Inter-relationship between polycystic ovary syndrome and metabolic syndrome

Polycystic Ovary Syndrome (PCOS), the endocrinopathy of adolescent girls and women of childbearing age, is highly prevalent across the globe with 3.7–22.5 of women affected. The varied prevalence is owing to the differences of populations studied and the diagnostic criteria used. Hyperandrogenism (HA) and insulin resistance (IR) being the most common etiopathogenic phenomena, of the condition, several other risk factors such as oxidative stress, defect in leptin-adiponectin (adipocyte biology) pathway, autoimmunity, etc., too play a role in its pathogenesis. Most of the studies have found a consistent relationship between PCOS and other associated metabolic comorbidities such as obesity, dyslipidemia, hypertension, non-alcoholic fatty liver disease (NAFLD), abnormal glucose tolerance (AGT), and long-term cardiovascular risks are more commonly implicated. A lot of overlap has been found between PCOS and metabolic syndrome (MS). Like PCOS, MS includes a constellation of metabolic disorders including AGT, dyslipidemia, and hypertension with IR as the central driver and hence the most common pathogenic link between the two. MS is very common among women with PCOS affecting approximately 43%–47% which is approximately twice greater than that of normal women. Accordingly, lifestyle modification has been proved to be most beneficial with or without pharmacological interventions such as therapy with an insulin sensitizing agents like metformin or thiazolidinediones(TZDs) among others. This article aims to summarize the existing data about the prevalence, presentation, and risk factors, metabolic links and treatment of MS in women with PCOS.