testosterone, among other androgens. Those with IH had lower luteinizing hormone (LH) and LH/follicle-stimulating hormone (FSH) ratios than those with PCOS. Those with IH had lower SHBG levels compared to the controls and a higher free androgen index (FAI). Those with IHA had higher androgens compared to those with IH, in particular, adrenal-derived androgens. Conclusions: The pathogenesis of hirsutism is complex, and the contributions of the pituitary gland, ovaries, adrenals, adipose tissue, and liver have to be ascertained to understand the clinical manifestations and delineate appropriate treatments. This study sheds new light on the fine hormonal regulation of these diseases.

Background/Objectives: This systematic review and meta-analysis aimed to investigate the effect of prebiotics, alone or as part of synbiotics, on cardiometabolic parameters in polycystic ovary syndrome (PCOS) women. Methods: Databases, including PubMed, Scopus, ISI Web of Science, Embase, and the Cochrane Central Register of Controlled Trials, were searched for relevant randomized-controlled trials (RCTs) until 12 December 2024. Changes in mean ± standard deviations were extracted and combined using a random-effects model. Bias was assessed using Cochrane risk of bias and evidence quality with GRADE. Results: Twenty RCTs with 1271 participants were included. Results showed high-quality evidence supporting prebiotics' effects, alone or as part of synbiotics, in reducing body-mass index [n = 853; weighted-mean difference (WMD): -0.510, 95%CI: -0.669, -0.351 kg/m2] and diastolic blood pressure (WMD: -2.218, 95%CI: -4.425, -0.010 mmHg), moderate-quality evidence for weight, waist-to-hip ratio, and triglycerides improvements, and low or very-low-quality evidence for waist circumference (WC), fat mass, fasting plasma glucose, fasting insulin, low-density lipoprotein (LDL), total cholesterol (TC), high sensitive-C reactive protein, total testosterone, follicle-stimulating hormone and free androgen index improvements. Subgroup analyses revealed possible reduction in LDL with prebiotics, as well as possible decreases in WC, TC, and total testosterone with synbiotics. Dietary approaches to stop hypertension diet improved insulin sensitivity. Conclusions: This study suggests that prebiotics may beneficially affect several cardiometabolic parameters in PCOS women. Approximately one-third of the results were based on moderate-to-high-quality evidence. This study highlights the need for future well-designed, larger RCTs with longer treatment duration to strengthen the evidence base and guide clinical decision-making.

To study ferritin levels, and potential factors influencing them, in women with polycystic ovary syndrome (PCOS) and investigate potential associations between ferritin levels and other parameters in these women.

Longitudinal general population-based cohort study, including data from both questionnaires and clinical measurements.

The study was conducted with data from the participants of the Women's Health Study, including a total of 1,918 Finnish women aged approximately 35 years.

Polycystic ovary syndrome was defined according to the Rotterdam criteria by the presence of at least 2 of the following findings: oligomenorrhea/amenorrhea, hyperandrogenism (clinical or biochemical), and polycystic ovarian morphology.

Serum ferritin levels and other parameters were determined from the cohort data, and the associations between ferritin levels and other investigated parameters were investigated with linear regression models.

Women with PCOS had significantly higher median ferritin levels than those without PCOS (51.43 μg/L vs. 44.85 μg/L). Low ferritin levels were less common among women with PCOS who had oligomenorrhea or amenorrhea compared with those among women who did not (1.5% vs. 11.8%). The median ferritin levels were also found to be lower in hyperandrogenic women with PCOS than in those with normoandrogenemia (49.96 μg/L vs. 73.50 μg/L). Women with PCOS had higher fasting insulin levels than those without PCOS (8.85 mU/L vs. 7.60 mU/L), and a positive association between fasting insulin and ferritin levels was found in the whole population (effect size, 0.0619; 95% confidence interval, 0.005-0.119). Finally, associations between ferritin levels and history of infertility were investigated in both the total population and women with PCOS; however, no significant associations were found.

Our results suggest that women with PCOS have higher ferritin levels than those without PCOS and that both the decreased blood loss from irregular menstruation and increased androgen levels can influence ferritin levels in women with PCOS. A metabolic connection was also found because the serum insulin levels were associated positively with the serum ferritin levels in the total population, whereas the history of infertility did not seem to be associated with the serum ferritin levels in any of the study groups.

We aimed to develop and validate an algorithm for identifying women with polycystic ovary syndrome (PCOS) in the French national health data system.

