Association of ageing and PCOS women’s metabolic turbulence: A cohort study in hospitals of Faisalabad, Pakistan

Authors

  • Laiq Ahmad Government College University, Pakistan.

Keywords:

Cardiovascular diseases, framingham risk scoring system, hyperandrogenism, metabolic syndrome, polycystic ovary syndrome

Abstract

Background: Ethno-demographic data on polycystic ovary syndrome (PCOS) is still prone to contentious debate since heterogeneity amid PCOS women of different regions.

Objective: To study the impacts of ageing on endocrinopathy of metabolic disorders (MetS) among PCOS women and cardiovascular risk (CVR).

Methods: In the current study, PCOS women (n = 500) with age range of 15 - 45 years were recruited from Faisalabad region of Pakistan and their reproductive history with brief demographic data were recorded through interview questionnaire while medical assessments were carried out under protocol. Following categorization of five age groups, statistical significance was determined through analyses of variance and regression analysis.

Results: Mean number of menstrual cycles per year, luteinizing hormone: follicle stimulating hormone ratio, hirsutism score declined significantly with advancing age of PCOS women (P < 0.05). While unprecedented age related progression was ensued in cycles’ duration, bleeding days after menarche onsets, polycystic ovary morphology (PCOM) components including ovarian volume, diameter and number of follicles. Among PCOS women with MetS, mean fasting blood glucose and waist to hip circumference ratio, body mass index, and blood pressures were examined the highest in older women but inverse relationship of high density lipoprotein (HDL) was noticed with progressive age groups (P < 0.01). Reciprocal attenuation in stillbirth and inflation in conception rate were also evident among progressive age groups accordingly. Similarly, Framingham points and CVR10 was significantly the highest (1.5%) among older age groups PCOS women with increasing age conformity (P < 0.05).

Conclusion: Ageing among PCOSs, unequivocally, exacerbated the endocrinopathy while synergetic metabolic abnormalities have transcended impacts on cardiovascular risks among older aged PCOS women.

Downloads

Download data is not yet available.

References

Hsu MI. Clinical characteristics in Taiwanese women with polycystic ovary syndrome. Clin Exp Reprod Med 2015;42:86-93. https://doi.org/10.5653/cerm.2015.42.3.86

Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome towards a rational approach. In: Dunaif A, Glvens JR, Haseltine FP, Marriam, GR, editors. Polycystic ovary syndrome. Boston: Blackwell Scientific; 1992. p. 377-84.

The Amsterdam ESHRE/ASRM- Sponsored 3rd PCOS Consensus workshop group. Consensus on women's health aspects of polycystic ovary syndrome (PCOS). Hum Reprod 2012;27:14-24.

https://doi.org/10.1093/humrep/der396

Rosenfield RL, Ehrmann DA, Littlejohn EE. Adolescents polycystic ovary syndrome due to functional ovarian hyperandrogenism persists into adulthood. J Clin Endocrinol Metab 2015;100:1537-43.

https://doi.org/10.1210/jc.2014-4290

Wang F, Pan J, Liu Y, Meng Q, Lv P, Qu F, et al. Alternative splicing of the androgen receptor in polycystic ovary syndrome. Proc Natl Acad Sci USA 2015;112:4743-8.

https://doi.org/10.1073/pnas.1418216112

Tsikouras P, Spyros L, Manav B, Zervoudis S, Poiana C, Nikolaos T, et al. Features of Polycystic Ovary Syndrome in adolescence. J Med Life 2015;8:291-6.

Wang FF, Pan JX, Wu Y, Zhu YH, Hardiman PJ, Qu F. American, European, and Chinese practice guidelines or consensuses of polycystic ovary syndrome: a comparative analysis. J Zhejiang Univ Sci B 2018;19:354-63. https://doi.org/10.1631/jzus.B1700074

Wei HJ, Young R, Kuo IL, Liaw CM, Chiang HS, Yeh CY. Prevalance of insulin resistance and determination of risk factors for glucose intolerance in polycystic ovary syndrome: a Cross-sectional study of Chinese infertility patients. Fertil Steril 2009;91:1864-8.

