CoChat
Sign Up
Cited by 411Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGenetic and Kidney Cyst Diseases

Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies

Open access
Barber, Thomas M, Hanson, Petra, Weickert, Martin O, Franks, Stephen·2019·Clinical Medicine Insights: Reproductive Health
DOI 10.1177/1179558119874042PMC PMC6734597
Open this paper in CoChat — free accountOpen PDF

Abstract

Polycystic ovary syndrome (PCOS) is a common female condition typified by reproductive, hyperandrogenic, and metabolic features. Polycystic ovary syndrome is a genetic condition, exacerbated by obesity. There is a close link between obesity and PCOS based on epidemiological data, and more recently corroborated through genetic studies. There are many mechanisms mediating the effects of weight-gain and obesity on the development of PCOS. The metabolic effects of insulin resistance and steroidogenic and reproductive effects of hyperinsulinaemia are important mechanisms. Adipokine production by subcutaneous and visceral fat appears to play a part in metabolic function. However, given the complexity of PCOS pathogenesis, it is important also to consider possible effects of PCOS on further weight-gain, or at least on hampering attempts at weight-loss and maintenance through lifestyle changes. Possible mediators of these effects include changes in energy expenditure, mental ill health, or physical inactivity. In this brief review, we discuss the main mechanisms that underlie the association between obesity and PCOS, from divergent perspectives of weight-gain contributing to development of PCOS and vice versa. We also consider novel management options for women with obesity and PCOS.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1177/1179558119874042

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • This would explain why lean women have all the same clinical, biochemical and endocrine features, although possibly less severe, than overweight and obese women with PCOS.

    “This would explain why lean women have all the same clinical, biochemical and endocrine features, although possibly less severe, than overweight and obese women with PCOS [186].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [186]

    The Abstract describes PCOS as a genetic condition exacerbated by obesity, and the 'Insulin resistance and fat distribution' section says weight gain worsens its metabolic, reproductive, and hyperandrogenic features. This supports the possibility of less severe features in lean women, but the paper does not establish that lean women have all the same clinical, biochemical, and endocrine features as overweight or obese women with PCOS. No page numbers were available in our copy. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Multiple lines of evidence from evolutionary history, genetic and twin studies support a genetic basis for obesity and differences in obese and lean phenotypes in women with PCOS.

    “Multiple lines of evidence from evolutionary history, genetic and twin studies, support a genetic basis for obesity and differences in obese and lean phenotypes in women with PCOS [183,184,185,186].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [186]

    The ‘Genetic factors in the development of PCOS’ section states that genetics contribute to both PCOS and obesity and describes genetic evidence linking them; its references include a twin-family study. The paper does not present evolutionary history as evidence for this genetic link or establish that genetic factors explain differences between obese and lean phenotypes in women with PCOS. Page numbers were not available in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • There is wide heterogeneity in reports examining the relationship between body composition measures, including extent of VAT and metabolic changes such as insulin resistance.

    “Consequently, there is wide heterogeneity in reports examining the relationship between body composition measures, including extent of VAT and metabolic changes such as IR [186].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [186]

    In ‘Insulin resistance and fat distribution in the development of PCOS’ (page unavailable), the review describes differing methods and limitations in studies measuring visceral fat, and reports insulin-resistance differences despite equivalent visceral fat in a matched comparison. This supports uncertainty about the relationship in PCOS, but it does not establish the claimed wide heterogeneity in reported relationships between body composition and insulin resistance. (LLM, conf=0.79)

    Experimental — accuracy not yet measured

  • The majority of women with PCOS are overweight or obese, with reported prevalence ranging from 38% to 88%.

