PCOS Forum

Research in Polycystic Ovary Syndrome Today and Tomorrow

Renato Pasquali; Elisabet Stener-Victorin; Bulent O. Yildiz; Antoni J. Duleba; Kathleen Hoeger; Helen Mason; Roy Homburg; Theresa Hickey; Steve Franks; Juha S. Tapanainen; Adam Balen; David H. Abbott; Evanthia Diamanti-Kandarakis; Richard S. Legro

Disclosures

Clin Endocrinol. 2011;74(4):424-433. 

In This Article

Predisposing Risk Factors for PCOS and Risk Reduction

Evidence suggests there are contributions from both heritable and nonheritable factors in the development of PCOS. The typical presentation of PCOS in adolescence suggests that the predisposition to the endocrine and metabolic abnormalities of PCOS originates prior to puberty. There is likely a genetic heritability that is enhanced by environmental factors notably increased dietary consumption and development of obesity. Studies demonstrate that peripubertal obesity is associated with hyperandrogenism,[59] although prospective studies linking this to the development of PCOS are lacking. If indeed peripubertal obesity, acting either through increased insulin resistance or other adipocyte factors, increases the development of hyperandrogenism, reduction in adiposity should reduce this risk.

No long-term studies are available to demonstrate that reduction in body weight reduces the risk of PCOS development. Peripubertal weight reduction has been shown to be associated with a reduction in testosterone levels in the general population of obese prepubertal girls.[60] There are limited studies that demonstrate the induction of modest weight reduction, with or without concomitant oral contraceptives, improves serum androgens in adolescents diagnosed with PCOS.[61] Limited data have been reported on the use of insulin sensitizers in the management of PCOS in adolescence with mixed result.[62,63] Future research should focus on early identification of predisposing risk factors in PCOS development and long-term studies that modify environmental factors to abrogate the risk.

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