Research demonstrates new treatment options and possible risks associated with PCOS
New findings show increased risk of PCOS among Mexican-Americans
New Orleans, Louisiana – Leading investigators in the area of polycystic ovary syndrome (PCOS), a common female endocrine disorder, are gathering in New Orleans, Louisiana this week to share new research on PCOS-associated risks, treatment options and increased prevalence of PCOS in specific populations of women. The new findings could help doctors and patients identify risks and more effectively treat the condition.
It is estimated that five to 10 percent of reproductive aged women suffer from PCOS. Symptoms of this condition, which increases a woman’s risk for developing diabetes and cardiovascular disease, include excess hair growth, irregular menstruation and central body obesity. While there is no actual cure for PCOS, researchers are working to identify effective treatments as well as possible causes for the condition. The five new studies on PCOS, which are highlighted below, will be presented in a press conference on Thursday, June 17 at 10:00 a.m. CT, during ENDO 2004, the 86th Annual Meeting of The Endocrine Society, which is taking place in New Orleans.
Diabetic drug effectively treats PCOS symptoms
A new study shows that rosiglitazone, an insulin sensitizer that is used to treat diabetics, increases ovulation and decreases insulin resistance in women with PCOS. At the same time, the drug did not cause any liver problems in the women studied. A group of 42 women with PCOS and insulin resistance were assigned at random to three doses of rosiglitazone by Dr. Nicholas Cataldo and colleagues from Stanford University. After 12 weeks of rosiglitazone treatment, more than half of the women in the study had ovulated, while levels of insulin resistance and circulating insulin decreased. “These promising findings indicate that rosiglitazones may be an effective, off-label treatment for PCOS. Other studies have also found that the glitazone class of drugs, which includes rosiglitazone, are effective in reducing the development of diabetes and atherosclerosis. Future studies are needed to determine whether these benefits can be achieved in women with PCOS.”
Anti-epileptic drug increases incidence of PCOS in women
PCOS occurs more frequently in women who take valproate to treat the psychiatric illness of bipolar disorder compared with other treatment options. The new research, which was conducted by Dr. Hadine Joffe and researchers at Massachusetts General Hospital in Boston, should help guide treatment and evaluation of reproductive age women when they are taking valproate. Dr. Joffe and her team compared the development of PCOS in 86 women taking valproate to 14 women taking other medications, including lithium, lamorigine, topiramate, gabapentin, carbamazepine and oxcarbazepine, to treat bipolar disorder. They found that approximately one in 10 women taking valproate for bipolar disorder will develop PCOS. “Bipolar disorder occurs in one to two percent of the population and valproate is used widely to stabilize this disorder. Unfortunately, we have discovered that reproductive aged women who are taking valproate may be at risk for developing PCOS when taking this medication,” explains Dr. Joffe. “Based on our findings, it is important for doctors prescribing valproate to monitor women taking the drug for signs of PCOS.”
Neck artery thicker in women with PCOS; could indicate increased risk for heart disease
Researchers have discovered that the carotid artery, which is located in the neck, is thicker in women with PCOS. This new finding indicates that these women are at a higher risk for developing heart disease. The researchers note that women with PCOS should be treated to reduce their androgen levels and should make appropriate life-style modifications to prevent the development of heart disease.
Researchers in Madrid, Spain, led by Dr. Hector Escobar-Morreale, measured the thickness of the carotid artery using ultrasonography in 12 women with high levels of androgens, which is a sign of PCOS. Insulin and testosterone levels were also measured in the women’s blood.
“The women in our study had much thicker carotid arteries compared with the standards for healthy women,” explained Dr. Jose I. Botella-Carretero, one of the authors on the study. “Previous research has shown that an increase in the carotid artery thickness is a cardiovascular risk factor and has also been related to insulin resistance.”
Researchers also note that the thickness of the carotid artery also correlated with increased levels of testosterone, but not increased insulin levels. This suggests that the frequency of cardiovascular disease in women may not be related to high insulin levels.
Sleep condition may increase risk for diabetes in women with PCOS
Women with PCOS who suffer from sleep apnea, a condition characterized by periods of halted breathing during sleep, may be at greater risk for developing diabetes, according to new research. The new findings give doctors another way to identify women who are at risk for developing diabetes as a result of PCOS.
Researchers already know that women with PCOS are at a higher risk for developing sleep apnea and that sleep apnea is linked to insulin resistance. However, Dr. Esra Tasali and researchers at the University of Chicago, sought to determine the relationship between hyperinsulinemia, a pre-diabetes condition when the blood sugar control system does not work properly body mass index (BMI) and risk for sleep apnea in women with PCOS.
The researchers screened forty women with PCOS through a survey that asked about snoring, daytime sleepiness, hypertension and BMI. They found that 75 percent of the women were at high risk for sleep apnea. Additionally, they found that the patients at high risk for sleep apnea had higher fasting insulin levels. Researchers also found a link between degree of obesity and fasting insulin levels in the high risk group.
“Sleep apnea appears to increase the incidence of hyperinsulinemia in women with PCOS. These findings indicate that women with PCOS who suffer from sleep apnea should be closely monitored for the development of diabetes,” notes Dr. Tasali.
PCOS more prevalent in Mexican-American women
Mexican-American women may have nearly double the prevalence of polycystic ovary syndrome (PCOS), according to new research. While previous research has shown that PCOS affects five to 10 percent of reproductive aged women, the new findings indicate that PCOS may affects as many as 17 percent of Mexican-American women.
Drs. Mark Goodarzi, Manuel Quinones, Willa Hsueh and fellow researchers at the David Geffen School of Medicine at UCLA and the Cedars-Sinai Medical Center in Los Angeles assessed the responses of 108 Mexican-American women (average age of 35) to a questionnaire, which evaluated symptoms of PCOS, such as insulin resistance and excess body hair. Dr. Goodarzi and his colleagues found that 17 percent of the women who filled out the questionnaire were classified as having PCOS, based on their symptoms. “While previous studies have looked at PCOS in African-American and Caucasian women, this is the first study to evaluate how common PCOS is in Mexican-American women,” explains Dr. Azziz, one of the study co-investigators. “Based on our findings, we believe that the prevalence of PCOS in these women is much higher than in other populations. As a result, a much higher percentage of Mexican-American women are at risk for developing diabetes and cardiovascular disease, which are both associated with PCOS.” Dr. Goodarzi and colleagues plan to verify the questionnaire findings with clinical examinations and androgen measurements.
Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Endocrinologists are specially trained doctors who diagnose, treat and conduct basic and clinical research on complex hormonal disorders such as diabetes, thyroid disease, osteoporosis, obesity, hypertension, cholesterol and reproductive disorders. Today, The Endocrine Society’s membership consists of over 11,000 scientists, physicians, educators, nurses and students, in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit the Society’s web site at www.endo-society.org