Using data from the French national health data system, we applied the International Classification of Diseases (ICD-10) related diagnoses E28.2 for PCOS among women aged 18 to 43 years in 2021. Then, we developed an algorithm to identify PCOS using combinations of clinical criteria related to specific drugs claims, biological exams, international classification of Diseases (ICD-10) related diagnoses during hospitalization, and/or registration for long-term conditions. The sensitivity, specificity and positive predictive value (PPV) of different combinations of algorithm criteria were estimated by reviewing the medical records of the Department of Reproductive Medicine at a university hospital for the year 2022, comparing potential women identified as experiencing PCOS by the algorithms with a list of clinically registered women with or without PCOS.

We identified 2,807 (0.01%) women aged 18 to 43 who received PCOS-related care in 2021 using the ICD-10 code for PCOS in the French National health database. By applying the PCOS algorithm to 349 women, the positive and negative predictive values were 0.90 (95%CI (83-95) and 0.93 (95%CI 0.90-0.96) respectively. The sensitivity of the PCOS algorithm was estimated at 0.85 (95%CI 0.77-0.91) and the specificity at 0.96 (95%CI 0.92-0.98).

The validity of the PCOS diagnostic algorithm in women undergoing reproductive health care was acceptable. Our findings may be useful for future studies on PCOS using administrative data on a national scale, or even on an international scale given the similarity of coding in this field.

Time-restricted eating (TRE) manages weight effectively, but choosing how long and what time window remain debatable. Although an 8:00 a.m. to 16:00 p.m. time frame is reported to show positive results in most weight loss trial, its safety and efficacy in overweight and obese women with polycystic ovary syndrome (PCOS) is uncertain. This randomized controlled trial is conducted to evaluate the safety and efficacy of TRE in specific populations.

This study aims to assess the 6-month effects of TRE on weight change, metabolic improvement, reproductive recovery, and health-related quality of life in overweight and obese women with polycystic ovary syndrome (PCOS), compared to those who did not receive TRE.

This randomized controlled trial will enroll 96 overweight and obese women with polycystic ovary syndrome (PCOS), who will be randomly assigned to either a TRE group (with an eating window from 8:00 a.m. to 16:00 p.m.) or a control group (without eating time restrictions), with 49 participants in each group. Evaluators and data analysts will remain blinded to group allocation throughout the study. The primary outcomes, including changes in weight and body mass index (BMI), will be assessed weekly. Secondary outcomes, encompassing alterations in sex hormones, metabolic parameters, body composition, sleep quality, quality of life, anxiety, and depression, will be evaluated monthly. Compliance and safety will be continuously monitored throughout the study. Additionally, a 6-month follow-up will be conducted at the end of the trial to assess the long-term effects of TRE. Statistical analysis will include the Anderson-Darling test for normality, T-test/Wilcoxon test based on distribution, mixed-effects models for assessing time/group effects, Cox model for time-to-event analysis, repeated ANOVA for change analysis, and sensitivity analysis. All tests will be conducted using appropriate software, with a significance level set at P<0.05. Missing data will be imputed.

The purpose of this study protocol is to further evaluate the effects of TRE in overweight and obese women with PCOS through a randomized controlled trial (RCT). Findings from this study are expected to provide new dietary intervention strategies for overweight and obese PCOS participants.

This study has received ethics approval from the Medical Ethics Committee of the University of South China (Number: NHHL027). Participants are included after signing informed consent. Results will be submitted for publication in peer-reviewed journals.

Trail registration number: ChiCTR2400086815.

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy, which leads to ovulation dysfunction and infertility, as well as metabolic and mental disorders. Women with PCOS exhibit several characteristic symptoms, with marked heterogeneity across different races and ethnicities.

In this review, the author outlines the phenotypic disparities of PCOS among various racial and ethnic populations. First, the prevalence of major symptoms in different racial and ethnic groups with PCOS is summarized. Next, the effects of four phenotypes, derived from the Rotterdam criteria for PCOS, on metabolic and reproductive features are recapitulated.

A growing body of evidence suggests that East Asian populations exhibit less hirsutism and adiposity compared with other groups. However, hirsutism is more prevalent in South Asian, Middle Eastern, and Hispanic populations. Hispanic and African American populations have more frequent obesity and insulin resistance. With regard to the association between mental disorders and racial and ethnic differences, limited studies exist; therefore, no conclusions can be drawn.

Race and ethnicity-specific factors related to PCOS must be considered in clinical practice. The diagnostic criteria of PCOS should be specific to race and ethnicity to avoid missing treatment opportunities.

