A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. Depression in women with polycystic ovary syndrome: clinical and biochemical correlates. A pilot study of the long-term effects of acipimox in polycystic ovarian syndrome. Trend in Obesity Prevalence in European Adult Cohort Populations during Follow-up since 1996 and Their Predictions to 2015 Overweight and obesity in Australia: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Insulin resistance and insulin secretory dysfunction are independent predictors of worsening of glucose tolerance during each stage of type 2 diabetes development. Weight, weight change, and coronary heart disease in women. Risk within the 'normal' weight range. The relationship between circulating androgens, obesity, and hyperinsulinemia on serum insulin-like growth factor binding protein-1 in the polycystic ovarian syndrome. Influence of body mass index on measured and calculated androgen parameters in adult women with Hirsutism and PCOS. Fasting serum insulin concentration and early insulin response as risk determinants for developing diabetes. Testosterone and visceral fat in midlife women: the Study of Women's Health Across the Nation (SWAN) fat patterning study. Hypothalamic-pituitary-adrenal axis sensitivity to opioids in women with polycystic ovary syndrome. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Weight characteristics and height in relation to risk of gestational diabetes mellitus. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus. Prospective studies of Pima Indians. The effects of spironolactone on testosterone fractions and sex-hormone binding globulin binding capacity in hirsute women Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome.
We prospect ively estimated the prevalence of the polycystic ovary syndrome ( PCOS ) , as defined by the NIH/NICHHD 1990 endocrine criteria , in a population of 154 Caucasian women of reproductive age reporting spontaneously for blood donation .  Anthropometric data ; the presence of hirsutism , acne , and and rogenic alopecia ; and the menstrual history were recorded by a single investigator . In 145 women , blood sample s were also obtained for measurement of serum and rogen levels .  PCOS was defined by the presence of 1 ) oligomenorrhea , 2 ) clinical and /or biochemical hyper and rogenism , and 3 ) exclusion of hyperprolactinemia , thyroid disorders , and nonclassic 21-hydroxylase deficiency . Hirsutism was defined by a modified Ferriman-Gallwey score of 8 or more , acne was considered as a sign of hyper and rogenism when persistent after the second decade of life , and hyper and rogenemia was defined by an increase in circulating testosterone or dehydroepi and rosterone sulfate or an increase in the free and rogen index above the 95th percentile of the control values derived from the nonhirsute , nonacneic women having regular menses who were not receiving hormonal therapy . PCOS was present in 10(6.5 % ) , hirsutism was present in 11 ( 7.1 % ) , and acne was present in 19 ( 12.3 % ) of the 154 women . Our results demonstrate a 6.5 % prevalence of PCOS , as defined , in a minimally biased population of Caucasian women from Spain . The polycystic ovary syndrome , hirsutism , and acne are common endocrine disorders in women Estimates of the prevalence of the polycystic ovary syndrome ( PCOS )  in the general population have ranged from 2 - 20 % . The vast majority of these reports have studied White population s in Europe , used limited definitions of the disorder , and /or used bias population s , such as those seeking medical care . To estimate the prevalence of this disorder in the United States and address these limitations , we prospect ively determined the prevalence of PCOS in a reproductive-aged population of 369 consecutive women ( 174 White and 195 Black ; aged 18 - 45 yr ) , examined at the time of their preemployment physical .  