https://doi.org/10.1016/j.fertnstert.2008.02.168

March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010;25:544-51. https://doi.org/10.1093/humrep/dep399

Hsu MI. Changes in the PCOS phenotype with age. Steroids 2013;78:761-6.

https://doi.org/10.1016/j.steroids.2013.04.005

Bili H, Laven J, Imani B, Eijkemans MJ, Fauser BC. Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhoeic infertile women of reproductive years. Eur J Endocrinol 2001;145:749-55. https://doi.org/10.1530/eje.0.1450749

Zhang HY, Guo CX, Zhu FF, Qu PP, Lin WJ, Xiong J. Clinical characteristics, metabolic features, and phenotype of Chinese women with polycystic ovary syndrome:a large-scale case-control study. Arch Gynecol Obstet 2013;287:525-31. https://doi.org/10.1007/s00404-012-2568-z

Wakabayashi I. Age-dependent influence of gender on the association between obesity and a cluster of cardiometabolic risk factors. Gend Med 2012;9:267-77. https://doi.org/10.1016/j.genm.2012.05.004

Macut D, Bozic I, Popovic B, Bogavac T, Petakov M, Ognjanovic S, et al. Metabolic syndrome indices and Framingham risk scoring in women with polycystic ovary syndrome. Endocrine Abstracts 2010;22:P473.

Hillman JK, Johnson LN, Limaye M, Feldman RA, Sammel M, Dokras A. Black women with polycystic ovary syndrome (PCOS) have increased risk for metabolic syndrome and cardiovascular disease compared with white women with PCOS [corrected]. Fertil Steril 2014;101:530-5.

https://doi.org/10.1016/j.fertnstert.2013.10.055

Rebar R. Evaluation of amenorrhea, anovulation, and abnormal bleeding. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A, et al, editors. Endotext. South Dartmouth (MA): MDText. com, Inc.; 2000.

Wijeyaratne CN, Seneviratne RA, Dahanayake S, Kumarapeli V, Palipane E, Kuruppu N, et al. Phenotype and metabolic profile of South Asian women with polycystic ovary syndrome (PCOS): results of a large database from a specialist Endocrine Clinic. Hum Reprod 2011;26:202-13.

https://doi.org/10.1093/humrep/deq310

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539-53.

https://doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S

Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 2003;9:505-14. https://doi.org/10.1093/humupd/dmg044

Unluhizarci K, Kaltsas G, Kelestimur F. Non polycystic ovary syndrome-related endocrine disorders associated with hirsutism. Eur J Clin Invest 2012;42:86-94. https://doi.org/10.1111/j.1365-2362.2011.02550.x

D'Agostino RB Sr, Pencina MJ, Massaro JM, Coady S. Cardiovascular disease risk assessment: insight from Framingham. Glob Heart 2013; 8:11-23. https://doi.org/10.1016/j.gheart.2013.01.001

Panidis D, Tziomalos K, Papadakis E, Chatzis P, Kandaraki EA, Tsourdi EA, et al. Associations of menstrual cycle irregularities with age, obesity and phenotype in patients with polycystic ovary syndrome. Hormones (Athens) 2015;14:431-7. https://doi.org/10.14310/horm.2002.1593

Franks S. Polycystic ovary syndrome in adolescents. Int J Obes (Lond) 2008; 32:1035-41.

https://doi.org/10.1038/ijo.2008.61

Bani Mohammad M, Majdi Seghinsara A. Polycystic ovary syndrome (PCOS), diagnostic criteria, and AMH. Asian Pac J Cancer Prev 2017;18:17-21.

Kuiri-Hanninen T, Kallio S, Seuri R, Tyrvainen E, Liakka A, Tapanainen J, et al. Postnatal developmental changes in the pituitary-ovarian axis in preterm and term infant girls. J Clin Endocrinol Metab 2011;96:3432-9. https://doi.org/10.1210/jc.2011-1502

Carmina E, Campagna AM, Lobo RA. A 20-year follow-up of young women with polycystic ovary syndrome. Obstet Gynecol 2012;119:263-9. https://doi.org/10.1097/AOG.0b013e31823f7135