The objective of this study is to assess the impact of pomegranate supplements on insulin resistance (IR) and insulin sensitivity through a systematic review and meta-analysis of randomized controlled trials (RCTs). Additionally, we aim to analyze the differences in efficacy among various pomegranate extracts and the sensitivity of different diseases to pomegranate supplementation. We conducted searches in PubMed, Embase, Web of Science, and Cochrane Library up to October 30, 2023, for relevant studies published in English. The treatment group required the intake of pomegranate extract for a minimum of 4 weeks, with no restrictions on the extract type. The control group received a placebo or a treatment excluding pomegranate extract. The primary outcome was homeostatic model assessment for insulin resistance (HOMA-IR) and fasting insulin (FI), and the secondary outcome was quantitative insulin sensitivity check index (QUICKI). RoB 2 was used to assess the risk of bias in the original studies. We pre-specified subgroup analyses based on types of intervention, intervention duration, health condition, and intervention dose. Sensitivity analysis was conducted to validate result stability, utilizing Begg's test and Egger's test for publication bias. Data synthesis and analysis were performed using Stata 15.1 software. This study included a total of 15 RCTs with 673 participants conducted in 7 countries. Risk of bias results indicated an overall low risk of bias of the articles. Participants included healthy individuals, overweight and obese individuals, non-alcoholic fatty liver disease (NAFLD) patients, type 2 diabetes (T2DM) patients, polycystic ovary syndrome (PCOS) patients, metabolic syndrome (MS) patients, and individuals with hyperlipidemia. Pomegranate extract variations included pomegranate juice (PJ), pomegranate seed oil (PSO) capsule, pomegranate/pomegranate peel (PP) extract capsule, and pomegranate peel-added bread. The control groups primarily received placebo treatments with varying dosage and frequency. No adverse reactions were reported in any of the studies. The summary results showed that compared to the control groups, pomegranate extract had no significant impact on improving HOMA-IR levels in participants (WMD = -0.03, 95%CI: -0.37 to 0.31, and p = 0.851) and FI (WMD = -0.03, 95%CI: -0.42 to 0.36, and p = 0.862). Additionally, there was no significant advantage of pomegranate extract on QUICKI changes in T2DM and PCOS patients (WMD = 0.00, 95%CI: 0.00 to 0.01, and p = 0.002). Subgroup analysis results indicated that pomegranate extract could improve HOMA-IR levels in PCOS patients (WMD = -0.42, 95%CI: -0.54 to -0.29, and p < 0.001) and FI levels in T2DM, PCOS, and NAFLD patients. Our results indicate that pomegranate extract only improves HOMA-IR and FI levels in PCOS patients and FI levels in T2DM and NAFLD patients. No significant difference has been found for HOMA-IR, FI, or QUICKI in other metabolic diseases. The current evidence suggests that we should interpret the value of pomegranate extract in regulating IR and sensitivity cautiously. In the future, there is a need for more rigorously designed RCTs to specifically evaluate the impact of pomegranate supplementation on insulin sensitivity in patients with NAFLD, PCOS, and T2DM.

Polycystic ovary syndrome (PCOS) occurs in 8%-13% of reproductive-aged women and is associated with reproductive, metabolic, and psychological dysfunction. Overweight and obesity are prevalent and exacerbate the features of PCOS. The aim of this review is to evaluate the extent of evidence examining the physiological factors affecting energy homeostasis, which may impact weight gain, weight loss, and weight maintenance in PCOS, and identify research gaps and recommendations for future research. Literature searches using MEDLINE, EMBASE, PsycInfo, AMED, CINAHL, and Cochrane Central Register of Controlled Trials were conducted up to June 22, 2022. Abstracts, non-English-language articles, and reviews were excluded. A total of n = 78 (n = 55 energy intake and n = 23 energy expenditure) primary research papers were included. Papers with multiple outcomes of interest were counted as separate studies. Energy-intake studies (n = 89) focussed on assessing food, nutrient, or supplements stimuli and were grouped into the outcomes of gastrointestinal appetite hormones (n = 43), adipokines (n = 34), subjective appetite (n = 9), functional brain imaging (n = 3), and neuropeptides (n = 0). Energy-expenditure studies (n = 29) were grouped into total energy expenditure (n = 1), resting energy expenditure (n = 15), meal-induced thermogenesis (n = 3), nutrient oxidation (n = 5), and metabolic flexibility (n = 5). Across both energy-intake and -expenditure papers, 60% of the studies compared outcome responses in women with PCOS with a control group. Results were inconsistent, with 57% reporting no differences and 43% reporting altered responses in PCOS compared with controls, including blunted appetite hormone responses, metabolic inflexibility, and reduced energy expenditure. The authors identified that there is inconsistent, yet preliminary, evidence of possible altered physiological factors, which may impact energy balance and weight management. Further work is needed to act on the identified clinical and research gaps to support women with PCOS and health professionals in informing and achieving realistic weight-management goals for women with PCOS.

