Emily W Gilbert1, Chau T Tay1,2, Danielle S Hiam3, Helena J Teede1,2, Lisa J Moran1,4. 1. Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia. 2. Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia. 3. Institute of Health, Exercise and Sport, Victoria University, Melbourne, Victoria, Australia. 4. Discipline of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting reproductive-aged women with adverse reproductive, metabolic and psychological outcomes. It has a complex pathophysiology and therefore requires a multidiscipline clinical approach. However, there remains limited research synthesizing the broad clinical implications of PCOS which would assist clinicians in the management of PCOS. OBJECTIVE: To summarize and appraise methodological quality of systematic reviews and meta-analyses evaluating complications and comorbidities associated with PCOS. METHODS: A literature search from MEDLINE, EMBASE, CINAHL PLUS and PROSPERO was performed until 15 September 2017. Article selection, data extraction and quality appraisal of included reviews using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool were performed in duplicate. A narrative synthesis of the findings was conducted. RESULTS: Twenty-three reviews were included. All reviews were of low (n = 2) to moderate quality (n = 21). PCOS was associated with adverse pregnancy outcomes (n = 2), impaired glucose tolerance (n = 6), insulin resistance (n = 6), increased risk of type 2 diabetes (n = 1), cardiovascular disease (n = 10), metabolic syndrome (n = 2), psychological stress (n = 7), endometrial cancer (n = 1) and vitamin D deficiency (n = 1). Obesity exacerbates many of these outcomes. CONCLUSIONS: There is a large body of reliable evidence for adverse metabolic outcomes and smaller, but consistent evidence for psychological issues in PCOS. We identified a shortage of systematic reviews regarding pregnancy outcomes of PCOS and significant gaps in knowledge of the association between PCOS and subclinical hyperthyroidism, vitamin D levels and cancers which future studies could aim to address.
BACKGROUND:Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting reproductive-aged women with adverse reproductive, metabolic and psychological outcomes. It has a complex pathophysiology and therefore requires a multidiscipline clinical approach. However, there remains limited research synthesizing the broad clinical implications of PCOS which would assist clinicians in the management of PCOS. OBJECTIVE: To summarize and appraise methodological quality of systematic reviews and meta-analyses evaluating complications and comorbidities associated with PCOS. METHODS: A literature search from MEDLINE, EMBASE, CINAHL PLUS and PROSPERO was performed until 15 September 2017. Article selection, data extraction and quality appraisal of included reviews using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool were performed in duplicate. A narrative synthesis of the findings was conducted. RESULTS: Twenty-three reviews were included. All reviews were of low (n = 2) to moderate quality (n = 21). PCOS was associated with adverse pregnancy outcomes (n = 2), impaired glucose tolerance (n = 6), insulin resistance (n = 6), increased risk of type 2 diabetes (n = 1), cardiovascular disease (n = 10), metabolic syndrome (n = 2), psychological stress (n = 7), endometrial cancer (n = 1) and vitamin D deficiency (n = 1). Obesity exacerbates many of these outcomes. CONCLUSIONS: There is a large body of reliable evidence for adverse metabolic outcomes and smaller, but consistent evidence for psychological issues in PCOS. We identified a shortage of systematic reviews regarding pregnancy outcomes of PCOS and significant gaps in knowledge of the association between PCOS and subclinical hyperthyroidism, vitamin D levels and cancers which future studies could aim to address.
Authors: Z Soyman; S Durmus; S Ates; G Simsek; V Sozer; B P Kundaktepe; D Kurtulus; R Gelisgen; V Sal; H Uzun Journal: Acta Endocrinol (Buchar) Date: 2022 Jan-Mar Impact factor: 1.104
Authors: Terhi T Piltonen; Maria Ruokojärvi; Helle Karro; Linda Kujanpää; Laure Morin-Papunen; Juha S Tapanainen; Elisabet Stener-Victorin; Inger Sundrström-Poromaa; Angelica L Hirschberg; Pernille Ravn; Dorte Glintborg; Jan Roar Mellembakken; Thora Steingrimsdottir; Melanie Gibson-Helm; Eszter Vanky; Marianne Andersen; Riikka K Arffman; Helena Teede; Kobra Falah-Hassani Journal: PLoS One Date: 2019-12-26 Impact factor: 3.240
Authors: Danielle Hiam; Alba Moreno-Asso; Helena J Teede; Joop S E Laven; Nigel K Stepto; Lisa J Moran; Melanie Gibson-Helm Journal: J Clin Med Date: 2019-10-03 Impact factor: 4.241