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Environmental Factors in the Polycystic Ovary Syndrome

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Androgen Excess Disorders in Women

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Polycystic ovary syndrome (PCOS) is a prevalent disorder that is still not well understood. Genetic predisposition is important, but neonatal, prepubertal, pubertal, and postpubertal factors participate in its clinical expression. In this chapter we will review these factors and the evidence that supports causal association with the development of PCOS. Unfortunately, little evidence exists for many of these factors. Obesity and its determinant, birthweight, progression of weight after birth, and precocious pubarche have been studied more extensively. Therefore, these factors will be reviewed in greater detail.

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References

  1. Franks S, Gharani N, Waterworth D, et al. Genetics of polycystic ovary syndrome. Mol Cell Endocrinol 1998;145:123–128.

    Article  PubMed  CAS  Google Scholar 

  2. Kahsar-Miller MD, Nixon C, Boots LR, Go RC, Azziz R. Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertil Steril 2001;75:53–58.

    Article  PubMed  CAS  Google Scholar 

  3. Baillargeon JP, Iuorno MJ, Nestler JE. Insulin sensitizers for polycystic ovary syndrome. Clin Obstet Gynecol 2003;46:325–340.

    Article  PubMed  Google Scholar 

  4. Baillargeon JP, Carpentier A. Determination of insulin sensitivity in brothers of women with polycystic ovary syndrome— preliminary result. Program and Abstracts of the 87th Annual Scientific Meeting of The Endocrine Society, 2005.

    Google Scholar 

  5. Jahanfar S, Eden JA, Warren P, Seppala M, Nguyen TV. A twin study of polycystic ovary syndrome. Fertil Steril 1995;63:478–486.

    PubMed  CAS  Google Scholar 

  6. Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord 2002;26:883–896.

    Article  PubMed  CAS  Google Scholar 

  7. Michelmore K, Ong K, Mason S, et al. Clinical features in women with polycystic ovaries: relationships to insulin sensitivity, insulin gene VNTR and birthweight. Clin Endocrinol (Oxf) 2001;55:439–446.

    Article  CAS  Google Scholar 

  8. Salehi M, Bravo-Vera R, Sheikh A, Gouller A, Poretsky L. Pathogenesis of polycystic ovary syndrome: What is the role of obesity? Metabolism 2004;53:358–376.

    Article  PubMed  CAS  Google Scholar 

  9. Linne Y. Effects of obesity on women’s reproduction and complications during pregnancy. Obes Rev 2004;5:137–143.

    Article  PubMed  CAS  Google Scholar 

  10. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes 1989;38:1165–1174.

    Article  PubMed  CAS  Google Scholar 

  11. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. JCEM 1999;84:165–169.

    PubMed  CAS  Google Scholar 

  12. Parsons TJ, Power C, Logan S, Summerbell CD. Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999;23 Suppl 8:S1–107.

    PubMed  CAS  Google Scholar 

  13. Rosenbaum M, Leibel RL. The physiology of body weight regulation: relevance to the etiology of obesity in children. Pediatrics 1998;101:525–539.

    PubMed  CAS  Google Scholar 

  14. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869–873.

    Article  PubMed  CAS  Google Scholar 

  15. Sherwood NE, Jeffery RW, French SA, Hannan PJ, Murray DM. Predictors of weight gain in the Pound of Prevention study. Int J Obes Relat Metab Disord 2000;24:395–403.

    Article  PubMed  CAS  Google Scholar 

  16. Schmitz KH, Jacobs DR Jr, Leon AS, Schreiner PJ, Sternfeld B. Physical activity and body weight: associations over ten years in the CARDIA study. Coronary Artery Risk Development in Young Adults. Int J Obes Relat Metab Disord 2000;24:1475–1487.

    Article  PubMed  CAS  Google Scholar 

  17. Wenche DB, Holmen J, Kruger O, Midthjell K. Leisure time physical activity and change in body mass inde: xan 11-year follow-up study of 9357 normal weight health women 20-49 years old. J Womens Health (Larchmt) 2004;13:55–62.

    Google Scholar 

  18. Guo SS, Huang C, Maynard LM, et al. Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study. Int J Obes Relat Metab Disord 2000;24:1628–1635.

    Article  PubMed  CAS  Google Scholar 

  19. Cole TJ. Children grow and horses race: is the adiposity rebound a critical period for later obesity? BMC Pediatr 2004;4:6.