Body measures  were obtained , and body hair was quantified by a modified Ferriman-Gallwey ( F-G ) method . All exams were initially performed by 2 trained nurses , and any subject with an F-G score above 3 was reexamined by a physician , the same for all patients . Of the 369 women , 277 ( 75.1 % ) also agreed to complete a question naire and have additional blood drawn . Subjects were studied regardless of current estrogen/progestin hormonal use ( 28.5 % ) . PCOS was defined as 1 ) oligoovulation , 2 ) clinical hyper and rogenism ( i.e. hirsutism ) and /or hyper and rogenemia , and 3 ) exclusion of other related disorders , such as hyperprolactinemia , thyroid abnormalities , and non-classic adrenal hyperplasia . Hirsutism was defined by a F-G score of 6 or more , and hyper and rogenemia was defined as a total or free testosterone , and rostenedione , and /or dehydroepi and rosterone sulfate level above the 95th percentile of control values [ i.e. all eumenorrheic women in the study , who had no hirsutism ( F-G < or = 5 ) or acne and were receiving no hormonal therapy ; n = 98 ] . Considering all 369 women studied , White and Black women had similar mean ages ( 29.4 + /- 7.1 and 31.1 + /- 7.8 yr , respectively ) , although White women had a lesser body mass than Black women ( 24.9 + /- 6.1 vs. 29.2 + /- 8.1 kg/m2 , respectively ; P < 0.001 ) . Of these 7.6 % , 4.6 % , and 1.9 % demonstrated a F-G score of 6 or more , 8 or 10 , respectively , and there was no significant racial difference , with hirsutism prevalences of 8.0 % , 2.8 % , and 1.6 % in Whites , and 7.1 % , 6.1 % , and 2.1 % in Blacks , respectively . Of the 277 women consenting to a history and hormonal evaluation , 4.0 % had PCOS as defined , 4.7 % ( 6 of 129 ) of Whites and 3.4 % ( 5 of 148 ) of Blacks . In conclusion , in our consecutive population of unselected women the prevalence of hirsutism varied from 2 - 8 % depending on the chosen cut-off F-G score , with no significant difference between White and Black women . Using an F-G score of 6 or more as indicative of hirsutism , 3.4 % of Blacks and 4.7 % of Whites had PCOS as defined . These data suggest that PCOS may be one of most common reproductive endocrinological disorders of women BACKGROUND We assessed the prevalence of mood disturbance among women with prospect ively documented polycystic ovary syndrome ( PCOS ) . METHODS Thirty-two women with PCOS completed the Center for Epidemiological Studies -Depression Rating Scale ( CES-D ) . Clinical and biochemical characteristics were assessed . RESULTS Sixteen women had CES-D scores indicative of depression . Depression was associated with greater insulin resistance ( P=0.02 ) and higher body mass index ( P=0.05 ) . Women receiving oral contraceptives  for the treatment of PCOS were less depressed than patients not receiving treatment ( P=0.03 ) . LIMITATIONS Possible selection bias , use of a screening tool alone without further diagnostic evaluation of depression , small sample s size and lack of direct comparison with an age matched control group , should be considered in interpretation of these results . CONCLUSION Findings suggest a high prevalence of depression among women with PCOS , and an association between depression and PCOS markers BACKGROUND To evaluate the effects of long-term acipimox administration on glucose-induced insulin secretion and peripheral insulin sensitivity in polycystic ovarian syndrome ( PCOS ) , 20 PCOS subjects ( eight lean and 12 obese ) and 14 body mass index-matched controls ( seven lean and seven obese ) were investigated . METHODS Fasting blood sample s were collected for basal hormone and lipoprotein assays , after which patients underwent an oral glucose tolerance test ( OGTT ) . The following day a euglycaemic-hyperinsulinaemic clamp was performed . After 4 - 6 weeks of treatment with acipimox at a dose of 250 mg given orally three times a day , the patients repeated the study protocol . RESULTS No significant differences were found in the glucose , insulin or C-peptide responses to OGTT before and after anti-lipolytic drug administration in any group , nor was there any effect on insulin sensitivity . Concerning the lipid profile , acipimox administration led to a significant decrease of cholesterol and low-density lipoprotein levels in obese PCOS patients as well as in obese and lean controls . Lower triglycerides were found after the drug administration in both obese groups . Post-treatment free fatty acid levels were not significantly different when