October 08, 2019
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Severe obesity increases likelihood of PCOS, metabolic syndrome

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Approximately 1 in 4 Swedish women with severe obesity has polycystic ovary syndrome and more than 40% have metabolic syndrome, although women with and without PCOS had comparable body composition measurements and experienced similar weight loss during a dietary intervention, according to findings published in Clinical Endocrinology.

Elisabet Stener-Victorin

“Although it is well established that obesity increases the severity of clinical features of PCOS, there are few studies on the prevalence of PCOS in women with severe obesity,” Elisabet Stener-Victorin, PhD, associate professor in the department of physiology and pharmacology at the Karolinska Institutet in Sweden, and colleagues wrote. “A study from the U.S. showed that the prevalence of PCOS using the NIH criteria was only minimally increased with obesity, while a Spanish study showed that the prevalence of PCOS in women with overweight and obesity using the same criteria was around 25%. In women with morbid obesity undergoing bariatric surgery, there was an even higher prevalence of PCOS.”

Stener-Victorin and colleagues analyzed data from 246 women with severe obesity, defined as a BMI of at least 35 kg/m², referred for weight-loss treatment to the Regional Obesity Center at Sahlgrenska University Hospital in Gothenburg, Sweden, between 2011 and 2016. Women underwent screenings for the diagnosis of PCOS and metabolic syndrome. A 12-month dietary intervention included a very low-energy diet for 12 weeks. At 12-month follow-up, 72 women with complete data were reexamined.

Within the cohort, 25.6% of women had PCOS and 43.4% of women had metabolic syndrome. The prevalence of metabolic syndrome did not differ among women with and without PCOS (43.5% vs. 43.4%).

At 12-month follow-up, mean weight loss among women with PCOS was 12.3 kg (P < .001) and 13.9 kg among women without PCOS (P < .001), with no between-group difference. Decreases in BMI, waist circumference, hip circumference and waist-to-hip ratio from baseline to 12 months were similar for women with and without PCOS; however, women without PCOS experienced a decrease in total bone mass vs. women with PCOS (P = .017).

“Weight loss has shown to decrease bone mass in adults, but in women with PCOS, the elevated androgen levels may have a protective effect on bone mass,” the researchers wrote.

The researchers noted that women with severe obesity, independent of PCOS, are at high risk for metabolic syndrome and therefore at greater risk for developing type 2 diabetes and cardiovascular disease.

“After 12% weight loss, both groups still had severe obesity,” the researchers wrote. “It might be that with even larger weight loss, greater improvements in metabolic parameters could be achieved, especially in women with PCOS.” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.