    Article  PubMed  CAS  Google Scholar 

  20. Korkeila M, Kaprio J, Rissanen A, Koshenvuo M, Sorensen TI. Predictors of major weight gain in adult Finns: stress, life satisfaction and personality traits. Int J Obes Relat Metab Disord 1998;22:949–957.

    Article  PubMed  CAS  Google Scholar 

  21. Lahti-Koski M, Pietinen P, Heliovaara M, Vartiainen E. Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982-1997 FINRISK Studies. Am J Clin Nutr 2002;75:809–817.

    PubMed  CAS  Google Scholar 

  22. Hu FB. Sedentary lifestyle and risk of obesity and type 2 diabetes. Lipids 2003;38:103–108.

    Article  PubMed  CAS  Google Scholar 

  23. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003;289:1785–1791.

    Article  PubMed  Google Scholar 

  24. Cresswell JL, Barker DJ, Osmond C, Egger P, Phillips DI, Fraser RB. Fetal growth, length of gestation, and polycystic ovaries in adult life. Lancet 1997;350:1131–1135.

    Article  PubMed  CAS  Google Scholar 

  25. Sadrzadeh S, Klip WA, Broekmans FJ, et al. Birthweight and age at menarche in patients with polycystic ovary syndrome or diminished ovarian reserve, in a retrospective cohort. Hum Reprod 2003;18:2225–2230.

    Article  PubMed  CAS  Google Scholar 

  26. Laitinen J, Taponen S, Martikainen H, et al. Body size from birth to adulthood as a predictor of self-reported polycystic ovary syndrome symptoms. Int J Obes Rel Metab Disord 2003;27:710–715.

    Article  CAS  Google Scholar 

  27. Ong KK, Potau N, Petry CJ, et al. Opposing influences of prenatal and postnatal weight gain on adrenarche in normal boys and girls. JCEM 2004;89:2647–2651.

    PubMed  CAS  Google Scholar 

  28. Ibanez L, Potau N, Ferrer A, Rodriguez-Hierro F, Marcos MV, de Zegher F. Reduced ovulation rate in adolescent girls born small for gestational age. JCEM 2002;87:3391–3393.

    PubMed  CAS  Google Scholar 

  29. Nestler JE. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Semin Reprod Endocrinol 1997;15:111–122.

    Article  PubMed  CAS  Google Scholar 

  30. Schroder AK, Tauchert S, Ortmann O, Diedrich K, Weiss JM. Insulin resistance in patients with polycystic ovary syndrome. Ann Med 2004;36:426–439.

    Article  PubMed  CAS  Google Scholar 

  31. Hofman PL, Regan F, Jackson WE, et al. Premature birth and later insulin resistance. N EnglJ Med 2004;351:2179–2186.

    Article  CAS  Google Scholar 

  32. Rich-Edwards JW, Colditz GA, Stampfer MJ, et al. Birthweight and the risk for type 2 diabetes mellitus in adult women. Ann Intern Med 1999;130:278–284.

    PubMed  CAS  Google Scholar 

  33. Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life. Diabetologia 2003;46:190–194.

    PubMed  CAS  Google Scholar 

  34. Bhargava SK, Sachdev HS, Fall CH, et al. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004;350:865–875.

    Article  PubMed  CAS  Google Scholar 

  35. Sinaiko AR, Donahue RP, Jacobs DR Jr, Prineas RJ. Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults. The Minneapolis Children’s Blood Pressure Study. Circulation 1999;99:1471–1476.

    CAS  Google Scholar 

  36. Srinivasan SR, Myers L, Berenson GS. Predictability of childhood adiposity and insulin for developing insulin resistance syndrome (syndrome X) in young adulthood: the Bogalusa Heart Study. Diabetes 2002;51:204–209.

    Article  PubMed  CAS  Google Scholar 

  37. Ibanez L, Potau N, Virdis R, et al. Postpubertal outcome in girls diagnosed of premature pubarche during childhood: increased frequency of functional ovarian hyperandrogenism. JCEM 1993;76:1599–1603.

    PubMed  CAS  Google Scholar 

  38. Ibanez L, de Zegher F, Potau N. Premature pubarche, ovarian hyperandrogenism, hyperinsulinism and the polycystic ovary syndrome: from a complex constellation to a simple sequence of prenatal onset. J Endocrinol Invest 1998;21:558–566.