    “The majority of women with PCOS are overweight or obese and evidence indicates that the microbiome of obese individuals is capable of extracting more energy from the host diet compared with the microbiome of lean individuals [132].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [186]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 95

  1. [2]Barber TM McCarthy MI Wass JA Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf). 2006; 65: 137- 145. 16886951
  2. [3]Saboor Aftab SA Kumar S Barber TM. The role of obesity and type 2 diabetes mellitus in the development of male obesity-associated secondary hypogonadism. Clin Endocrinol (Oxf). 2013; 78: 330- 337. 23121123
  3. [4]Passarello K Kurian S Villanueva V. Endometrial cancer: an overview of pathophysiology, management, and care. Semin Oncol Nurs. 2019; 35: 157- 165. 30867105
  4. [6]Wild S Pierpoint T McKeigue P Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol (Oxf). 2000; 52: 595- 600. 10792339
  5. [7]Barber TM McCarthy MI Franks S Wass JA. Metabolic syndrome in polycystic ovary syndrome. Endokrynol Pol. 2007; 58: 34- 41. 17354203
  6. [8]Mohlig M Floter A Spranger J, et al Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling. Diabetologia. 2006; 49: 2572- 2579. 16972044
  7. [9]Ramezani-Binabaj M Motalebi M Karimi-Sari H Rezaee-Zavareh MS Alavian SM. Are women with polycystic ovarian syndrome at a high risk of non-alcoholic Fatty liver disease; a meta-analysis. Hepat Mon. 2014; 14:e23235. PMC4286712 25598791
  8. [10]Ehrmann DA. Metabolic dysfunction in PCOS: relationship to obstructive sleep apnea. Steroids. 2012; 77: 290- 294. 22178788 PMC3279609
  9. [11]Azziz R Woods KS Reyna R Key TJ Knochenhauer ES Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004; 89: 2745- 2749. 15181052
  10. [12]Sanchon R Gambineri A Alpanes M Martinez-Garcia MA Pasquali R Escobar-Morreale HF. Prevalence of functional disorders of androgen excess in unselected premenopausal women: a study in blood donors. Hum Reprod. 2012; 27: 1209- 1216. 22343706
  11. [13]Yildiz BO Bozdag G Yapici Z Esinler I Yarali H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod. 2012; 27: 3067- 3073. 22777527
  12. [14]Asuncion M Calvo RM San Millan JL Sancho J Avila S Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000; 85: 2434- 2438. 10902790
  13. [15]Legro RS. The genetics of obesity. Lessons for polycystic ovary syndrome. Ann N Y Acad Sci. 2000; 900: 193- 202. 10818406
  14. [18]Kiddy DS Hamilton-Fairley D Bush A, et al Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 1992; 36: 105- 111. 1559293
  15. [19]Holte J Bergh T Berne C Wide L Lithell H. Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1995; 80: 2586- 2593. 7673399
  16. [20]Dunaif A Segal KR Futterweit W Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989; 38: 1165- 1174. 2670645
  17. [21]Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997; 18: 774- 800. 9408743
  18. [22]Venkatesan AM Dunaif A Corbould A. Insulin resistance in polycystic ovary syndrome: progress and paradoxes. Recent Prog Horm Res. 2001; 56: 295- 308. 11237218
  19. [23]Mohlig M Jurgens A Spranger J, et al The androgen receptor CAG repeat modifies the impact of testosterone on insulin resistance in women with polycystic ovary syndrome. Eur J Endocrinol. 2006; 155: 127- 130. 16793958
  20. [25]Rice S Christoforidis N Gadd C, et al Impaired insulin-dependent glucose metabolism in granulosa-lutein cells from anovulatory women with polycystic ovaries. Hum Reprod. 2005; 20: 373- 381. 15539436
  21. [26]Nestler JE Strauss JF 3rd Insulin as an effector of human ovarian and adrenal steroid metabolism. Endocrinol Metab Clin North Am. 1991; 20: 807- 823. 1778178
  22. [27]Franks SMH White D Willis D Mechanisms of An ovulation in Polycystic Ovary Syndrome. Filicori MF, ed. Amsterdam: Elsevier; 1996: 183- 186.
