Endocrinology and Metabolism

Review Article

Obesity and Metabolism
An Update on Contraception in Polycystic Ovary Syndrome: Seda Hanife Oguz, Bulent Okan Yildiz; Endocrinol Metab. 2021;36(2):296-311. Published online April 15, 2021; DOI: https://doi.org/10.3803/EnM.2021.958

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Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, characterized by hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology. Combined oral contraceptives (COCs), along with lifestyle modifications, represent the first-line medical treatment for the long-term management of PCOS. Containing low doses of estrogen and different types of progestin, COCs restore menstrual cyclicity, improve hyperandrogenism, and provide additional benefits such as reducing the risk of endometrial cancer. However, potential cardiometabolic risk associated with these agents has been a concern. COCs increase the risk of venous thromboembolism (VTE), related both to the dose of estrogen and the type of progestin involved. Arterial thrombotic events related to COC use occur much less frequently, and usually not a concern for young patients. All patients diagnosed with PCOS should be carefully evaluated for cardiometabolic risk factors at baseline, before initiating a COC. Age, smoking, obesity, glucose intolerance or diabetes, hypertension, dyslipidemia, thrombophilia, and family history of VTE should be recorded. Patients should be re-assessed at consecutive visits, more closely if any baseline cardiometabolic risk factor is present. Individual risk assessment is the key in order to avoid unfavorable outcomes related to COC use in women with PCOS.

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Nafiye Helvaci, Bulent Okan Yildiz
Expert Opinion on Pharmacotherapy.2023; 24(1): 105. CrossRef
Weighted Gene Co-Expression Network Analysis (WGCNA) Discovered Novel Long Non-Coding RNAs for Polycystic Ovary Syndrome
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Contemporary Management of the Patient with Polycystic Ovary Syndrome
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Original Articles

Clinical Study
The Modified Ferriman-Gallwey Score and Hirsutism among Filipino Women: Ma. Karen Celine C. Ilagan, Elizabeth Paz-Pacheco, Darwin Z. Totesora, Lyra Ruth Clemente-Chua, Jundelle Romulo K. Jalique; Endocrinol Metab. 2019;34(4):374-381. Published online December 23, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.4.374

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Background

The modified Ferriman-Gallwey (mFG) score is the gold standard for the clinical evaluation of hirsutism. However, racial variations in terminal hair growth limit this tool. This study aimed to determine the mFG cut-off score among Filipino women and its association with biochemical hyperandrogenism.

Methods

A total of 128 Filipino women were included in this prospective cross-sectional study and were divided into two groups: a polycystic ovary syndrome (PCOS) group (n=28) and a non-PCOS group (n=100). The participants underwent mFG score determination, ovarian ultrasound conducted by a single sonographer, and hormone testing. The mFG cut-off score was determined based on the 95th percentile of the non-PCOS group. Logistic regression was used to analyze the relationship between mFG score and biochemical hyperandrogenism.

Results

Although the mFG score was generally low in both the PCOS and non-PCOS groups, the former exhibited a higher mean score than the latter (4.3±3.0 vs. 2.0±2.2, P<0.001). Normal values for the total mFG score ranged from 0 to 7. Using a cut-off score of 7, a higher proportion of hirsute women (mFG score ≥7) was observed in the PCOS group versus the non-PCOS group (17.9% vs. 5.0%, P=0.025). Elevated calculated free testosterone (FT) was also found to be significantly associated with hirsutism (odds ratio, 6.2; 95% confidence interval, 1.2 to 32.4 pmol/L; P=0.030).

Conclusion

A score of 7 and above constitutes hirsutism in this population of Filipino women. Hirsute women are more likely than non-hirsute women to have elevated calculated FT.

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Indian Journal of Clinical Biochemistry.2023; 38(2): 231. CrossRef
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Free-androgen Index in Women with Polycystic Ovarian Syndrome: A Meta-Analysis
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Obesity and Metabolism
Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam: Minh Tam Le, Vu Quoc Huy Nguyen, Quang Vinh Truong, Dinh Duong Le, Viet Nguyen Sa Le, Ngoc Thanh Cao; Endocrinol Metab. 2018;33(4):447-458. Published online November 30, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.4.447

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Background

Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS.