compared with basal values . CONCLUSIONS Acipimox does not appear to be an effective insulin-lowering drug in PCOS , even if it can be used in obese women with PCOS as an additional therapeutic agent to ameliorate the atherogenic lipid profile of the syndrome Objective To investigate trends in obesity prevalence in recent years and to predict the obesity prevalence in 2015 in European population s. Methods Data of 97 942 participants from seven cohorts involved in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study participating in the Diogenes project ( named as “ Diogenes cohort ” in the following ) with weight measurements at baseline and follow-up were used to predict future obesity prevalence with logistic linear and non-linear ( leveling off ) regression models . In addition , linear and leveling off models were fitted to the EPIC-Potsdam data set with five weight measures during the observation period to find out which of these two models might provide the more realistic prediction . Results During a mean follow-up period of 6 years , the obesity prevalence in the Diogenes cohort increased from 13 % to 17 % . The linear prediction model predicted an overall obesity prevalence of about 30 % in 2015 , whereas the leveling off model predicted a prevalence of about 20 % . In the EPIC-Potsdam cohort , the shape of obesity trend favors a leveling off model among men ( R2 = 0.98 ) , and a linear model among women ( R2 = 0.99 ) . Conclusion Our data show an increase in obesity prevalence since the 1990ies , and predictions by 2015 suggests a sizeable further increase in European population s. However , the estimates from the leveling off model were considerably lower OBJECTIVE To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors . DESIGN AusDiab , a cross-sectional study conducted between May 1999 and December 2000 , involved participants from 42 r and omly selected districts throughout Australia . PARTICIPANTS Of 20,347 eligible people aged > or = 25 years who completed a household interview , 11,247 attended the physical examination at local survey sites  ( response rate , 55 % ) . MAIN OUTCOME MEASURES Overweight and obesity defined by body mass index ( BMI ; kg/m(2 ) ) and waist circumference ( cm ) ; sociodemographic factors ( including smoking , physical activity and television viewing time ) . RESULTS The prevalence of overweight and obesity ( BMI > or = 25.0 kg/m(2 ) ; waist circumference > 80.0 cm [ women ] or > or = 94.0 cm [ men ] ) in both sexes was almost 60 % , defined by either BMI or waist circumference . The prevalence of obesity was 2.5 times higher than in 1980 . Using waist circumference , the prevalence of obesity was higher in women than men ( 34.1 % v 26.8 % ; P < 0.01 ) . Lower educational status , higher  television viewing time and lower physical activity time were each strongly associated with obesity , with television viewing time showing a stronger relationship than physical activity time . CONCLUSIONS The prevalence of obesity in Australia has more than doubled in the past 20 years . Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity , and underline the potential benefits of reducing sedentary behaviour , as well as increasing physical activity , to curb the obesity epidemic OBJECTIVE Although prospect i ve studies indicate that insulin resistance and insulin secretory dysfunction predict type 2 diabetes , they provide limited information on the relative contributions of both abnormalities to worsening glucose tolerance at different developmental stages of the disease . We therefore assessed the predictive effect of insulin resistance and insulin secretory dysfunction separately for the progression from normal glucose tolerance ( NGT ) to impaired glucose tolerance ( IGT ) and from IGT to diabetes . RESEARCH DESIGN AND METHODS  Insulin-stimulated glucose disposal ( M ) ( hyperinsulinemic clamp ) , acute insulin secretory response ( AIR ) ( 25-g intravenous glucose tolerance test ) , and body composition  ( hydrodensitometry or dual-energy X-ray absorptiometry ) were measured in 254 Pima Indians with NGT and in 145 Pima Indians with IGT , who were then followed for 0.5 - 13 years . RESULTS After follow-ups of 4.4 + /- 3.1 and 5.5 + /- 3.4 years , 79 ( 31 % ) of the subjects with initial NGT had developed IGT , and 64 ( 44 % ) of the subjects with initial IGT had developed diabetes . In proportional-hazards analyses with adjustment for age , sex , and percent body fat , low M and low AIR were independent predictors of both the progression from NGT to IGT ( relative hazards [ 95 % CI ] for 10th vs. 90th percentile : M 2.4 [ 1.2 - 4.7 ] , P < 0.02 ; AIR 2.1 [ 1.1 - 4.1 ] , P < 0.04 ) and from IGT to diabetes ( M 2.5 [ 1.3 - 5.0 ] , P < 0.01 ; AIR 1.8 [ 0.99 - 3.3 ] , P = 0.055 ) . CONCLUSIONS During each stage of the development of type 2 diabetes , insulin resistance and insulin secretory dysfunction are independent predictors of worsening glucose tolerance and are , therefore , both targets for the primary prevention of the disease OBJECTIVE --To assess the validity of the 1990 US weight guidelines for women that support a substantial gain in weight at approximately 35 years of age and recommend a range of body mass index ( BMI ) ( defined as weight in kilograms divided by the square of height in meters ) from 21 to 27 kg/m2 , in terms of coronary heart disease ( CHD ) risk in women . DESIGN -- Prospect i ve cohort study . SETTING --Female registered nurses in the United States . PARTICIPANTS --A total of 115,818 women aged 30 to 55 years in 1976 and without a history of previous CHD . MAIN OUTCOME MEASURE -- Incidence of CHD defined as nonfatal myocardial infa rct ion or fatal CHD . RESULTS --During 14 years of follow-up , 1292 cases of CHD were ascertained . After controlling for age , smoking , menopausal status , postmenopausal hormone use , and parental history of CHD and using as a reference women with a BMI of less than 21 kg/m2 , relative risks ( RRs ) and 95 % confidence intervals ( CIs ) for CHD were 1.19 ( 0.97 to 1.44 ) for a BMI of 21 to 22.9 kg/m2 , 1.46 ( 1.20 to 1.77 ) for a BMI of 23 to 24.9 kg/m2 , 2.06 ( 1.72 to 2.48 ) for a BMI of 25 to 28.9 kg/m2 , and 3.56 ( 2.96 to 4.29 ) for a BMI of 29 kg/m2 or more . Women who gained weight from 18 years of age were compared with those with stable weight ( + /- 5 kg ) in analyses that controlled for the same variables as well as BMI at 18 years of age . The RRs and CIs were 1.25 ( 1.01 to 1.55 ) for a 5- to 7.9-kg gain , 1.64 ( 1.33 to 2.04 ) for an 8- to 10.9-kg gain , 1.92 ( 1.61 to 2.29 ) for an 11- to 19-kg gain , and 2.65 ( 2.17 to 3.22 ) for a gain of 20 kg or more . Among women with the BMI range of 18 to 25 kg/m2 , weight gain after 18 years of age remained a strong predictor of CHD risk . CONCLUSIONS --Higher levels of body weight within the " normal " range , as well as modest weight gains after 18 years of age , appear to increase risks of CHD in middle-aged women . These data provide evidence that current US weight guidelines may be falsely reassuring to the large proportion of women older than 35 years who are within the current guidelines but have potentially avoidable risks of CHD OBJECTIVE Our purpose was to evaluate the relationship of obesity , hyperinsulinemia , and hyper and rogenemia on serum insulin-like growth factor binding protein-1 levels in women with the polycystic ovarian syndrome . STUDY DESIGN Insulin-like growth factor binding protein-1 , insulin , and and rogen levels were studied during a 3-hour intravenous glucose tolerance test in 16 women with polycystic ovarian syndrome ( nine obese and seven nonobese ) and 20 healthy control women ( 10 obese and 10 nonobese ) . RESULTS Positive correlations were observed between basal ( r = 0.77 , p = 0.04 ) and area under curve ( r = 0.86 , p < 0.001 ) insulin-like growth factor binding protein-1 with basal and rostenedione in the nonobese women with polycystic ovarian syndrome but not in other groups of women examined or between other and rogens and insulin-like growth factor binding protein-1 . An inverse relationship was observed between log area under curve insulin-like growth factor binding protein-1 levels and log body mass index in polycystic ovarian syndrome ( r = -0.54 , p = 0.03 ) and in normal women ( r = -0.43 , p = 0.06 ) . The log area under curve insulin-like growth factor binding protein-1 level was approximately an