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Hyperandrogenism, Polycystic Ovarian Disease

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Pan Vascular Medicine

Abstract

Stein and Leventhal originally described polycystic ovarian disease (PCOD) as characterized by enlarged, polycystic ovaries [1]. It is now known to be associated with a variety of pathological findings, the most common of which is a white, smooth, sclerotic ovary with a thickened capsule, multi-follicular cysts in various stages of atresia, a hyperplastic theca and stroma, and rare or absent corpora albicans. PCOD is further characterized by hyperandrogenism, anovulation, a substantially increased incidence of type 2 diabetes mellitus and insulin resistance, and coronary artery disease in midadult life.

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References

  1. Stein IF, Leventhal ML (1935) Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 29:181

    Google Scholar 

  2. Clayton RN, Ogden V, Hodgkinson J, et al (1992) How common are polycystic ovaries in normal women and what is their significance for the fertility of the population? Clin Endocrinol (Oxf) 37:127–134

    Article  CAS  Google Scholar 

  3. Farquar CM, Birdsall M, Manning P, et al (1994) The prevalence of polycystic ovaries on ultrasound scanning in a population of randomly selected women. Aust NZ J Obstet Gynecol 34:67–72

    Article  Google Scholar 

  4. Poison DW, Adams J, Wadsworth J, et al (1988) Polycystic ovaries — a common finding in normal women. Lancet 1:870–872

    Google Scholar 

  5. Petterson F, Fries H, Nillius SJ (1973) Epidemiology of secondary amenorrhoea. Am J Obstet Gynecol 117:80–86

    Google Scholar 

  6. Solomon CG, Rich-Edwards JW, Dunaif A, et al (1998) Abnormal menstrual cycle length predicts subsequent non-insulin-dependent diabetes mellitus. Am J Epidemiol 11 [Suppl]:S237

    Google Scholar 

  7. Roumain J, Charles MA, de Courten MP et al (1998) The relationship of menstrual irregularities to type 2 diabetes in Pima Indian women. Diabetes Care 21:346–349

    Article  CAS  PubMed  Google Scholar 

  8. Diamanti-Kandarakis E, Kouli C, Tsianateli T, et al (1997) A survey of PCOS in a Greek population. 79th annual meeting of the Endocrine Society, Minneapolis, MN

    Google Scholar 

  9. Knochenhauer ES, Key TJ, Kahsar-Miller M, et al (1998) Prevalence of the polycystic ovary syndrome in unselected black and white women of Southeastern United States: a prospective study. J Clin Endocrinol Metab 83:3078–3082

    Article  CAS  PubMed  Google Scholar 

  10. Bonadonna RC (1999) Insulin as a vascular hormone. Pract Diabetes Int 16 [Suppl]:S15-S18

    Google Scholar 

  11. Stehouwer CDA (1999) Insulin resistance and hypertension. Pract Diabetes Int 16 [Suppl]:S19-S21

    Article  Google Scholar 

  12. Dunaif A (1999) Insulin action in the polycystic ovary syndrome. Endocrinol Metab Clin North Am 28:341–359

    Article  CAS  PubMed  Google Scholar 

  13. Kissebah AH, Peiris AN (1989) Biology of regional fat distribution. Relationship to non-insulin-dependent diabetes mellitus. Diabet Metab Rev 5:83–109

    Article  CAS  Google Scholar 

  14. Dunaif A, Futterweit W, Segal KR, et al (1992) Evidence for distinctive and intrinsic defects in insulin action in polycystic ovary syndrome. Diabetes 41:1257–1266

    Article  CAS  PubMed  Google Scholar 

  15. Dunaif A, Futterweit W, Segal KR, et al (1989) Profound peripheral insulin resistance, independent of obesity in polycystic ovary syndrome. Diabetes 38:1165–1174

    Article  CAS  PubMed  Google Scholar 

  16. Holte J, Bergh T, Berne C, et al (1995) Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 80:2586–2593

    Article  CAS  PubMed  Google Scholar 

  17. Dunaif A, Finegood DT (1996) B-Cell dysfunction independent of obesity and glucose tolerance in polycystic ovary syndrome. J Clin Endocrinol Metab 81:949–947

    Google Scholar 

  18. Ehrmann DA, Sturis J, Byrne NM, et al (1995) Insulin secretory defects in polycystic ovary syndrome. Relationship to insulin sensitivity and family history of known insulin-dependent diabetes mellitus. J Clin Invest 95:520–527

    Article  Google Scholar 

  19. Polderman KH, Gooren JG, Asscherman H, et al (1994) Induction of insulin resistance by androgens and estrogens. J Clin Endocrinol Metab 79:265–271

    Article  CAS  PubMed  Google Scholar 

  20. Willis D, Mason H, Gilling-Smith C, et al (1996) Modulation by insulin of follicle-stimulating and luteinizing hormone action in human granulosa cells of normal and polycystic ovaries. J Clin Endocrinol Metab 81:302–309

    Article  CAS  PubMed  Google Scholar 

  21. Amowitz LL, Sobel BE (1999) Cardiovascular consequences of polycystic ovary syndrome. Endocrinol Metab Clin North Am 28:439–458

