Polycystic ovary syndrome as a plausible evolutionary outcome of metabolic adaptation

As a common endocrinopathy of reproductive-aged women, polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, oligo-anovulation and polycystic ovarian morphology. It is linked with insulin resistance through preferential abdominal fat accumulation that is worsened by obesity. Over th...

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Bibliographic Details
Published in:Reproductive biology and endocrinology 2022-01, Vol.20 (1), p.12-12, Article 12
Main Authors: Dumesic, Daniel A, Padmanabhan, Vasantha, Chazenbalk, Gregorio D, Abbott, David H
Format: Article
Language:English
Subjects:
Adaptation, Physiological - physiology
Adipocyte
Adipocytes
Adipose stem cells
Adult
Animal models
Animals
Developmental programming
Endocrine disorders
Energy Metabolism - physiology
Energy storage
Evolution
Fatty acids
Female
Fetuses
Humans
Hyperandrogenism
Hyperandrogenism - etiology
Hyperandrogenism - metabolism
Infertility
Insulin
Insulin resistance
Insulin Resistance - physiology
Kinases
Menstruation
Menstruation Disturbances - etiology
Menstruation Disturbances - metabolism
Metabolic Syndrome - complications
Metabolic Syndrome - metabolism
Obesity
Oxidation
Phenotypes
Polycystic ovary syndrome
Polycystic Ovary Syndrome - etiology
Polycystic Ovary Syndrome - metabolism
Review
Stein-Leventhal syndrome
Stem cell transplantation
Stem cells
Type 2 diabetes
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Summary:As a common endocrinopathy of reproductive-aged women, polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, oligo-anovulation and polycystic ovarian morphology. It is linked with insulin resistance through preferential abdominal fat accumulation that is worsened by obesity. Over the past two millennia, menstrual irregularity, male-type habitus and sub-infertility have been described in women and confirm that these clinical features of PCOS were common in antiquity. Recent findings in normal-weight hyperandrogenic PCOS women show that exaggerated lipid accumulation by subcutaneous (SC) abdominal stem cells during development to adipocytes in vitro occurs in combination with reduced insulin sensitivity and preferential accumulation of highly-lipolytic intra-abdominal fat in vivo. This PCOS phenotype may be an evolutionary metabolic adaptation to balance energy storage with glucose availability and fatty acid oxidation for optimal energy use during reproduction. This review integrates fundamental endocrine-metabolic changes in healthy, normal-weight PCOS women with similar PCOS-like traits present in animal models in which tissue differentiation is completed during fetal life as in humans to support the evolutionary concept that PCOS has common ancestral and developmental origins.
ISSN:1477-7827
1477-7827
DOI:10.1186/s12958-021-00878-y