inverse linear function of log area under curve insulin response for both women with polycystic ovarian syndrome ( r = -0.70 , p < 0.001 ) and control women ( r = -0.72 , p < 0.001 ) . Additionally , after the area under curve insulin response during intravenous glucose tolerance testing was controlled for , the decline in area under curve insulin-like growth factor binding protein-1 responses was on average 66 % less in both obese and nonobese women with polycystic ovarian syndrome compared with same-weight controls ( 95 % confidence interval 110 % to 270 % , p = 0.04 ) . CONCLUSION These data indicate that insulin and body mass index are the major determinants of circulating insulin-like growth factor binding protein-1 and that chronic hyper and rogenemia does not appear to further reduce serum insulin-like growth factor binding protein-1 levels in obese or normal-weight women with polycystic ovarian syndrome There is growing evidence that obesity in women lead to a more severe form of hyper and rogenism and other endocrine abnormalities which may have some health implication s later in life . Obese females are at higher risk for metabolic syndrome due to severe hyper and rogenemia . Calculated values for free testosterone are equivalent to those obtained by equilibrium dialysis , which is one of the reference measurement procedures ( RMP ) for estimation of free testosterone and may be capable of replacing values estimated using RMP 's . For adult women correlations of body mass index ( BMI ) with calculated free ( cFT ) and bioavailable testosterone ( cBT ) are still rare , while these data are reported for peripubertal and adolescent girls . In this study we aim ed to investigate the association between BMI and different and rogen parameters ( including calculated free and bioavailable testosterone , free and rogen index , and sex hormone-binding globulin [ SHBG ] ) in adult women with Hirsutism and with PCOS . In hirsute women with BMI > or = 25 kg/m2 measured total testosterone ( TT ) was significantly higher , SHBG was significantly lower and the calculated and rogen parameter ( FAI , cFT and cBT ) were significantly higher compared to women with BMI < 25 kg/m2 . In PCOS women with BMI > or = 25 kg/m2 TT was significantly higher , SHBG was significantly lower and the calculated and rogen parameter ( FAI , cFT and cBT ) were also significantly higher compared to women with BMI < 25 kg/m2 . In both the Hirsutism and PCOS-group there was a positive correlation between BMI and TT , cFT , and cBT , while BMI was negatively correlated with SHBG . In summary , in adult women with Hirsutism and PCOS obesity is associated with increased levels of TT and decreased levels of SHBG result ing in significant elevated calculated free and bioavailable testosterone levels . Obesity might lead to a more severe form of hyper and rogenism with elevated calculated free and bioavailable testosterone in the study population Among a cohort of 348 women aged 50 on entering a 12-year prospect i ve study , the incidence of diabetes was increased ( 17.1 % ) during follow-up in those who initially had fasting glucose concentration above the upper quintile , a fasting serum insulin concentration above the upper quintile ( 14.9 % ) , a disappearance rate of glucose below the lowest quintile in an IV glucose tolerance test ( 12.7 % ) , or early insulin response below the lowest quintile ( 17.1 % ) . The incidence in all women was 4.9 % . By multivariate analysis , the highest risk was for high fasting serum insulin concentration . Obesity and treatment with antihypertensive drugs further increased the risk . An initial low early insulin response was not however a prerequisite for the development of manifest diabetes . Determination of fasting insulin concentration , especially in overweight hypertensive subjects , is of value in order to find out which subjects are at high risk of developing diabetes Visceral fat ( VF ) increases with the menopause and is an independent predictor of the metabolic syndrome , diabetes , and cardiovascular disease ( CVD ) in women . Little is known about how hormonal changes during the menopausal transition are related to the increase in VF . We