  23. [28]White D Leigh A Wilson C Donaldson A Franks S. Gonadotrophin and gonadal steroid response to a single dose of a long-acting agonist of gonadotrophin-releasing hormone in ovulatory and anovulatory women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 1995; 42: 475- 481. 7621565
  24. [29]Robinson S Kiddy D Gelding SV, et al The relationship of insulin insensitivity to menstrual pattern in women with hyperandrogenism and polycystic ovaries. Clin Endocrinol (Oxf). 1993; 39: 351- 355. 8222298
  25. [30]Willis DS Watson H Mason HD Galea R Brincat M Franks S. Premature response to luteinizing hormone of granulosa cells from anovulatory women with polycystic ovary syndrome: relevance to mechanism of anovulation. J Clin Endocrinol Metab. 1998; 83: 3984- 3991. 9814480
  26. [32]Morin-Papunen LC Vauhkonen I Koivunen RM Ruokonen A Tapanainen JS. Insulin sensitivity, insulin secretion, and metabolic and hormonal parameters in healthy women and women with polycystic ovarian syndrome. Hum Reprod. 2000; 15: 1266- 1274. 10831553
  27. [34]Yki-Jarvinen H Makimattila S Utriainen T Rutanen EM. Portal insulin concentrations rather than insulin sensitivity regulate serum sex hormone-binding globulin and insulin-like growth factor binding protein 1 in vivo. J Clin Endocrinol Metab. 1995; 80: 3227- 3232. 7593430
  28. [35]Reaven GM. The metabolic syndrome: requiescat in pace. Clin Chem. 2005; 51: 931- 938. 15746300
  29. [36]Azziz R Ehrmann D Legro RS, et al Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial. J Clin Endocrinol Metab. 2001; 86: 1626- 1632. 11297595
  30. [37]Banerji MA Faridi N Atluri R Chaiken RL Lebovitz HE. Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999; 84: 137- 144. 9920074
  31. [38]Marks SJ Moore NR Clark ML Strauss BJ Hockaday TD. Reduction of visceral adipose tissue and improvement of metabolic indices: effect of dexfenfluramine in NIDDM. Obes Res. 1996; 4: 1- 7. 8787932
  32. [39]Zhuang XF Zhao MM Weng CL Sun NL. Adipocytokines: a bridge connecting obesity and insulin resistance. Med Hypotheses. 2009; 73: 981- 985. 19692185
  33. [40]Horejsi R Moller R Rackl S, et al Android subcutaneous adipose tissue topography in lean and obese women suffering from PCOS: comparison with type 2 diabetic women. Am J Phys Anthropol. 2004; 124: 275- 281. 15197822
  34. [41]Yildirim B Sabir N Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2003; 79: 1358- 1364. 12798883
  35. [42]Barber TM Franks S. Adipocyte biology in polycystic ovary syndrome. Mol Cell Endocrinol. 2013; 373: 68- 76. 23084978
  36. [43]Kirchengast S Huber J. Body composition characteristics and body fat distribution in lean women with polycystic ovary syndrome. Hum Reprod. 2001; 16: 1255- 1260. 11387301
  37. [44]Puder JJ Varga S Kraenzlin M De Geyter C Keller U Muller B. Central fat excess in polycystic ovary syndrome: relation to low-grade inflammation and insulin resistance. J Clin Endocrinol Metab. 2005; 90: 6014- 6021. 16105965
  38. [47]Dolfing JG Stassen CM van Haard PM Wolffenbuttel BH Schweitzer DH. Comparison of MRI-assessed body fat content between lean women with polycystic ovary syndrome (PCOS) and matched controls: less visceral fat with PCOS. Hum Reprod. 2011; 26: 1495- 1500. 21406446
  39. [49]Macut D Bjekic-Macut J Livadas S, et al Nonalcoholic fatty liver disease in patients with polycystic ovary syndrome. Curr Pharm Des. 2018; 24: 4593- 4597. 30652641
  40. [51]Young T Evans L Finn L Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997; 20: 705- 706. 9406321
  41. [52]Romero-Corral A Caples SM Lopez-Jimenez F Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010; 137: 711- 719. 20202954 PMC3021364