Methods

A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression.

Results

The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-Müllerian hormone levels increased the risk of IRS, but not that of MS.

Conclusion

MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.

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Mohammed A. Abdalla, Najeeb Shah, Harshal Deshmukh, Amirhossein Sahebkar, Linda Östlundh, Rami H. Al‐Rifai, Stephen L. Atkin, Thozhukat Sathyapalan
Clinical Endocrinology.2022; 96(4): 443. CrossRef
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Obesity and Metabolism
Correlation between Expression of Glucose Transporters in Granulosa Cells and Oocyte Quality in Women with Polycystic Ovary Syndrome: Eunju Kim, Hyun Ha Seok, Su-Yeon Lee, Dong Ryul Lee, Jisook Moon, Tae Ki Yoon, Woo Sik Lee, Kyung-Ah Lee; Endocrinol Metab. 2014;29(1):40-47. Published online March 14, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.1.40

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Background

The glucose transporters (GLUTs) exhibit different tissue-specific expression. This study aimed to investigate the types of GLUTs expressed in human granulosa cells (GCs) obtained from women with polycystic ovary syndrome (PCOS) and their relationship with insulin resistance (IR) and the outcomes of in vitro maturation (IVM) of immature oocytes.

Methods

Expression of GLUTs was evaluated in GCs from women with PCOS with or without IR. Thirty-six women with PCOS undergoing an IVM program were included. Differential gene expression between the insulin sensitive (IS) and IR group was measured by reverse transcription polymerase chain reaction.

Results

Expression of GLUTs 1, 3, 5, 8, and 13 was constitutive, whereas expression of GLUTs 2 and 7 was not observed in human GCs. The remaining GLUTs, 4, 6, 9, 10, 11, and 12, were differentially expressed among patients according to metabolic status, such as insulin sensitivity. A higher number of GCs from patients with IR (92%) expressed GLUT6 than GCs from IS PCOS patients (46.3%). Logistic regression showed that expression of GLUTs 9, 11, and 12 correlates with rates of IVM at 48 hours, fertilization, and implantation, respectively.

Conclusion

This is the first report describing the expression pattern of all 13 members of the GLUT family in human GCs. Results of the present study suggest that patients' insulin sensitivity regulates GLUT expression in GCs in PCOS patients, and this may control oocyte quality for IVM and subsequent processes such as fertilization and implantation in patients taking part in an in vitro fertilization program.

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Review Articles

Reproduction and Metabolism: Insights from Polycystic Ovary Syndrome.: Prathima Jasti, Andrea Dunaif; Endocrinol Metab. 2012;27(3):180-190. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.180

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Abstract PDF

Until the 1980s, polycystic ovary syndrome (PCOS) was considered to be a poorly defined reproductive disorder. During that decade, it was recognized that PCOS was associated with profound insulin resistance and a substantially increased risk for type 2 diabetes mellitus in young women. Accordingly, the mechanisms linking the reproductive and metabolic features of the syndrome became the subject of intense investigation. Insulin is now recognized as a reproductive as well as a metabolic hormone and insulin signaling in the central nervous system participates in normal reproductive function. These insights have been directly translated into a novel therapy for PCOS with insulin sensitizing drugs. Androgens also have reversible metabolic actions to decrease insulin sensitivity and increase visceral fat. Prenatal androgen administration to non-human primates, sheep and rodents produces reproductive and metabolic features of PCOS suggesting that the disorder also has developmental origins. PCOS is highly heritable and male as well as female relatives have reproductive and metabolic phenotypes. A number of confirmed genetic susceptibility loci have now been mapped for PCOS and genes in well-known as well as novel biologic pathways have been implicated in disease pathogenesis.