aim ed to determine the relationship between bioavailable testosterone and VF in middle-aged women at various stages of the menopausal transition and whether this relationship is independent of age and other CVD risk factors . The Study of Women 's Health Across the Nation ( SWAN ) is a longitudinal , community-based study . This report uses baseline data from a population -based longitudinal ancillary study at the Chicago site to examine the cross-sectional relationship between testosterone and computed tomography (CT)-assessed VF  in women at different stages of the menopausal transition . Included are 359 women ( 47.2 % black ) , aged 42 - 60 years , who were r and omly selected from a complete community census in which a 72 % participation rate was achieved . In multivariate models , bioavailable testosterone was associated with VF independent of age , race , percent total body fat , and other cardiovascular risk factors . Bioavailable testosterone was a stronger predictor than estradiol and was interchangeable in its strength of association with sex hormone-binding globulin ( SHBG ) . As bioavailable testosterone was associated with VF even after adjusting for insulin resistance , this suggests that it plays an important role in regional fat distribution . Our findings may have direct implication s in explaining the effect of menopause-related testosterone predominance on VF accumulation and subsequent cardiovascular risk OBJECTIVE To evaluate the influence of the opioid system on the hypothalamic-pituitary-adrenal axis in women with polycystic ovary syndrome ( PCOS ) . DESIGN Controlled clinical study . SETTING Academic research environment . PATIENT(S ) Eight lean and 12 obese women with PCOS , and seven lean and 5 obese control subjects . INTERVENTION(S ) Each patient received an i.v . bolus of naloxone at a dose of 125 microgram per kilogram of body weight ; 48 hours later , each patient received 16 mg of loperamide p.o . MAIN OUTCOME MEASURE(S ) Sample s were collected for 2 hours for the naloxone test and for 3 hours for the loperamide test .  Levels of adrenocorticotropic hormone ( ACTH ) and cortisol were measured in all plasma sample s. RESULT ( S ) The obese women with PCOS had a greater ACTH and cortisol response to opiate blockade than either the lean women with PCOS or the control subjects , but there was no difference between the lean or obese control subjects and the lean women with PCOS . There was no difference in the responsiveness of the hypothalamic-pituitary-adrenal axis to loperamide between the PCOS and control groups . CONCLUSION ( S ) The data indicate that the sensitivity of the hypothalamic-pituitary-adrenal axis to opioids can not be altered in women with PCOS . However , abnormalities of the hypothalamic-pituitary-adrenal axis in women with PCOS could be central in origin , as suggested by the effects of naloxone administration , and probably are related to the anthropometric characteristics of these hyper and rogenic patients BACKGROUND Type 2 diabetes affects approximately 8 percent of adults in the United States . Some risk factors -- elevated plasma glucose concentrations in the fasting state and after an oral glucose load , overweight , and a sedentary lifestyle -- are potentially reversible . We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes . METHODS We r and omly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo , metformin ( 850 mg twice daily ) , or a lifestyle-modification program  with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week . The mean age of the participants was 51 years , and the mean body-mass index ( the weight in kilograms divided by the square of the height in meters ) was 34.0 ; 68 percent were women , and 45 percent were members of minority groups . RESULTS The average follow-up was 2.8 years . The incidence of diabetes was 11.0 , 7.8 , and 4.8 cases per 100 person-years in the placebo , metformin , and lifestyle groups , respectively . The lifestyle intervention reduced the incidence by 58 percent ( 95 percent confidence interval , 48 to 66 percent ) and metformin by 31 percent ( 95 percent confidence interval , 17 to 43 percent ) , as compared with placebo ; the lifestyle