The protocol was prospectively registered on the Open Science Framework on February 16, 2021 (https://osf.io/9jnsm).

Objective. Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathies in women characterized by hyperandrogenism, ovulatory dysfunction, and insulin resistance affecting 5-20% of reproductive-aged women worldwide. Recent studies have emphasized the role of the fat mass and obesity-associated (FTO) gene in the development of PCOS, specifically the rs9939609 A/T polymorphism, which is linked to an increased risk of PCOS. The study aimed to investigate the levels of FTO protein and its association with luteinizing hormone (LH), follicle-stimulating hormone (FSH) and anthropometric parameters in patients with PCOS compared to healthy controls. Materials. A total of 298 women, comprising 149 patients and 149 healthy controls, enrolled in the study. Anthropometric parameters (body mass index, BMI; waist circumference, WC; hip circumference, HC; waist-to-hip ratio, WHR), and hormonal assays (LH, FSH, LH/FSH ratio) were performed. FTO protein levels were measured by ELISA kit and their association with these parameters was analyzed. A receiver operator characteristic (ROC) curve analysis was performed to evaluate the discriminatory power of FTO protein levels in distinguishing PCOS cases and controls. A value p<0.05 was considered statistically significant. Results. FTO protein levels were significantly elevated in PCOS women with increased BMI, WC, HC, and WHR (p=<0.05). The mean of BMI showed a positive correlation with both WC (r=0.367, p<0.001) and HC (r=0.395, p<0.001). WC strongly correlated with HC (r=0.780, p<0.001) and WHR (r=0.465, p<0.001). LH significantly correlated with FSH (r=0.543, p<.001), and LH/FSH (r=0.553, p<.001). FTO protein showed a positive correlation with LH (r=0.364, p<0.001), and FSH (r=0.166, p<0.001). Additionally, a negative correlation of FTO protein with BMI (r=-0.190, p<0.05), WC (r=-0.277, p<0.05), and WHR (r=-0.408 p<0.001) was observed. The levels of FTO protein were significantly higher in PCOS patients compared to controls. Significant correlations were also found between FTO protein levels and the anthropometric or hormonal parameters. The AUC for FTO protein levels was 0.624 (p=0.550), indicating moderate discriminatory power, but lacking statistical significance. Conclusion. The study found that FTO protein levels are significantly higher in PCOS women correlating with anthropometric and hormonal parameters (increased LH, decreased FSH). This highlights potential involvement of FTO protein in the hormonal and metabolic disturbances characteristics of the syndrome indicating its biomarker character for the condition.

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder with profound implications for the reproductive and metabolic health of women. The utilization of anthropometric measures in the diagnosis and management of PCOS has gained increasing attention due to their practicality and predictive capacity for associated conditions such as obesity and insulin resistance. This review rigorously explores the application of various anthropometric indices, including body mass index, waist-to-hip ratio, and advanced metrics such as the body shape index and body roundness index, wrist circumference, neck circumference. These indices offer critical insights into body fat distribution and its association with the metabolic and hormonal perturbations characteristic of PCOS. The review underscores the necessity of addressing obesity, a prevalent comorbidity in PCOS, through lifestyle modifications and personalized therapeutic approaches. By incorporating anthropometric evaluations into routine clinical practice, healthcare professionals can enhance diagnostic precision, optimize treatment strategies, and ultimately improve patient outcomes. This integrative approach not only facilitates the management of the metabolic challenges inherent in PCOS but also contributes to the development of more individualized therapeutic interventions, thereby enhancing the overall quality of life for women affected by PCOS.

To investigate various supplements that improve insulin resistance, hormonal status, and oxidative stress in overweight or obese women with polycystic ovarian syndrome (PCOS).