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Young Suk Choi, Joo Eun Song, Byung Soo Kong, Jae Won Hong, Silvia Novelli, Eun Jig Lee
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Polycystic Ovary Syndrome in Korean Women: Clinical Characteristics and Diagnostic Criteria.: Yeon Ah Sung; Endocrinol Metab. 2011;26(3):203-207. Published online September 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.3.203

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Abstract PDF

Polycystic ovary syndrome (PCOS) is a common disorder of premenopausal women, affecting 4 to 8% of this population. Diagnosis of PCOS lays on a combination of clinical, biological and ultrasound criteria that has been used variably worldwide. The phenotype of women with PCOS is variable depending on ethnic background and diagnostic criteria may rely on it. Fewer studies have extensively examined reproductive and metabolic characteristics and hyperandrogenism in Korean women. Despite the paucity of these studies, they are critical for the ascertainment of criteria for the diagnosis of PCOS. This review address the issues pertaining to diagnostic issues of PCOS in Korean women, specifically: reproductive and metabolic derangements and criteria for hyperandrogenism based on hirsutism and serum androgen concentrations. The prevalence (estimated) of PCOS in Korean women was 5.8%. To diagnose PCOS, the cut off value for hirsutism needs to be differently adjusted in Korean women. Regarding phenotypic characteristics of PCOS in Korean women, the various phenotypes of PCOS have the different overall morbidity (e.g. insulin resistance and hyperinsulinism, abnormal glucose metabolism and metabolic syndrome). Especially patients with oligomenorrhea/polycystic ovary and hyperandrogenism/polycystic ovary did not seem to have metabolic derangements. Thus these subgroups need to be determined if they can be classified as PCOS.

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Original Articles

Gly1057Asp Polymorphism of the Insulin Receptor Substrate-2 Genes May Not Have a Significant Impact on Insulin Resistance in Korean Women with Polycystic Ovary Syndrome.: Ji Young Oh, Jee Young Oh, Yeon Ah Sung, Hye Jin Lee, Hye Won Chung; J Korean Endocr Soc. 2009;24(2):100-108. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.100

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Abstract PDF

BACKGROUND
Insulin resistance is a key factor in the pathogenesis of polycystic ovary syndrome (PCOS), and several candidate genes involved in insulin action such as insulin receptor or insulin recpetor substrate (IRS) have been investigated. In this study, we examined the genetic effects of the IRS-1 and IRS-2 genes on the metabolic and reproductive features in women with PCOS. METHODS: 125 patients with PCOS and 344 regular cycling controls were enrolled. Analysis of the polymorphisms of Gly972Arg in the IRS-1 gene and Gly1057Asp in the IRS-2 gene was performed and oral glucose tolerance tests and hyperinsulinemic euglycemic clamp tests were done. RESULTS: The genotype frequencies of the Gly972Arg polymorphism in the IRS-1 gene and the Gly1057Asp polymorphism in the IRS-2 gene were not significantly different between the women with PCOS and the controls. Gly972Arg polymorphism of the IRS-1 gene was extremely rare in both groups. PCOS women with the IRS-2 Asp1057Asp genotype showed significantly higher hirsutism scores, higher levels of free testosterone and higher post-load 60, 90, and 120 min plasma glucose levels compared to those women with the Gly1057Gly or Gly1057Asp genotype. In contrast, the control women with the Asp1057Asp genotype showed significantly lower post-load 60, 90, and 120 min plasma glucose levels compared with those women with the Gly1057Gly or Gly1057Asp genotype. CONCLUSION: Gly972Arg polymorphism of the IRS-1 gene was extremely rare in Korean women. Gly1057Asp polymorphism of the IRS-2 gene was associated with the phenotypic features of PCOS such as hirsutism, hyperandrogenemia and hyperglycemia, but it was not associated with the insulin sensitivity index. In conclusion, Gly1057Asp polymorphism of the IRS-2 gene may not have a significant impact on insulin resistance in Korean women with PCOS.

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Insulin Receptor Substrate 1 Gly972Arg (rs1801278) Polymorphism Is Associated with Obesity and Insulin Resistance in Kashmiri Women with Polycystic Ovary Syndrome
Shayaq Ul Abeer Rasool, Mudasar Nabi, Sairish Ashraf, Shajrul Amin
Genes.2022; 13(8): 1463. CrossRef

Calpain-10 Polymorphism in Korean Women with Polycystic Ovary Syndrome.: Hye jin Lee, Gun Woo Pyun, Eun Kyung Byun, Ji Young Oh, Jee Young Oh, Youngsun Hong, Yeon Ah Sung, Hye Won Chung; J Korean Endocr Soc. 2008;23(5):319-326. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.319