intervention was significantly more effective than metformin . To prevent one case of diabetes during a period of three years , 6.9 persons would have to participate in the lifestyle-intervention program , and 13.9 would have to receive metformin . CONCLUSIONS Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk . The lifestyle intervention was more effective than metformin Increasing prevalence of overweight and obesity motivated this prospect i ve examination of gestational diabetes mellitus in relation to self-reported adult height , weight , and weight fluctuation . Gestational diabetes was assessed by use of medical records in 1,644 women enrolled in Seattle and Tacoma , Washington , between 1996 and 2002 . After adjustment , risk was inversely related to height and directly related to pregravid body mass index ( p(trend ) < 0.001 ) . The relation with body mass index at age 18 years was J shaped , with higher risk among lean women ( adjusted relative risk ( RR ) = 1.79 , 95 % confidence interval ( CI ) : 1.01 , 2.84 ) and obese women ( RR = 4.53 , 95 % CI : 1.25 , 16.43 ) versus normal-weight women . Weight gain between age 18 years and the study pregnancy was associated with increased risk independently of body mass index at 18 years and other confounders ( > /=10-kg gain vs. < 2.5-kg change : RR = 3.43 , 95 % CI : 1.60 , 7.37 ) . Weight cycling ( loss and regain of > /=6.8 kg ) was not associated after adjustment for body mass index at 18 years and adult weight change ( > /=3 vs. zero cycles : RR = 1.23 , 95 % CI : 0.56 , 2.73 ) . Cycling was nonsignificantly related among women who gained 10 kg or more during adulthood ( > /=3 vs. zero cycles : RR = 2.04 , 95 % CI : 0.83 , 5.02 ) . Efforts to prevent obesity and weight gain among young women may reduce gestational diabetes risk Women with polycystic ovary syndrome ( PCOS ) are insulin resistant , have insulin secretory defects , and are at high risk for glucose intolerance . We performed this study to determine the prevalence of glucose intolerance and parameters associated with risk for this in PCOS women . Two-hundred and fifty-four PCOS women , aged 14 - 44 yr , were prospect ively evaluated at 2 centers , 1 urban and ethnically diverse ( n = 110 ) and 1 rural and ethnically homogeneous ( n = 144 ) . The rural PCOS women were compared to 80 control women of similar weight , ethnicity , and age . A 75-g oral glucose challenge was administered after a 3-day 300-g carbohydrate diet and an overnight fast with 0 and 2 h blood sample s for glucose levels .  Diabetes was categorized according to WHO criteria . The prevalence of glucose intolerance was 31.1 % impaired glucose intolerance ( IGT ) and 7.5 % diabetes . In nonobese PCOS women ( body mass index , < 27 kg/m2 ) , 10.3 % IGT and 1.5 % diabetes were found . The prevalence of glucose intolerance was significantly higher in PCOS vs. control women ( chi2 = 7.0 ; P = 0.01 ; odds ratio = 2.76 ; 95 % confidence interval = 1.23 - 6.57 ) . Variables most associated with postchallenge glucose levels were fasting glucose levels ( P < 0.0001 ) , PCOS status ( P = 0.002 ) , waist/hip ratio ( P = 0.01 ) , and body mass index ( P = 0.021 ) . The American Diabetes Association criteria applied to fasting glucose significantly underdiagnosed diabetes compared to the WHO criteria ( 3.2 % vs. 7.5 % ; chi2 = 4.7 ; P = 0.046 ; odds ratio = 2.48 ; 95 % confidence interval = 1.01 - 6.69 ) . We conclude that 1 ) PCOS women are at significantly increased risk for IGT and type 2 diabetes mellitus at all weights and at a young age ; 2 ) these prevalence rates are similar in 2 different population s of PCOS women , suggesting that PCOS may be a more important risk factor than ethnicity or race for glucose intolerance in young women ; and 3 ) the American Diabetes Association diabetes diagnostic criteria failed to detect a significant number of PCOS women with diabetes by postchallenge glucose values BACKGROUND The relative roles of obesity , insulin resistance , insulin secretory dysfunction , and excess hepatic glucose production in the development of non-insulin-dependent diabetes mellitus ( NIDDM ) are controversial . We conducted a prospect i ve study to determine