    PubMed  CAS  Google Scholar 

  39. Ibanez L, de Zegher F, Potau N. Anovulation after precocious pubarche: early markers and time course in adolescence. JCEM 1999;84:2691–2695.

    PubMed  CAS  Google Scholar 

  40. Ibanez L, Ong K, de Zegher F, Marcos MV, del Rio L, Dunger DB. Fat distribution in non-obese girls with and without precocious pubarche: central adiposity related to insulinaemia and androgenaemia from prepuberty to postmenarche. Clin Endocrinol (Oxf) 2003;58:372–379.

    Article  Google Scholar 

  41. Ibanez L, Potau N, Francois I, de Zegher F. Precocious pubarche, hyperinsulinism, and ovarian hyperandrogenism in girls: relation to reduced fetal growth. JCEM 1998;83:3558–3562.

    PubMed  CAS  Google Scholar 

  42. Ibanez L, Valls C, Potau N, Marcos MV, de Zegher F. Polycystic ovary syndrome after precocious pubarche: ontogeny of the low-birthweight effect. Clin Endocrinol (Oxf) 2001;55:667–672.

    Article  CAS  Google Scholar 

  43. Ibanez L, Ferrer A, Ong K, Amin R, Dunger D, de Zegher F. Insulin sensitization early after menarche prevents progression from precocious pubarche to polycystic ovary syndrome. J Pediatr 2004;144:23–29.

    Article  PubMed  Google Scholar 

  44. Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular riskin women with polycystic ovary syndrome. JCEM 1985;61:946–951.

    PubMed  CAS  Google Scholar 

  45. Wright CE, Zborowski JV, Talbott EO, McHugh-Pemu K, Youk A. Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome. Int J Obes Relat Metab Disord 2004;28:1026–1032.

    Article  PubMed  CAS  Google Scholar 

  46. Carmina E, Legro RS, Stamets K, Lowell J, Lobo RA. Difference in body weight between American and Italian women with polycystic ovary syndrome: influence of the diet. Hum Reprod 2003;1 8:2289–2293.

    Article  Google Scholar 

  47. Jahanfar S, Eden JA, Nguyent TV. Bulimia nervosa and polycystic ovary syndrome. Gynecol Endocrinol 1995;9:113–117.

    Article  PubMed  CAS  Google Scholar 

  48. McCluskey S, Evans C, Lacey JH, Pearce JM, Jacobs H. Polycystic ovary syndrome and bulimia. Fertil Steril 1991;55:287–291.

    PubMed  CAS  Google Scholar 

  49. McCluskey SE, Lacey JH, Pearce JM. Binge-eating and polycystic ovaries. Lancet 1992;340:723.

    Article  PubMed  CAS  Google Scholar 

  50. Morgan JF, McCluskey SE, Brunton JN, Hubert LJ. Polycystic ovarian morphology and bulimia nervosa: a 9-year follow-up study. Fertil Steril 2002;77:928–931.

    Article  PubMed  Google Scholar 

  51. Michelmore KF, Balen AH, Dunger DB. Polycystic ovaries and eating disorders: Are they related? Hum Reprod 2001;16:765–769.

    Article  PubMed  CAS  Google Scholar 

  52. Lobo RA, Granger LR, Paul WL, Goebelsmann U, Mishell DR Jr. Psychological stress and increases in urinary norepinephrine metabolites, platelet serotonin, and adrenal androgens in women with polycystic ovary syndrome. Am J Obstet Gynecol 1983;145:496–503.

    PubMed  CAS  Google Scholar 

  53. Trent ME, Rich M, Austin SB, Gordon CM. Quality of life in adolescent girls with polycystic ovary syndrome. Arch Pediatr Adolesc Med 2002;156:556–560.

    PubMed  Google Scholar 

  54. McCook JG, Reame NE, Thatcher SS. Health-related quality of life issues in women with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs 2005;34:12–20.

    Article  PubMed  Google Scholar 

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Hivert, MF., Baillargeon, JP. (2006). Environmental Factors in the Polycystic Ovary Syndrome. In: Azziz, R., Nestler, J.E., Dewailly, D. (eds) Androgen Excess Disorders in Women. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-179-6_22

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  • DOI: https://doi.org/10.1007/978-1-59745-179-6_22

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-663-4

  • Online ISBN: 978-1-59745-179-6

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