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Abstract PDF

BACKGROUND
Polycystic ovary syndrome (PCOS) is characterized by chronic anovulation, hyperandrogenism and insulin resistance, and PCOS is known to be associated with an increased risk of type 2 diabetes mellitus (DM). PCOS has also been proposed to share a common genetic background with type 2 DM. The calpain 10 (CAPN10) gene is known to be associated with type 2 DM in several different population. We examined the association of CAPN10 gene polymorphisms and their influence on the metabolic abnormalities in Korean women who suffer with PCOS. METHODS: One hundred sixty four women with PCOS and 325 control women were studied. The CAPN10 gene polymorphisms were genotyped by amplifying the genomic DNA. Anthropometric measures, a 75g oral glucose tolerance test and measurement of insulin sensitivity by the euglycemic hyperinsulinemic clamp technique were performed. RESULTS: The frequencies of CAPN10 UCSNP-43, UCSNP-19, UCSNP-63 and the haplotype combinations were not different between the women with PCOS and the control subjects. In the women with PCOS and who had the UCSNP-43 GA genotype, the post-load 90 minute plasma glucose level was significantly greater and the HDL cholesterol and insulin mediated glucose uptake were significantly lower compared to the women with PCOS and who had the GG genotype. CONCLUSION: The CAPN10 UCSNP-43 genotype might be responsible for insulin resistance, yet further study is required to confirm the role of this genetic polymorphism in the development of PCOS and the presentation of its disease features.

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Comments on the latest meta-analysis of CAPN10 polymorphism associations with polycystic ovary syndrome
Sidra Raihan, Dawood Shariff, Sami Bizzari
Gene.2019; 717: 144006. CrossRef

Phenotypic Variation of Polycystic Ovary Syndrome.: Gun Woo Pyun, Young Ju Choi, Hyejin Lee, Jee Young Oh, Young Sun Hong, Yeon Ah Sung, Hye Won Chung; J Korean Endocr Soc. 2007;22(5):326-331. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.326

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Abstract PDF

BACKGROUND
Polycystic ovary syndrome (PCOS) is a common disorder in premenopausal women, but there has been little agreement on its diagnostic criteria due to its uncertain pathogenesis and the heterogeneity of symptoms. This study was performed in order to assess the differences in clinical, metabolic, and hormonal characteristics of women in the PCOS subgroups defined by ESHRE criteria. METHODS: Subjects were divided into four PCOS subgroups based on ESHRE criteria. The grouping groupings included: 1) hyperandrogenism, oligomenorrhea, and polycystic ovary morphology (HA + OM + PCO); 2) hyperandrogenism and oligomenorrhea (HA + OM); 3) hyperandrogenism and polycystic ovary morphology (HA + PCO); and 4) oligomenorrhea and polycystic ovary morphology (OM + PCO). Reproductive hormones and metabolic profiles were measured. RESULTS: Of the total number of subjects, 60 (40%) fulfilled the criteria for HA + OM + PCO, 50 (33%) for HA + OM, 11 (7%) for HA + PCO, and 30 (20%) for OM + PCO. There were no significant differences in clinical or metabolic features among the groups, except for LH, total cholesterol, and HDL cholesterol. CONCLUSION: In this population defined by ESHRE criteria, 73% of the patients met the former NIH definition for PCOS. Different phenotypes of PCOS cases were clinically or biochemically similar. Whether these women have an increased risk of infertility or metabolic complications remains to be determine.

Citations

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Epidemiology and Diagnostic Criteria of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-Ah Sung
The Journal of Korean Diabetes.2015; 16(3): 189. CrossRef
Hyperandrogenism in Women: Polycystic Ovary Syndrome
Yeon-Ah Sung
Hanyang Medical Reviews.2012; 32(4): 197. CrossRef
Polycystic Ovary Syndrome in Korean Women: Clinical Characteristics and Diagnostic Criteria
Yeon-Ah Sung
Endocrinology and Metabolism.2011; 26(3): 203. CrossRef
Clinical Manifestation of Polycysticv Ovary Syndrome
Yu-Bae Ahn
Journal of Korean Endocrine Society.2007; 22(5): 323. CrossRef

