Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: An analysis of 263 consecutive cases

KIDDY, D. S.; SHARP, P. S.; WHITE, D. M.; SCANLON, M. F.; MASON, H. D.; BRAY, C. S.; POLSON, D. W.; REED, M. J.; FRANKS, S.

doi:10.1111/j.1365-2265.1990.tb00857.x

Cited by 364Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGenetic and Kidney Cyst Diseases

Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: An analysis of 263 consecutive cases

KIDDY, D. S., SHARP, P. S., WHITE, D. M., SCANLON, M. F., MASON, H. D., BRAY, C. S., POLSON, D. W., REED, M. J. +1 more·1990·Clinical Endocrinology

DOI 10.1111/j.1365-2265.1990.tb00857.x

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Abstract

Two hundred and sixty-three women with ultrasound-diagnosed polycystic ovary syndrome were studied of whom 91 (35%) were obese (BMI greater than 25 kg/m2). Obese women with PCOS had a greater prevalence of hirsutism (73% compared with 56%) and menstrual disorders than non-obese subjects. Total testosterone and androstenedione concentrations in serum were similar in the two subgroups but SHBG concentrations were significantly lower, and free testosterone levels higher, in obese compared with lean subjects. In addition, concentrations of androsterone glucuronide, a marker of peripheral 5 alpha-reductase activity, were higher in obese than in non-obese women with PCOS. There were no significant correlations of either SHBG or free testosterone with androsterone glucuronide suggesting that obesity has independent effects on transport and on metabolism of androgen. There were no significant differences between the subgroups in either baseline gonadotrophin concentrations or the pulsatile pattern of LH and FSH secretion studied over an 8-h period. There was, however, an inverse correlation of FSH with BMI, but only in the obese subgroup. In conclusion, the increased frequency of hirsutism in obese compared with lean women with PCOS is associated with increased bio-availability of androgens to peripheral tissues and enhanced activity of 5 alpha-reductase in obese subjects. The mechanism underlying the higher prevalence of anovulation in obese women remains unexplained.

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Increased susceptibility to obesity may further exacerbate reproductive dysfunctions in PCOS.
“whilst their increased susceptibility to obesity [16] may further exacerbate IR and the accompanying metabolic [17, 18] and reproductive [10, 19] dysfunctions.”
From Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis (2019) · cites this paper as [19]
Obesity may exacerbate features of PCOS by worsening IR and stimulating hyperandrogenism.
“Furthermore, obesity may exacerbate features of PCOS by worsening IR and stimulating hyperandrogenism [190, 191].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [190]
Obesity, especially central obesity, worsens the clinical and biochemical presentation of PCOS, contributing to insulin resistance, hyperandrogenism, reproductive disorders, diabetes and cardiovascular disease.
“Obesity, especially central obesity, worsens the clinical and biochemical presentation of the syndrome, contributing to IR, hyperandrogenism, reproductive disorders, diabetes and cardiovascular disease [18,19,20].”
From Weight management interventions in women with and without PCOS: a systematic review (2017) · cites this paper as [19]
IR is further exacerbated by excess weight.
“and is further exacerbated by excess weight. 20,21,102”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [21]

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Correlation of clinical and biochemical hyperandrogenism in Thai women with polycystic ovary syndrome
Leerasiri, P., Wongwananuruk, T., Indhavivadhana, S., Techatraisak, K., Rattanachaiyanont, M., & Angsuwathana, S. (2016) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.12945 · Cited by 19 · see citing works
Hyperandrogenism: Defining the Reference Range for “Normal” Androgens
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Spironolactone therapeutic effect in the hyperandrogenism syndrome
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Authors: KIDDY, D. S., SHARP, P. S., WHITE, D. M., SCANLON, M. F., MASON, H. D., BRAY, C. S., POLSON, D. W., REED, M. J., & FRANKS, S.
Affiliations: St Mary's Hospital (GB)
Corresponding author: FRANKS, S.
ORCID: SHARP, P. S.
FRANKS, S.
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 1990-02
Volume: 32
Issue: 2
Pages: 213-220
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1111/j.1365-2265.1990.tb00857.x
OpenAlex: W2014698814
Cited by: 364
References: 30
Citations by year: 2026: 5 · 2025: 3 · 2024: 8 · 2023: 6 · 2022: 14 · 2021: 8 · 2020: 9 · 2019: 13 · 2018: 13 · 2017: 9 · 2016: 13 · 2015: 14 · 2014: 24 · 2013: 12 · 2012: 11
FWCI: 10.40
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6722 d)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
Keywords: polycystic ovary syndrome, obesity, hirsutism, sex hormone-binding globulin, free testosterone, androsterone glucuronide, 5alpha-reductase activity, gonadotropin secretion, luteinizing hormone, follicle-stimulating hormone, anovulation, menstrual disorders, body mass index
MeSH terms: Androgens, Androstenedione, Androsterone, Biological Transport, Female, Follicle Stimulating Hormone, Hirsutism, Humans, Luteinizing Hormone, Obesity, Polycystic Ovary Syndrome, Sex Hormone-Binding Globulin, Testosterone, Prevalence

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Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: An analysis of 263 consecutive cases

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