R Pasquali1,2, A Gambineri3. 1. University Alma Mater Studiorum of Bologna, Bologna, Italy. renato.pasquali@unibo.it. 2. , Via Santo Stefano 38, 40125, Bologna, Italy. renato.pasquali@unibo.it. 3. Unit of Endocrinology, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy.
Abstract
BACKGROUND: There is a growing debate on the opportunity of improving the understanding in the diagnosis and management of polycystic ovary syndrome (PCOS). OBJECTIVE: This review article summarizes recent research related to the definition of polycystic ovary syndrome (PCOS). METHODS: Review of the recent literature on the topic. RESULTS: New ideas on the definition of hyperandrogenism, based on new scientific data and clinical perspectives are presented. (i) In fact, recent studies have pointed out the need to improve the concept of androgen excess by using a larger androgen profile, rather than simply measuring the testosterone blood levels. (ii) Due to the poor correlation between androgen blood levels and the degree of hirsutism, it is proposed that the definition of hyperandrogenism should be based on the presence of blood androgen excess and hirsutism, considered separately, because their pathophysiological mechanisms may differ according to the different phenotypes of PCOS. (iii) The potential role of obesity in favoring the development of PCOS during adolescence is also discussed and the concept of "PCOS secondary to obesity" is developed. (iv) Finally, the need for greater appropriateness in the evaluation of possible coexistence is highlighted, in patients with PCOS who have fasting or glucose-stimulated very high insulin levels, or severe insulin-resistant states. CONCLUSIONS: Based on what was discussed in this review, we believe that there are margins for modifying some of the current criteria that define the various PCOS phenotypes.
BACKGROUND: There is a growing debate on the opportunity of improving the understanding in the diagnosis and management of polycystic ovary syndrome (PCOS). OBJECTIVE: This review article summarizes recent research related to the definition of polycystic ovary syndrome (PCOS). METHODS: Review of the recent literature on the topic. RESULTS: New ideas on the definition of hyperandrogenism, based on new scientific data and clinical perspectives are presented. (i) In fact, recent studies have pointed out the need to improve the concept of androgen excess by using a larger androgen profile, rather than simply measuring the testosterone blood levels. (ii) Due to the poor correlation between androgen blood levels and the degree of hirsutism, it is proposed that the definition of hyperandrogenism should be based on the presence of blood androgen excess and hirsutism, considered separately, because their pathophysiological mechanisms may differ according to the different phenotypes of PCOS. (iii) The potential role of obesity in favoring the development of PCOS during adolescence is also discussed and the concept of "PCOS secondary to obesity" is developed. (iv) Finally, the need for greater appropriateness in the evaluation of possible coexistence is highlighted, in patients with PCOS who have fasting or glucose-stimulated very high insulin levels, or severe insulin-resistant states. CONCLUSIONS: Based on what was discussed in this review, we believe that there are margins for modifying some of the current criteria that define the various PCOS phenotypes.
Authors: Christopher R McCartney; Susan K Blank; Kathleen A Prendergast; Sandhya Chhabra; Christine A Eagleson; Kristin D Helm; Richard Yoo; R Jeffrey Chang; Carol M Foster; Sonia Caprio; John C Marshall Journal: J Clin Endocrinol Metab Date: 2006-11-21 Impact factor: 5.958
Authors: Robert K Semple; David B Savage; Elaine K Cochran; Phillip Gorden; Stephen O'Rahilly Journal: Endocr Rev Date: 2011-05-02 Impact factor: 19.871
Authors: Stephen Franks; Lisa J Webber; Micaela Goh; Anne Valentine; Davinia M White; Gerard S Conway; Steven Wiltshire; Mark I McCarthy Journal: J Clin Endocrinol Metab Date: 2008-06-17 Impact factor: 5.958
Authors: S Taponen; S Ahonkallio; H Martikainen; R Koivunen; A Ruokonen; U Sovio; A-L Hartikainen; A Pouta; J Laitinen; V King; S Franks; M I McCarthy; M-R Järvelin Journal: Hum Reprod Date: 2004-03-25 Impact factor: 6.918
Authors: D Romualdi; V Versace; V Tagliaferri; S De Cicco; V Immediata; R Apa; M Guido; A Lanzone Journal: J Endocrinol Invest Date: 2019-03-07 Impact factor: 4.256
Authors: Z Esmaeilinezhad; R Barati-Boldaji; N R Brett; J O T de Zepetnek; N Bellissimo; S Babajafari; Z Sohrabi Journal: J Endocrinol Invest Date: 2019-11-11 Impact factor: 5.467