Adiponectin and Ghrelin Polymorphism in Korean Women with Polycystic Ovary Syndrome.: Hyejin Lee, Eun Kyung Byun, Hwi Ra Park, Jee Young Oh, Youngsun Hong, Yeon Ah Sung, Hyewon Chung; J Korean Endocr Soc. 2006;21(5):394-401. Published online October 1, 2006; DOI: https://doi.org/10.3803/jkes.2008.21.5.394

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Abstract PDF: BACKGROUND
Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and chronic anovulation, and this is a common disorder in premenopausal women. However, the pathogenesis is still uncertain. There has been no studies about PCOS-related genetic abnormalities in Korea. In this study, we examined the frequency of the adiponectin and ghrelin genotypes in Korean women with PCOS. METHODS: Fifty four women with PCOS and 174 regular cycling healthy women were recruited for the study, and their reproductive hormones and metabolic profiles were measured. The polymorphisms of the ghrelin and adiponectin genes were analyzed. RESULTS: The frequency of ghrelin gene polymorphism was not different between the women with PCOS and the controls. The frequency of the TG adiponectin genotype was higher and the frequency of the TT genotype was lower in the women with PCOS compared to the controls (P < 0.05). For the PCOS women with GG adiponectin genotype, their triglycerides levels were significantly higher compared to the PCOS women with the TT and TG genotypes even after adjusting for the BMI. CONCLUSION: Adiponectin gene polymorphism is associated with presence of PCOS and it is responsible for the dyslipidemia seen in PCOS. Yet further study is required to confirm the role of this genetic polymorphism in the susceptibility to PCOS and the associated metabolic features.

Therapeutic Effects of Metformin and Rosiglitazone in Korean Women with Polycystic Ovary Syndrome.: Jee Young Oh, Eun Kyung Byun, Hwi Ra Park, Young Ju Choi, Hyo Jung Kim, Hye Jin Lee, Young Sun Hong, Yeon Ah Sung, Hye Won Chung; J Korean Endocr Soc. 2005;20(5):467-475. Published online October 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.5.467

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Abstract PDF

BACKGROUND
Insulin resistance is a central feature of polycystic ovary syndrome (PCOS), and hyperinsulinemia contributes to anovulation, oligo or amenorrhea, hyperandrogenism and infertility in women with PCOS. The use of insulin sensitizers, such as metformin or thiazolidinedione, in PCOS is becoming increasingly accepted. The purpose of our study was to evaluate the therapeutic effects of metformin and rosiglitazone on the metabolic and reproductive derangement, and find parameters predicting their therapeutic efficacy in Korean PCOS women. METHODS: Sixty-two women with PCOS were recruited. The baseline characteristics, including BMI, glucose tolerance test, lipid profiles, sex hormones and hyperinsulinemic euglycemic clamp test, were assessed. After the administration of the insulin sensitizer (metformin 1.5g/day or rosiglitazone 4mg/day) for 3 months, the insulin sensitivity was reassessed. A drug response was defined as menstrual restoration or pregnancy. RESULTS: Of the 62 women with PCOS, 36 gained restored regular menstruation, and a further 5 conceived (a drug response rate of 66.7%). There were no significant clinical differences between responders and nonresponders. Twelve weeks after taking the drugs, the insulin sensitivity was significantly improved (M-value 4.7+/-0.2 vs. 5.5+/-0.4mg/kg/min, P<0.05), and the free testosterone levels(72.5+/-39.9 vs. 45.8 +/-3.8pmol/L, P<0.05) were significantly decreased, without significant weight reduction. CONCLUSION: Metformin and rosiglitazone restored menstruation in 66.1% of women with PCOS. Hyperandrogenemia and insulin sensitivity were significantly improved with the use of the two drugs. However, metabolic or hormonal markers for predicting the drug response could not be found.

