Titre du document / Document title

Obesity and the polycystic ovary syndrome

Auteur(s) / Author(s)

GAMBINERI A. ⁽¹⁾ ; PELUSI C. ⁽¹⁾ ; VICENNATI V. ⁽¹⁾ ; PAGOTTO U. ⁽¹⁾ ; PASQUALI R. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Endocrinology Unit, Department of Internal Medicine, S. Qrsola-Malpighi Hospital, University Alma Mater Studiorum, Bologna, ITALIE

Résumé / Abstract

The polycystic ovary syndrome (PCOS) is a condition characterized by hyperandrogenism and chronic oligo-anovulation. However, many features of the metabolic syndrome are inconsistently present in the majority of women with PCOS. Approximately 50% of PCOS women are overweight or obese and most of them have the abdominal phenotype. Obesity may play a pathogenetic role in the development of the syndrome in susceptible individuals. In fact, insulin possesses true gonadotrophic function and an increased insulin availability at the level of ovarian tissue may favour excess androgen synthesis. Obesity, particularly the abdominal phenotype, may be partly responsible for insulin resistance and associated hyperinsulinemia in women with PCOS. Therefore, obesity-related hyperinsulinemia may play a key role in favouring hyperandrogenism in these women. Other factors such as increased estrogen production rate, increased activity of the opioid system and of the hypothalamic-pituitary-adrenal axis, decreased sex hormone binding globulin synthesis and, possibly, high dietary lipid intake, may be additional mechanisms by which obesity favours the development of hyperandrogenism in PCOS. Irrespective of the pathogenetic mechanism involved, obese PCOS women have more severe hyperandrogenism and related clinical features (such as hirsutism, menstrual abnormalities and anovulation) than normal-weight PCOS women. This picture tends to be more pronounced in obese PCOS women with the abdominal phenotype. Body weight loss is associated with beneficial effects on hormones, metabolism and clinical features. A further clinical and endocrinological improvement can also be achieved by adding insulin-sensitizing agents and/or antiandrogens to weight reduction programmes. These obviously emphasize the role of obesity in the pathophysiology of PCOS.

Revue / Journal Title

International journal of obesity   ISSN 0307-0565   CODEN IJOBDP 

Source / Source

2002, vol. 26, n^o7, pp. 883-896 (114 ref.)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing, Basingstoke, ROYAUME-UNI  (1977) (Revue)

Mots-clés anglais / English Keywords

Cyst ; Benign neoplasm ; Female sterility ; Ovarian diseases ; Female genital diseases ; Nutrition disorder ; Endocrinopathy ; Nutritional status ; Female ; Human ; Polycystic ovary ; Obesity ; Association ; Hyperandrogenism ;

Mots-clés français / French Keywords

Kyste ; Tumeur bénigne ; Stérilité femelle ; Ovaire pathologie ; Appareil génital femelle pathologie ; Trouble nutrition ; Endocrinopathie ; Etat nutritionnel ; Femelle ; Homme ; Ovaire polykystique ; Obésité ; Association ; Hyperandrogénie ;

Mots-clés espagnols / Spanish Keywords

Quiste ; Tumor benigno ; Esterilidad femenina ; Ovario patología ; Aparato genital hembra patología ; Trastorno nutricíon ; Endocrinopatía ; Estado nutricional ; Hembra ; Hombre ; Ovario poliquístico ; Obesidad ; Asociación ; Hiperandrogenismo ;

Localisation / Location

INIST-CNRS, Cote INIST : 18243, 35400010175389.0010