which of these factors predicted the development of the disease in a group of Pima Indians . METHODS A body-composition assessment , oral and intravenous glucose-tolerance tests , and a hyperinsulinemic -- euglycemic clamp study were performed in 200 non-diabetic Pima Indians ( 87 women and 113 men ; mean [ + /- SD ] age , 26 + /- 6 years ) . The subjects were followed yearly thereafter for an average of 5.3 years . RESULTS Diabetes developed in 38 subjects during follow-up . Obesity , insulin resistance ( independent of obesity ) , and low acute plasma insulin response to intravenous glucose ( with the degree of obesity and insulin resistance taken into account ) were predictors of NIDDM : The six-year cumulative incidence of NIDDM was 39 percent in persons with values below the median for both insulin action and acute insulin response , 27 percent in those with values below the median for insulin action but above that for acute insulin response , 13 percent in those with values above the median for insulin action and below that for acute insulin response , and 0 in those with values originally above the median for both characteristics . CONCLUSIONS Insulin resistance is a major risk factor for the development of NIDDM : A low acute insulin response to glucose is an additional but weaker risk factor This study explored the effect of the anti- and rogen spironolactone on sex-hormone binding globulin ( SHBG ) and the distribution of circulating testosterone ( T ) into various free and bound fractions in seven women with hirsutism assessed before and then monthly for three months on a regimen of spironolactone , 100 mg bid as the sole therapeutic agent . Blood sample s were taken at each assessment time for a battery of and rogen parameters and serum T fractions studies . None of the women were judged obese based upon body mass index values . After three months of spironolactone therapy , there was little change in the hirsutism index , and measurement of serum T , and rostenedione , DHEA-S and 17ß-estradiol showed no significant changes , the same occurring with SHBG-binding capacity . However , there was a shift in the distribution of circulating T , with a decrease in SHBG-bound T and an increase in albumin-bound and free T ( non-SHBG-bound fractions ) . As previous reports suggest that non-SHBG-bound fractions represent bioavailable fractions , the current data suggests that T fraction studies may not be clinical ly useful parameters of hyper and rogenism in women receiving anti and rogen therapy OBJECTIVE To assess the impact of adding exercise to dietary restriction on depressive symptoms and health-related quality of life ( HRQOL ) in women with polycystic ovary syndrome ( PCOS ) . DESIGN Analysis of depression and quality of life outcomes from a r and omized , controlled prospect i ve clinical intervention that evaluated the effects on a range of health outcomes in women with PCOS . SETTING Clinical research unit . PATIENT(S ) One hundred four overweight/obese PCOS women ( aged 29.3 ± 0.7 years ; body mass index [ BMI ] 36.1 ± 0.5 kg/m(2 ) ) . INTERVENTION(S ) R and omized to one of three 20-week lifestyle programs : diet only , diet and aerobic exercise , or diet and combined aerobic-resistance exercise . MAIN OUTCOME MEASURE(S ) Depression and PCOS-specific HRQOL . RESULT ( S ) Forty-nine women completed the intervention ( diet only = 14 , diet and aerobic exercise = 15 , diet and combined aerobic-resistance exercise = 20 ) . By week 20 all groups achieved weight loss and had improvements in depression and PCOS-specific HRQOL scores , except for body hair domain score . There was no difference between treatments for all outcomes . CONCLUSION ( S ) This study demonstrated that dietary restriction alone and combined with exercise had similar benefits for improving depression and HRQOL scores in overweight and obese women with PCOS
While many women with polycystic ovary syndrome ( PCOS ) are overweight , obese or central ly obese , the effect of excess weight on the outcomes of PCOS is inconsistent .
The review aim ed to assess the effects of overweight , obesity and central obesity on the reproductive , metabolic and psychological features of PCOS .