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Diagnosis and Treatment of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-ah Sung
Journal of Korean Endocrine Society.2007; 22(4): 252. CrossRef

The Prevalence of Polycystic Ovary Syndrome in College Students from Seoul.: Eun Kyung Byun, Hyo Jeong Kim, Jee Young Oh, Young Sun Hong, Yeon Ah Sung; J Korean Endocr Soc. 2005;20(2):120-126. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.120

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Abstract PDF

BACKGROUND
Polycystic ovary syndrome(PCOS) is characterized by the presence of chronic anovulation and hyperandrogenism, The prevalence of PCOS in premenopausal women of about 5~ 10%. There may be significant ethnic and racial variations in the prevalence and clinical presentation of PCOS. The current study was undertaken to determine the prevalence of PCOS and to identify the clinical characteristics of PCOS in Korea. METHODS: From March 2003 to March 2004, medical students from Ewha Womans University were investigated for the prevalence of PCOS. The evaluation included a history and physical examination, a modified Ferriman-Gallwey hirsutism score and screening for hyperandrogenemia. PCOS was diagnosed by the presence of the following: 1) oligomenorrhea, 2) hyperandrogenemia and/or hirsutism(a modified Ferriman-Gallwey score> or =6), and 3) the exclusion of related disorders. Hyperandrogenemia was defined as a free testosterone level above the 95th percentile of that for normal cycling nonhirsute women. RESULTS: Out of 492 students, 386 replied to the questionnaire and 203 students(19~31 yr of age) participated in the physical examination and blood sampling. Eumenorrhea without hirsutism was present in 133 students(65.5%), oligomenorrhea was present in 39 students(19.2%), hyperandrogenism was present in 21 students(10.3%) and hirsutism was present in 3(1.5%) of the 203 women. The prevalence of PCOS was 4.9%(10 of 203 students), and only 2 of 10 women with PCOS were hirsute. The mean body mass index of students with PCOS was 22.7+/- 4.3kg/m2, and two women was obese. The plasma insulin levels during the 75g oral glucose tolerance test in women with PCOS was significantly higher when compared to the age and body mass index of the controls. CONCLUSION: The prevalence of PCOS was 4.9% in college students from Seoul. This rate is similar to those rates reported by other investigators in Greece(6.7%) and United States(4%). Obesity and hirsutism are not common in Korean women with PCOS. We are planning to survey a more diverse age groups to determine the prevalence of PCOS