    Article  CAS  PubMed  Google Scholar 

  22. Dahlgren E, Johansson S, Lindstedt G, et al (1992) Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focussing on natural history and circulating hormones. Fertil Steril 57:505

    CAS  PubMed  Google Scholar 

  23. Role of insulin resistance in human disease (1988) Banting lecture 1988. Diabetes 37:1595

    Article  Google Scholar 

  24. Wild RA (1997) Metabolic aspects of polycystic ovary syndrome. Semin Reprod Endocrinol 15:105

    Article  CAS  PubMed  Google Scholar 

  25. Graf MJ, Richards CJ, Brown V, et al (1990) The independent effects of hyperandrogenaemia, hyperinsulinaemia and obesity on lipid and lipoprotein profiles in women. Clin Endocrinol (Oxf) 33: 119

    Article  CAS  Google Scholar 

  26. Manson JE, Colditz GA, Stampfer MJ, et al (1996) A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 322:882

    Article  Google Scholar 

  27. Rich-Edwards JW, Manson JE, Hennekens CH, et al (1995) The primary prevention of coronary heart disease in women. N Engl J Med 332:1758

    Article  CAS  PubMed  Google Scholar 

  28. Pasquale R, Casmirri F (1994) Body fat distribution has weight-independent effects on clinical, hormonal and metabolic features in women with polycystic ovary syndrome. Metabolism 43:706

    Article  Google Scholar 

  29. Talbott EO, Guzick DS, Clerici A, et al (1995) Coronary heart disease risk factors in women with polycystic ovary syndrome. Atheroscler Thromb Vasc Biol 15:821

    Article  CAS  Google Scholar 

  30. Wenger NK, Speroff L, Packard B (1993) Cardiovascular health and disease in women. N Engl J Med 329:247

    Article  CAS  PubMed  Google Scholar 

  31. Guzick DS, Talbott EO, Sutton-Tyrell K, et al (1994) Carotid atherosclerosis in women with polycystic ovary syndrome: initial results from a case control study. Am J Obstet Gynecol 74:1224

    Google Scholar 

  32. Myrup B, Rossing P, Jensen T, et al (1995) Procoagulant activity and intimal dysfunction in IDDM. Diabetologia 38:73

    Article  CAS  PubMed  Google Scholar 

  33. Kannel WB, D’Agostino RB, Wilson PWF, et al (1990) Fibrinogen and the risk of cardiovascular disease: the Framingham experience. Am Heart J 120:672

    Article  CAS  PubMed  Google Scholar 

  34. Schneider DJ, Ricci MA, Taatjes DJ, et al (1997) Changes in arterial expression of fibrinolytic system proteins in atherogenesis. Arterioscler Thromb Vasc Biol 17:3294

    Article  CAS  PubMed  Google Scholar 

  35. Sobel BE, Woodcock-Mitchell J, Schneider DJ (1998) Increased plasminogen activator inhibitor type 1 in coronary artery atherectomy specimens from type 2 diabetics compared with nondiabetic patients. A potential factor predisposing to thrombosis and its persistence. Circulation 97:2213

    Article  CAS  PubMed  Google Scholar 

  36. Culiner A, Shippel S (1949) Virilism and theca cell hyperplasia of the ovary syndrome. J Obstet Gynaecol Br Commonw 56:439

    Article  CAS  Google Scholar 

  37. Chang RJ, Katz SE (1999) Diagnosis of polycystic ovary syndrome. Endocrinol Metab Clin North Am 28:397–408

    Article  CAS  PubMed  Google Scholar 

  38. DeFronzo R, Brazilai N, Simonson D (1991) Mechanisms of metformin action in obese and lean non-insulin-dependent diabetic subjects. J Clin Endocrinol Metab 73:1294–1301

    Article  CAS  PubMed  Google Scholar 

  39. Fantus I, Brosseau R (1986) Mechanism of action of metformin: insulin receptor and post receptor effects in vitro and in vivo. J Clin Endocrinol Metab 63:898–905

    Article  CAS  PubMed  Google Scholar 

  40. Jackson R; Hawa M, Jaspan J (1987) Mechanism of metformin action in non-insulin-dependent diabetes. Diabetes 36:632–640

    Article  CAS  PubMed  Google Scholar 

  41. Saltiel A, Olefsky J (1996) Thiazolidinediones in the treatment of insulin resistance and type 2 diabetes. Diabetes 45:1661–1669

    Article  CAS  PubMed  Google Scholar 

  42. Ehrmann DA (1999) Insulin-lowering therapeutic modalities for polycystic ovary syndrome. Endocrinol Metab Clin North Am 28:423–438

    Article  CAS  PubMed  Google Scholar 

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© 2002 Springer-Verlag Berlin Heidelberg

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Sathiavageeswaran, M., Wass, J.A.H. (2002). Hyperandrogenism, Polycystic Ovarian Disease. In: Lanzer, P., Topol, E.J. (eds) Pan Vascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56225-9_121

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  • DOI: https://doi.org/10.1007/978-3-642-56225-9_121

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62565-7

  • Online ISBN: 978-3-642-56225-9

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