  42. [53]Tassone F Lanfranco F Gianotti L, et al Obstructive sleep apnoea syndrome impairs insulin sensitivity independently of anthropometric variables. Clin Endocrinol (Oxf). 2003; 59: 374- 379. 12919162
  43. [54]Nitsche K Ehrmann DA. Obstructive sleep apnea and metabolic dysfunction in polycystic ovary syndrome. Best Pract Res Clin Endocrinol Metab. 2010; 24: 717- 730. 21112021 PMC3030192
  44. [55]Fogel RB Malhotra A Pillar G Pittman SD Dunaif A White DP. Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2001; 86: 1175- 1180. 11238505
  45. [56]Balachandran K Sumilo D O’Reilly MW, et al Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population-based cohort study [published online ahead of print February 1, 2019]. Eur J Endocrinol. doi: 10.1530/EJE-18-0693. PMC6410684 30763274 · DOI
  46. [57]Popovic RM White DP. Upper airway muscle activity in normal women: influence of hormonal status. J Appl Physiol (1985). 1998; 84: 1055- 1062. 9480969
  47. [58]Zhou XS Rowley JA Demirovic F Diamond MP Badr MS. Effect of testosterone on the apneic threshold in women during NREM sleep. J Appl Physiol (1985). 2003; 94: 101- 107. 12391093
  48. [59]Shinohara E Kihara S Yamashita S, et al Visceral fat accumulation as an important risk factor for obstructive sleep apnoea syndrome in obese subjects. J Intern Med. 1997; 241: 11- 18. 9042088
  49. [61]Tasali E Chapotot F Leproult R Whitmore H Ehrmann DA. Treatment of obstructive sleep apnea improves cardiometabolic function in young obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2011; 96: 365- 374. 21123449 PMC3048326
  50. [62]Ashrafian H le Roux CW Rowland SP, et al Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax. 2012; 67: 442- 449. 21709167
  51. [65]Lagaly DV Aad PY Grado-Ahuir JA Hulsey LB Spicer LJ. Role of adiponectin in regulating ovarian theca and granulosa cell function. Mol Cell Endocrinol. 2008; 284: 38- 45. 18289773
  52. [66]Iniguez G Torrealba IM Avila A Cassorla F Codner E. Adiponectin serum levels and their relationships to androgen concentrations and ovarian volume during puberty in girls with type 1 diabetes mellitus. Horm Res. 2008; 70: 112- 117. 18547959
  53. [67]Barber TM Hazell M Christodoulides C, et al Serum levels of retinol-binding protein 4 and adiponectin in women with polycystic ovary syndrome: associations with visceral fat but no evidence for fat mass-independent effects on pathogenesis in this condition. J Clin Endocrinol Metab. 2008; 93: 2859- 2865. 18445670
  54. [68]Yildiz BO Bozdag G Otegen U, et al Visfatin and retinol-binding protein 4 concentrations in lean, glucose-tolerant women with PCOS. Reprod Biomed Online. 2010; 20: 150- 155. 20159001
  55. [69]Cekmez F Cekmez Y Pirgon O, et al Evaluation of new adipocytokines and insulin resistance in adolescents with polycystic ovary syndrome. Eur Cytokine Netw. 2011; 22: 32- 37. 21411410
  56. [70]Dikmen E Tarkun I Canturk Z Cetinarslan B. Plasma visfatin level in women with polycystic ovary syndrome. Gynecol Endocrinol. 2011; 27: 475- 479. 20586547
  57. [71]Jongwutiwes T Lertvikool S Leelaphiwat S Rattanasiri S Jultanmas R Weerakiet S. Serum visfatin in Asian women with polycystic ovary syndrome. Gynecol Endocrinol. 2009; 25: 536- 542. 19533482
  58. [72]Mohlig M Weickert MO Ghadamgahi E, et al Retinol-binding protein 4 is associated with insulin resistance, but appears unsuited for metabolic screening in women with polycystic ovary syndrome. Eur J Endocrinol. 2008; 158: 517- 523. 18362299
  59. [73]Mohlig M Weickert MO Ghadamgadai E, et al Adipocyte fatty acid-binding protein is associated with markers of obesity, but is an unlikely link between obesity, insulin resistance, and hyperandrogenism in polycystic ovary syndrome women. Eur J Endocrinol. 2007; 157: 195- 200. 17656598
  60. [74]Walley AJ Blakemore AI Froguel P. Genetics of obesity and the prediction of risk for health. Hum Mol Genet. 2006; 15 Spec No 2:R124-R130. 16987875