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Ethnicity in polycystic ovary syndrome
D. Shah, S. Rasool
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Metabolic Syndrome and Related Disorders.2022;[Epub] CrossRef
Age-Adjusted Prevalence and Characteristics of Women with Polycystic Ovarian Syndrome in Korea: A Nationwide Population-Based Study (2010–2019)
Ju Hee Kim, Min Hyung Jung, Se Hwa Hong, Nalae Moon, Dae Ryong Kang
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Effects of Exposure Duration and Exposure Levels of Ambient Air Pollutants on the Risk of Polycystic Ovarian Syndrome: A 2015–2019 Korean Population-Based Cohort Study
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Gamitaeeumjowee-tang for Weight Loss in Overweight and Obese Women with Polycystic Ovary Syndrome: A Retrospective Chart Review
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Prevalence of Gestational Diabetes Mellitus in Korea: A National Health Insurance Database Study
Bo Kyung Koo, Joon Ho Lee, Jimin Kim, Eun Jin Jang, Chang-Hoon Lee, Noel Christopher Barengo
PLOS ONE.2016; 11(4): e0153107. CrossRef
Ethnic differences: Is there an Asian phenotype for polycystic ovarian syndrome?
Zhongwei Huang, Eu-Leong Yong
Best Practice & Research Clinical Obstetrics & Gynaecology.2016; 37: 46. CrossRef
Oral Contraceptive Use, Micronutrient Deficiency, and Obesity among Premenopausal Females in Korea: The Necessity of Dietary Supplements and Food Intake Improvement
Boyoung Park, Jeongseon Kim, David O. Carpenter
PLOS ONE.2016; 11(6): e0158177. CrossRef
Metabolic effects of polycystic ovary syndrome in adolescents
Yejin Han, Hae Soon Kim, Hye-Jin Lee, Jee-Young Oh, Yeon-Ah Sung
Annals of Pediatric Endocrinology & Metabolism.2015; 20(3): 136. CrossRef
Epidemiology and Diagnostic Criteria of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-Ah Sung
The Journal of Korean Diabetes.2015; 16(3): 189. CrossRef
Dietary intake, dietary habits, and depression in Korean women with polycystic ovary syndrome
Seung Hyun Kim, Hyesook Kim, Seung Hee Park, Ji Yun Hwang, Hey Won Chung, Namsoo Chang
Korean Journal of Nutrition.2012; 45(3): 229. CrossRef
Hyperandrogenism in Women: Polycystic Ovary Syndrome
Yeon-Ah Sung
Hanyang Medical Reviews.2012; 32(4): 197. CrossRef
Polymorphism T→C of gene CYP17 promoter and polycystic ovary syndrome risk: A meta-analysis
Ya Li, Fei Liu, Shan Luo, Han Hu, Xiao-Hong Li, Shang-Wei Li
Gene.2012; 495(1): 16. CrossRef
Polycystic Ovary Syndrome in Korean Women: Clinical Characteristics and Diagnostic Criteria
Yeon-Ah Sung
Endocrinology and Metabolism.2011; 26(3): 203. CrossRef
Pro12Ala and His447His polymorphisms of PPAR-γ are associated with polycystic ovary syndrome
Bon-Hee Gu, Kwang-Hyun Baek
Reproductive BioMedicine Online.2009; 18(5): 644. CrossRef
Association study between single nucleotide polymorphisms in the VEGF gene and polycystic ovary syndrome
Eung-Ji Lee, Bermseok Oh, Jong-Young Lee, Kuchan Kimm, Jung-Mi Park, Kwang-Hyun Baek
Fertility and Sterility.2008; 89(6): 1751. CrossRef
Androgen receptor gene CAG repeat polymorphism in women with polycystic ovary syndrome
Jin Ju Kim, Seon Ha Choung, Young Min Choi, Sang Ho Yoon, Seok Hyun Kim, Shin Yong Moon
Fertility and Sterility.2008; 90(6): 2318. CrossRef
A novel single nucleotide polymorphism of INSR gene for polycystic ovary syndrome
Eung-Ji Lee, Bermseok Oh, Jong-Young Lee, Kuchan Kimm, Sook-Hwan Lee, Kwang-Hyun Baek
Fertility and Sterility.2008; 89(5): 1213. CrossRef
Diagnosis and Treatment of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-ah Sung
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Single nucleotide polymorphism in exon 17 of the insulin receptor gene is not associated with polycystic ovary syndrome in a Korean population
Eung-Ji Lee, Kyong-Jai Yoo, So-Jeong Kim, Sook-Hwan Lee, Kwang Yul Cha, Kwang-Hyun Baek
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Association of Serum Adiponectin Levels with Insulin Resistance in Women with Polycystic Ovary Syndrome.: Young Sun Hong, Jee Young Oh, Eun Kyung Byun, Yeon Ah Sung; J Korean Endocr Soc. 2004;19(4):369-378. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Polycystic ovary syndrome (PCOS) is known to be associated with obesity and insulin resistance. The exact mechanism of insulin resistance in PCOS is not completely understood, but there are several pieces of evidence suggesting humoral mediator involvement. Adiponectin, an adipocyte-secreted protein, could be a possible link between adiposity and insulin resistance. This study was performed to see whether the serum adiponectin levels are suppressed in woman with PCOS and if this is associated with the characteristic hormonal and metabolic features of PCOS. METHODS: 20 women with PCOS and 8 normal controls with regular cycles were recruited. The serum adiponectin levels were measured by RIA, and the fasting glucose to insulin ratio (GIR) used as an insulin sensitivity index. RESULTS: The patients with PCOS were classified as lean (BMI < 23 kg/m2, n=9) and obese groups (BMI 25 kg/m2, n=11) based on the WPRO criteria. The GIR was significantly lower in the obese compared to the control group. The adiponectin level was lower in women with PCOS than the controls, but without statistical significance. In 5 of the 20 patients, the GIR was higher than 0.30, which was the lowest limit in the controls, and the adiponectin level was significantly higher than in those patients with a lower GIR. The adiponectin level was significantly correlated with the BMI, subcutaneous and visceral fat areas, post challenge 2 hr glucose, fasting insulin, GIR and SHBG. After adjustment for BMI, adiponectin was significantly correlated with the GIR in all subjects, including the controls. CONCLUSION: The serum adiponectin level was associated with and related to adiposity in women with PCOS; however, adiponectin might be associated with insulin resistance independently from adiposity

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