Forslund M, Landin Wilhelmsen K, Schmidt J, Brannstrom M, Trimpou P, Dahlgren E. Higher menopausal age but no differences in parity in women with polycystic ovary syndrome compared with controls. Acta Obstet Gynecol Scand 2019;98:320-6. https://doi.org/10.1111/aogs.13489

Luque-Ramirez M, Alpanes M, Sanchon R, Fernandez-Duran E, Ortiz-Flores AE, EscobarMorreale HF. Refferal bias in female functional hyperandrogenism and polycystic ovary syndrome. Eur J Endocrinol 2015;173:603-10. https://doi.org/10.1530/EJE-15-0646

Handelsman DJ, Sikaris K, Ly LP. Estimating agespecific trends in circulating testosterone and sex hormone-binding globulin in males and females across the lifespan. Ann Clin Biochem 2016;53:377-84.

https://doi.org/10.1177/0004563215610589

Moran C, Knochenhauer E, Boots LR, Azziz R. Adrenal androgen excess in hyperandrogenism: relation to age and body mass. Fertil Steril 1999;71:671-4. https://doi.org/10.1016/S0015-0282(98)00536-6

Liang SJ, Hsu CS, Tzeng CR, Chen CH, Hsu MI. Clinical and biochemical presentation of polycystic ovary syndrome in women between the ages of 20 and 40. Hum Reprod 2011;26:3443-9.

https://doi.org/10.1093/humrep/der302

Munzker J, Hofer D, Trummer C, Ulbing M, Harger A, Pieber T, et al. Testosterone to dihydrotestosterone ratio as a new biomarker for an adverse metabolic phenotype in the polycystic ovary syndrome. J Clin Endocrinol Metab 2015;100:653-60. https://doi.org/10.1210/jc.2014-2523

Semmens J, Rouse I, Beilin LJ, Masarei JR. Relationship of plasma HDL cholesterol to testosterone, estradiol and sex hormone binding flobulin levels in men and women. Metabolism 1983;32:428-32.

https://doi.org/10.1016/0026-0495(83)90002-1

Haffner SM, Kushwaha RS, Foster DM, ApplebaumBowden D, Hazzard WR. Studies on the metabolic mechanism of reduced high density lipoproteins during anabolic steroid therapy. Metabolism 1983;32: 413-20. https://doi.org/10.1016/0026-0495(83)90052-5

Sorva R, Kuusi T, Dunkel L, Taskinen MR. Effects of endogenous sex steroids on serum lipoproteins and postheparin plasma lipolytic enzymes. J Clin Endocrinol Metab 1988;66:408-13.

https://doi.org/10.1210/jcem-66-2-408

Liou TH, Yang JH, Hsieh CH, Lee CY, Hsu CS, Hsu MI. Clinical and biochemical presentations of polycystic ovary syndrome among obese and nonobese women. Fertil Steril 2009;92:1960-5.

https://doi.org/10.1016/j.fertnstert.2008.09.003

Panidis D, Tziomalos K, Macut D, Delkos D, Betsas G, Misichronis G, et al. Cross-sectional analysis of the effects of age on the hormonal, metabolic, and ultrasonographic features and the prevalence of the different phenotypes of polycystic ovary syndrome. Fertil Steril 2012;97:494-500.

https://doi.org/10.1016/j.fertnstert.2011.11.041

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644

Wild RA, Grubb B, Hartz A, Van Nort JJ, Bachman W, Bartholomew M. Clinical signs of androgen excess as risk factors for coronary artery disease. Fertil Steril 1990;54:255-9.

https://doi.org/10.1016/S0015-0282(16)53699-1

Tzeng CR, Chang YC, Chang YC, Wang CW, Chen CH, Hsu MI. Cluster analysis of cardiovascular and metabolic risk factors in women of reproductive age. Fertil Steril 2014;101:1404-10.

https://doi.org/10.1016/j.fertnstert.2014.01.023

Downloads

Published

2023-07-26

How to Cite

1.
Ahmad L. Association of ageing and PCOS women’s metabolic turbulence: A cohort study in hospitals of Faisalabad, Pakistan. Chula Med J [Internet]. 2023 Jul. 26 [cited 2024 Dec. 22];64(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/196