A literature search was conducted on four different databases, which led to the discovery of twenty - five randomized controlled trials (RCTs). These RCTs evaluated the efficacy of various supplements in improving insulin resistance (IR), hormonal status, and oxidative stress among overweight or obese women diagnosed with PCOS. Subsequently, data extraction and analysis were carried out to determine the quality of the study's methodological design and the potential for bias. Moreover, a meta-analysis was performed using the data from the RCTs.

A total of 25 RCTs were carried out, and 1636 women were enrolled. All participants were overweight or obese. The standardized mean differences (SMD) were as follows: For fasting plasma glucose (FPG), it was -0.34 (95% confidence interval [CI], -0.49 to -0.19, p = 0.123, I2 = 30.8%); for insulin, it was -0.67 (95% CI, -0.83 to -0.52, p = 0.208, I2 = 24%); for fasting insulin (FI), it was -0.26 (95% CI, -0.52 to -0.00, p = 0.269, I2 = 21.9%); for homeostatic model assessment-insulin resistance index (HOMA-IR), it was -0.59 (95% CI, -0.73 to -0.45, p = 0.015, I2 = 48.7%); for homoeostatic model assessment beta - cell function (HOMA-B), it was -0.51 (95% CI, -0.75 to -0.27, p = 0.547, I2 = 0%); for quantitative insulin sensitivity check index (QUICKI), it was 0.94 (95% CI, 0.76 to -1.12, p = 0.191, I2 = 27.5%); for total testosterone, it was -0.61 (95% CI, -1.14 to -0.09, p = 0.00, I2 = 78.5%); for testosterone, it was -0.38 (95% CI, -0.86 to 0.10, p = 0.03, I2 = 71.5%); for follicle - stimulating hormone (FSH), it was 0.16 (95% CI, -0.08 to 0.40, p = 0.470, I2 = 0%); for luteinizing hormone (LH), it was -0.56 (95% CI, -1.32 to 0.20, p = 0.000, I2 = 91.1%); for sex hormone - binding globulin (SHBG), it was 0.35 (95% CI, 0.02 to 0.69, p = 0.000, I2 = 78%); for dehydroepiandrosterone (DHEAS), it was -0.27 (95% CI, -0.76 to 0.21, p = 0.001, I2 = 78.7%); for plasma total antioxidant capacity (TAC), it was 0.87 (95% CI, 0.45 to 1.30, p = 0.004, I2 = 71.3%); for plasma malondialdehyde (MDA), it was -0.57 (95% CI, -0.79 to -0.36, p = 0.992, I2 = 0.0%).

This study's findings indicate that, in comparison with a placebo, supplements have a favorable effect on IR, hormonal functions, and oxidative stress in PCOS. Nevertheless, it is crucial to note that the above-drawn conclusions need to be verified by more high-quality studies, given the limitations regarding the number and quality of the included studies.

Excessive body weight, particularly the abdominal distribution of adipose tissue, has remained an important public health concern for years.

The study aimed to assess the prevalence of general overweight status and obesity, as well as abdominal overweight status and obesity in the adult Polish population.

The results are based on the analysis of anthropometric data of 3735 people aged 19 and over who were surveyed under the 2016-2020 National Health Program.

Excessive body weight (BMI > 25 kg/m2) was reported in 56.6% of the respondents. Abdominal overweight was found in 20.8% of respondents and abdominal obesity in 31.7% of the respondents. Abdominal obesity was more common in women than in men (44.3% vs. 18.0%, p < 0.001). Over half of women over 55 (approx. 60%) had abdominal obesity. The odds of becoming overweight/obese as measured by the BMI depended on the age and sex of the respondents. It was confirmed that men were over 28% more likely to develop such a condition than women (OR = 1.288, p < 0.001). The odds increased with age (OR = 1.029, p < 0.001). The type of person with obesity/found to be overweight in Polish population was most often a rural resident, aged 65.0-74.9, assessing their financial situation as average, being married/in a partnership, and not declaring the occurrence of cardiovascular diseases. The person with an overweight status had secondary education, and the person with obesity had primary/lower secondary/vocational education.

Being overweight and having obesity, both general and abdominal, are still a major epidemiological problem in Poland. The results obtained in this study suggest that the prevalence of being overweight and having obesity has decreased over the last 10 years, though this assumption requires further investigation. Rural residents with lower education should be covered by educational activities adapted to their needs and possibilities, considering that obesity in young women, especially when having abdominal obesity, may be associated with an increased risk of infertility caused by ovulation disorders. Further research and educational activities are necessary. Excessive body weight affected almost 42% of the women from the youngest age group, and abdominal obesity was found in 21% of them.