Daria Lizneva1, Richard Kirubakaran2, Kateryna Mykhalchenko3, Larisa Suturina4, Galina Chernukha5, Michael P Diamond6, Ricardo Azziz7. 1. Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia; Medical Company IDK, Samara, Russian Federation; Department of Reproductive Health Protection, Scientific Center of Family Health and Human Reproduction, Irkutsk, Russian Federation. 2. Cochrane South Asia, BV Moses Center for Evidence-Informed Health Care and Health Policy, Christian Medical College, Vellore, India. 3. Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York. 4. Department of Reproductive Health Protection, Scientific Center of Family Health and Human Reproduction, Irkutsk, Russian Federation. 5. Department of Gynecological Endocrinology, Scientific Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation. 6. Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia. 7. Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia; Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia. Electronic address: razziz@augusta.edu.
Abstract
OBJECTIVE: To compare the prevalence of polycystic ovary syndrome (PCOS) phenotypes and obesity among patients detected in referral versus unselected populations. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Thirteen thousand seven hundred ninety-six reproductive-age patients with PCOS, as defined by the extended Rotterdam 2003 criteria. INTERVENTION(S): Review of PUBMED, EMBASE, and Cochrane Library, 2003-2016. Only observational studies were included. Data were extracted using a web-based, piloted form and combined for meta-analysis. MAIN OUTCOME MEASURE(S): PCOS phenotypes were classified as follows: phenotype A, clinical and/or biochemical hyperandrogenism (HA) + oligo-/anovulation (OA) + polycystic ovarian morphology (PCOM); phenotype B, HA+OA; phenotype C, HA+PCOM; and phenotype D, OA+PCOM. RESULT(S): Forty-one eligible studies, reporting on 43 populations, were identified. Pooled estimates of detected PCOS phenotype prevalence were consequently documented in referral versus unselected populations, as [1] phenotype A, 50% (95% confidence interval [CI], 46%-54%) versus 19% (95% CI, 13%-27%); [2] phenotype B, 13% (95% CI, 11%-17%) versus 25% (95% CI, 15%-37%); [3] phenotype C, 14% (95% CI, 12%-16%) versus 34% (95% CI, 25-46%); and [4] phenotype D, 17% (95% CI, 13%-22%) versus 19% (95% CI, 14%-25%). Differences between referral and unselected populations were statistically significant for phenotypes A, B, and C. Referral PCOS subjects had a greater mean body mass index (BMI) than local controls, a difference that was not apparent in unselected PCOS. CONCLUSION(S): The prevalence of more complete phenotypes in PCOS and mean BMI were higher in subjects identified in referral versus unselected populations, suggesting the presence of significant referral bias.
OBJECTIVE: To compare the prevalence of polycystic ovary syndrome (PCOS) phenotypes and obesity among patients detected in referral versus unselected populations. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Thirteen thousand seven hundred ninety-six reproductive-age patients with PCOS, as defined by the extended Rotterdam 2003 criteria. INTERVENTION(S): Review of PUBMED, EMBASE, and Cochrane Library, 2003-2016. Only observational studies were included. Data were extracted using a web-based, piloted form and combined for meta-analysis. MAIN OUTCOME MEASURE(S): PCOS phenotypes were classified as follows: phenotype A, clinical and/or biochemical hyperandrogenism (HA) + oligo-/anovulation (OA) + polycystic ovarian morphology (PCOM); phenotype B, HA+OA; phenotype C, HA+PCOM; and phenotype D, OA+PCOM. RESULT(S): Forty-one eligible studies, reporting on 43 populations, were identified. Pooled estimates of detected PCOS phenotype prevalence were consequently documented in referral versus unselected populations, as [1] phenotype A, 50% (95% confidence interval [CI], 46%-54%) versus 19% (95% CI, 13%-27%); [2] phenotype B, 13% (95% CI, 11%-17%) versus 25% (95% CI, 15%-37%); [3] phenotype C, 14% (95% CI, 12%-16%) versus 34% (95% CI, 25-46%); and [4] phenotype D, 17% (95% CI, 13%-22%) versus 19% (95% CI, 14%-25%). Differences between referral and unselected populations were statistically significant for phenotypes A, B, and C. Referral PCOS subjects had a greater mean body mass index (BMI) than local controls, a difference that was not apparent in unselected PCOS. CONCLUSION(S): The prevalence of more complete phenotypes in PCOS and mean BMI were higher in subjects identified in referral versus unselected populations, suggesting the presence of significant referral bias.
Authors: Qing Peng; Carrie A Karvonen-Gutierrez; John F Randolph; Bin Nan; Daniel McConnell; Siobán D Harlow Journal: J Clin Endocrinol Metab Date: 2019-05-01 Impact factor: 5.958
Authors: Carolyn E Cesta; Anna S Öberg; Abraham Ibrahimson; Ikram Yusuf; Henrik Larsson; Catarina Almqvist; Brian M D'Onofrio; Cynthia M Bulik; Lorena Fernández de la Cruz; David Mataix-Cols; Mikael Landén; Mina A Rosenqvist Journal: Psychol Med Date: 2019-03-12 Impact factor: 7.723
Authors: Brooke Tata; Nour El Houda Mimouni; Anne-Laure Barbotin; Samuel A Malone; Anne Loyens; Pascal Pigny; Didier Dewailly; Sophie Catteau-Jonard; Inger Sundström-Poromaa; Terhi T Piltonen; Federica Dal Bello; Claudio Medana; Vincent Prevot; Jerome Clasadonte; Paolo Giacobini Journal: Nat Med Date: 2018-05-14 Impact factor: 53.440