  61. [77]Barber TM Franks S. Genetics of polycystic ovary syndrome. Front Horm Res. 2013; 40: 28- 39. 24002403
  62. [79]Frayling TM Timpson NJ Weedon MN, et al A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science. 2007; 316: 889- 894. 17434869 PMC2646098
  63. [80]Dina C Meyre D Gallina S, et al Variation in FTO contributes to childhood obesity and severe adult obesity. Nat Genet. 2007; 39: 724- 726. 17496892
  64. [81]Barber TM Bennett AJ Groves CJ, et al Association of variants in the fat mass and obesity associated (FTO) gene with polycystic ovary syndrome. Diabetologia. 2008; 51: 1153- 1158. 18478198
  65. [82]Li T Wu K You L, et al Common variant rs9939609 in gene FTO confers risk to polycystic ovary syndrome. PLoS ONE 2013; 8:e66250. PMC3698074 23840863
  66. [83]Ewens KG Jones MR Ankener W, et al FTO and MC4R gene variants are associated with obesity in polycystic ovary syndrome. PLoS ONE. 2011; 6:e16390. PMC3024473 21283731
  67. [84]Yan Q Hong J Gu W, et al Association of the common rs9939609 variant of FTO gene with polycystic ovary syndrome in Chinese women. Endocrine. 2009; 36: 377- 382. 19859840
  68. [85]Koivuaho E Laru J Ojaniemi M, et al Age at adiposity rebound in childhood is associated with PCOS diagnosis and obesity in adulthood-longitudinal analysis of BMI data from birth to age 46 in cases of PCOS. Int J Obes (Lond). 2019; 43: 1370- 1379. 30718819 PMC6760596
  69. [87]Romualdi D Versace V Tagliaferri V, et al The resting metabolic rate in women with polycystic ovary syndrome and its relation to the hormonal milieu, insulin metabolism, and body fat distribution: a cohort study. J Endocrinol Invest. 2019; 42: 1089- 1097. 30847861
  70. [88]Ek I Arner P Ryden M, et al A unique defect in the regulation of visceral fat cell lipolysis in the polycystic ovary syndrome as an early link to insulin resistance. Diabetes. 2002; 51: 484- 492. 11812759
  71. [89]Xu X De Pergola G Bjorntorp P. The effects of androgens on the regulation of lipolysis in adipose precursor cells. Endocrinology. 1990; 126: 1229- 1234. 2153523
  72. [91]Small L Aplasca A. Child obesity and mental health: a complex interaction. Child Adolesc Psychiatr Clin N Am. 2016; 25: 269- 282. 26980129
  73. [92]Deeks AA Gibson-Helm ME Paul E Teede HJ. Is having polycystic ovary syndrome a predictor of poor psychological function including anxiety and depression. Hum Reprod. 2011; 26: 1399- 1407. 21436137
  74. [93]Ozturk A Kucur SK Seven A, et al Temperament and character differences of patients with polycystic ovary syndrome. J Gynecol Obstet Hum Reprod. 2019; 48: 255- 259. 30711689
  75. [94]Hopkins CS Kimble LP Hodges HF Koci AF Mills BB. A mixed-methods study of coping and depression in adolescent girls with polycystic ovary syndrome. J Am Assoc Nurse Pract. 2019; 31: 189- 197. 30681649
  76. [95]Karjula S Morin-Papunen L Auvinen J, et al Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women With PCOS Symptoms: 15-Year Follow-Up. J Clin Endocrinol Metab. 2017; 102: 1861- 1869. 28323926 PMC5470769
  77. [96]Booth FW Roberts CK Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012; 2: 1143- 1211. 23798298 PMC4241367
  78. [97]Pedersen BK. Physical activity and muscle-brain crosstalk. Nat Rev Endocrinol. 2019; 15: 383- 392. 30837717
  79. [98]Vigorito C Giallauria F Palomba S, et al Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007; 92: 1379- 1384. 17264174
  80. [100]Thomson RL Buckley JD Noakes M Clifton PM Norman RJ Brinkworth GD. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008; 93: 3373- 3380. 18583464
  81. [101]Fernandes J Ferreira-Santos F Miller K Torres S. Emotional processing in obesity: a systematic review and exploratory meta-analysis. Obes Rev. 2018; 19: 111- 120. 29024361
