Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: diagnostic and methodological challenges

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Women with polycystic ovary syndrome (PCOS) have a considerable risk of metabolic dysfunction. This review aims to present contemporary
knowledge on obesity, insulin resistance and PCOS with emphasis on the diagnostic and methodological challenges encountered in research
and clinical practice. Variable diagnostic criteria for PCOS and associated phenotypes are frequently published. Targeted searches were
conducted to identify all available data concerning the association of obesity and insulin resistance with PCOS up to September 2016. Articles
were considered if they were peer reviewed, in English and included women with PCOS. Obesity is more prevalent in women with PCOS, but
studies rarely reported accurate assessments of adiposity, nor split the study population by PCOS phenotypes. Many women with PCOS have
insulin resistance, though there is considerable variation reported in part due to not distinguishing subgroups known to have an impact on
insulin resistance as well as limited methodology to measure insulin resistance. Inflammatory markers are positively correlated with androgen
levels, but detailed interactions need to be identified. Weight management is the primary therapy; specific advice to reduce the glycaemic load
of the diet and reduce the intake of pro-inflammatory SFA and advanced glycation endproducts have provided promising results. It is
important that women with PCOS are educated about their increased risk of metabolic complications in order to make timely and appropriate
lifestyle modifications. Furthermore, well-designed robust studies are needed to evaluate the mechanisms behind the improvements observed
with dietary interventions.

© 2017, The Authors. This is the final published version of the article (version of record) uploaded in accordance with the publisher’s self- archiving policy. It first appeared online via Cambridge University Press at
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalNutrition Research Reviews
Publication statusPublished - 22 Feb 2017


  • PCOS
  • Obesity

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