European Journal of Endocrinology www.eje-online.org © 2016 European Society of Endocrinology Printed in Great Britain Published by Bioscientifica Ltd. DOI: 10.1530/EJE-16-0373 www.eje-online.org © 2017 European Society of Endocrinology 176:2 R53–R65 D Glintborg and M Andersen Morbidity in PCOS European Journal of Endocrinology (2017) 176, R53–R65 MANAGEMENT OF ENDOCRINE DISEASE Morbidity in polycystic ovary syndrome Dorte Glintborg and Marianne Andersen Department of Endocrinology, Odense University Hospital, Odense C, Denmark Abstract Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition in premenopausal women. The syndrome is characterized by hyperandrogenism, irregular menses and polycystic ovaries when other etiologies are excluded. Obesity, insulin resistance and low vitamin D levels are present in more than 50% patients with PCOS, these factors along with hyperandrogenism could have adverse effects on long-term health. Hyperinfammation and impaired epithelial function were reported to a larger extent in women with PCOS and could particularly be associated with hyperandrogenism, obesity and insulin resistance. Available data from register-based and data linkage studies support that metabolic-vascular and thyroid diseases, asthma, migraine, depression and cancer are diagnosed more frequently in PCOS, whereas fracture risk is decreased. Drug prescriptions are signifcantly more common in PCOS than controls within all diagnose categories including antibiotics. The causal relationship between PCOS and autoimmune disease represents an interesting new area of research. PCOS is a lifelong condition and long-term morbidity could be worsened by obesity, sedentary way of life, Western-style diet and smoking, whereas lifestyle intervention including weight loss may partly or fully resolve the symptoms of PCOS and could improve the long-term prognosis. In this review, the possible implications of increased morbidity for the clinical and biochemical evaluation of patients with PCOS at diagnosis and follow-up is further discussed along with possible modifying effects of medical treatment. Review Correspondence should be addressed to D Glintborg Email dorte.glintborg@rsyd.dk Invited Author’s profile Dorte Glintborg MD, PhD, DMSc has been a medical doctor since 1999 and specialist in medical endocrinology since 2011. She is currently a consultant at Odense University Hospital, Department of Endocrinology within the specialist areas of pituitary, gonadal and adrenal diseases. She has also been an Associate professor at the University of Southern Denmark since June 2016. Professor Glintborg has been a member of the Nordic PCOS awareness Group and the Danish Endocrine Society. She has 66 published articles mainly within the research areas of PCOS, hirsutism, pituitary diseases and hypogonadism. Introduction The prevalence of polycystic ovary syndrome (PCOS) is more than 10% in reproductive-aged women when the Rotterdam criteria are applied (1). The Rotterdam criteria include irregular ovulation, biochemical/clinical hyperandrogenism, polycystic ovaries and the exclusion of other causes for the patient’s signs and symptoms (2). Approximately 75% patients with PCOS are overweight or obese and central obesity is present also in normal weight PCOS patients (3, 4). The pathogenesis of PCOS involves insulin resistance and hyperandrogenism. These two factors are associated with subclinical infammation, the meta- bolic syndrome, increased risk of type 2 diabetes (T2D) Downloaded from Bioscientifica.com at 05/30/2020 04:59:41AM via free access