  82. [102]Fontaine KR Barofsky I. Obesity and health-related quality of life. Obes Rev. 2001; 2: 173- 182. 12120102
  83. [103]Thomson RL Buckley JD Brinkworth GD. Exercise for the treatment and management of overweight women with polycystic ovary syndrome: a review of the literature. Obes Rev. 2011; 12:e202-e210. 20546140
  84. [104]Banting LK Gibson-Helm M Polman R Teede HJ Stepto NK. Physical activity and mental health in women with polycystic ovary syndrome. BMC Womens Health. 2014; 14: 51. 24674140 PMC3986680
  85. [105]Liao LM Nesic J Chadwick PM Brooke-Wavell K Prelevic GM. Exercise and body image distress in overweight and obese women with polycystic ovary syndrome: a pilot investigation. Gynecol Endocrinol. 2008; 24: 555- 561. 19012098
  86. [106]Clark AM Thornley B Tomlinson L Galletley C Norman RJ. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod. 1998; 13: 1502- 1505. 9688382
  87. [108]Thomson RL Buckley JD Moran LJ, et al Comparison of aerobic exercise capacity and muscle strength in overweight women with and without polycystic ovary syndrome. BJOG. 2009; 116: 1242- 1250. 19438498
  88. [109]Wright CE Zborowski JV Talbott EO McHugh-Pemu K Youk A. Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome. Int J Obes Relat Metab Disord. 2004; 28: 1026- 1032. 15159768
  89. [111]Saboor Aftab SA Halder L Piya MK, et al Predictors of weight loss at 1 year after laparoscopic adjustable gastric banding and the role of presurgical quality of life. Obes Surg. 2014; 24: 885- 890. 24442423
  90. [112]Sumithran P Prendergast LA Delbridge E, et al Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011; 365: 1597- 1604. 22029981
  91. [113]Zac-Varghese S De Silva A Bloom SR. Translational studies on PYY as a novel target in obesity. Curr Opin Pharmacol. 2011; 11: 582- 585. 22019565
  92. [114]Mai K Bobbert T Reinecke F, et al Intravenous lipid and heparin infusion-induced elevation in free fatty acids and triglycerides modifies circulating androgen levels in women: a randomized, controlled trial. J Clin Endocrinol Metab. 2008; 93: 3900- 3906. 18664538
  93. [115]Hanson P Shuttlewood E Halder L, et al Application of Mindfulness in a Tier 3 Obesity Service Improves Eating Behavior and Facilitates Successful Weight Loss. J Clin Endocrinol Metab. 2019; 104: 793- 800. 30566609
  94. [116]Hakimi O Cameron LC. Effect of exercise on ovulation: a systematic review. Sports Med. 2017; 47: 1555- 1567. 28035585
  95. [117]Barber TM Franks S. Genetic basis of polycystic ovary syndrome. Expert Rev Endocrinol Metab. 2010; 5: 549- 561. 30780807

Cited by

Sorted by citations

Authors
Barber, T. M., Hanson, P., Weickert, M. O., & Franks, S.
Affiliations
  • University Hospital Coventry (GB)
  • Imperial College London (GB)
Corresponding author
Barber, Thomas M
ORCID
Venue
Clinical Medicine Insights: Reproductive Health
Publisher
SAGE Publications
Published
2019-01
Volume
13
Pages
1179558119874042-1179558119874042
ISSN
1179-5581 (ISSN-L)
DOI
10.1177/1179558119874042
PMC
PMC6734597
OpenAlex
W2972935931
Cited by
411
References
22
Citations by year
2026: 51 · 2025: 79 · 2024: 95 · 2023: 66 · 2022: 63 · 2021: 43 · 2020: 14
FWCI
4.23
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Medicine Insights Reproductive Health (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Spiral (Imperial College London) (submittedVersion, cc-by-nc)
Funders
National Institute for Health and Care Research (ACF-2014-08-004)
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, PCOS pathogenesis, insulin resistance, hyperinsulinemia, adipokines, visceral fat, weight gain, weight loss, lifestyle intervention, energy expenditure, mental health, physical inactivity, hyperandrogenism, metabolic dysfunction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review