What is the Evaluating the Roles of Lifestyle, Genetics, and Menstrual Cycle in Polycystic Ovarian Syndrome: A Meta-Analysis

Authors

  • Dian Ayu Pramukawati Sebelas Maret University
  • Rulita Ayu Rachmawati Master's Program in Public Health, Universitas Sebelas Maret
  • Normalia Levi Rismawati Master's Program in Public Health, Universitas Sebelas Maret
  • Bhisma Murti Master's Program in Public Health, Universitas Sebelas Maret
  • Siti Mar'atul Munawaroh Doctoral Program in Public Health, Faculty of Medicine, Universitas Sebelas Maret

DOI:

https://doi.org/10.26911/thejmch.2024.09.03.08

Abstract

Background: The WHO in 2023 reports that polycystic ovary syndrome (PCOS) has affected about 8–13% of women of reproductive age. Some studies report that lifestyle, hormones, and genetics are one of the risk factors for PCOS. This study aims to analyze and estimate the magnitude of the effects of obesity, smoking, irregular menstruation, and having a family history of PCOS with the incidence of PCOS in women of childbearing age.

Subjects and Method: Systematic review and meta-analysis studies were conducted according to the PRISMA flowchart and PICO model. Population: women of childbearing age. Intervention: obesity, smoking, irregular periods, and a family history of PCOS. Comparison: Normal BMI, no smoking, regular periods, and no family history of PCOS. Outcome: PCOS. The basic data used involves Google Scholar, PubMed, BMC, ScienceDirect, and Springer Link. The inclusion criteria are full-text articles with observational study design using multivariate analysis that attaches aOR values and is published from 2013-2024. Data analysis using Review Manager 5.3 application.

Results: Five primary studies were used to analyze obesity with PCOS. Women with obesity had 2.49 times the risk of developing PCOS compared to non-obese (OR= 2.49; CI 95%= 1.59 to 3.88; p < 0.001). Five primary studies were used to analyze smoking with PCOS. Women with smoking habits have a risk of developing PCOS 1.42 times compared to nonsmokers (OR= 1.42; CI 95%= 1.04 to 1.95; p= 0.03). Ten primary studies were used to analyze irregular periods with PCOS. Women with irregular periods had a 3.32 times risk of developing PCOS compared to regular periods (OR= 3.32; CI 95%= 2.77 to 3.97; p < 0.001). Eleven primary studies used for analysis had a family history of PCOS with PCOS. Women with a family history of PCOS had a 2.94 times higher risk of having PCOS than no family history of PCOS (OR= 2.94; CI 95%= 2.11 to 4.09; p < 0.001).

Conclusion: Obesity, smoking, irregular periods, and a family history of PCOS increase the risk of PCOS in women of childbearing age.

Keywords:

Obesity, smoking, menstrual cycle, family history, PCOS

References

Amanat S, Ashkar F, Eftekhari MH, Tanideh N, Doaei S, Gholamalizadeh M, Koohpeyma F, Mokhtari M (2021). The effect of genistein on insulin resistance, inflammatory factors, lipid profile, and histopathologic indices in rats with polycystic ovary syndrome. Clin Exp Reprod Med. 48(3): 1–9. https://doi.org/10.5653/cerm.2020.04231

Azevedo MMP, de Marqui ABT, Bacalá BT, Balarin MAS, de Resende EAMR, Lima MFP, de Oliveira GMK, Cintra MTR (2021). Polymorphisms of the GSTT1 and GSTM1 genes in polycystic ovary syndrome. Rev Assoc Med Bras, 66(11): 1560–1565. https://doi.org/10.1590/18069282.66.11.1560

Bahadori A, Khazamipour A, Farhud DD (2016). Genetics poly cystic ovary syndrome. Asian Pac J Cancer Biol, 1(4), 97–105. https://doi.org/10.31557/APJCB.2016.1.4.97

Bedrick BS, Eskew AM, Chavarro JE, Jungheim ES (2020). Self-Administered questionnaire to screen for polycystic ovarian syndrome. Womens Health Rep. 1(1): 566–573. https://doi.org/10.1089/whr.2020.0073

Bogari NM (2020). Genetic construction between polycystic ovarian syndrome and type 2 diabetes. Saudi J Biol Sci. 27(10): 2539–2543. https://doi.org/10.1016/j.sjbs.2020.05.004

Coffin T, Wray J, Sah R, Maj M, Nath R, Nauhria S, Maity S, Nauhria S (2023). A Review and Meta-Analysis of the Prevalence and Health Impact of Polycystic Ovary Syndrome Among Medical and Dental Students. Cureus. https://doi.org/10.7759/cureus.40141

Cooney LG, Dokras A (2018). Beyond fertility: polycystic ovary syndrome and longterm health. Fertil Steril, 110(5), 794–809. https://doi.org/10.1016/j.fertnstert.2018.08.021

Hanedan N, Ersoy B, Hanedan C, Ozyurt BC, Taneli F (2022). Effect of the presence of polycystic ovary syndromerelated features on anti-Mullerian hormone and androstenedione levels in adolescents with or without menstrual irregularity. Obstet Gynecol. 306(2): 523–531. https://doi.org/10.1007/s00404022065054

Hu KL, Gan K, Ying Y, Zheng J, Chen R, Xue J, Wu Y, Liu Y, Zhu Y, Xing L, Zhang D (2021). Oligo/amenorrhea is an independent risk factor associated with low ovarian response. Front Endocrinol. 12. https://doi.org/10.3389/fendo.2021.612042

Jafari A, Rajabi A, Gholian-Aval M, Peyman N, Mahdizadeh M, Tehrani H (2021). National, regional, and global prevalence of cigarette smoking among women/ females in the general population: a systematic review and meta-analysis. Environ Health Prev Med. 26(1). https://doi.org/10.1186/s1219902000924y

Jain T, Negris O, Brown D, Galic I, Salimgaraev R, Zhaunova L (2021). Characterization of polycystic ovary syndrome among Flo app users around the world. Reprod Biol Endocrin, 19(1). https://doi.org/10.1186/s1295802100719y

Kaur R, Kaur M, Singh S, Kaur T, Kaur A (2022). Genetic variants of CYP11B2 and cyp1a1 among the north-indian punjabi females with polycystic ovary syndrome. Korean J Clin Lab Sci. 54(4): 316–324. https://doi.org/10.15324/kjcls.2022.54.4.316

Kim C, Schreiner PJ, Siscovick D, Wang A, Wellons MF, Ebong I, Vu TH, Appiah D, Catov J, Schisterman EF, Yin Z, Lewis CE (2023). Factors associated with self-report of polycystic ovary syndrome in the coronary artery risk development in young adults study (CARDIA). BMC Women’s Health, 23(1). https://doi.org/10.1186/s12905023023940

Krysiak R, Kowalcze K, Okopień B (2023). Impact of lisinopril on cardiometabolic risk factors in sisters of women with polycystic ovary syndrome. J Clin Pharmacol. 63(9): 1045–1052. https://doi.org/10.1002/jcph.2268

Makhija N, Tayade S, Toshniwal S, Tilva H (2023). Clinicometabolic profile in lean versus obese polycystic ovarian syndrome women. Cureus. https://doi.org/10.7759/cureus.37809

Moran LJ, Brown WJ, McNaughton SA, Joham AE, Teede HJ (2017). Weight management practices associated with PCOS and their relationships with diet and physical activity. Hum Reprod 32(3): 669–678. https://doi.org/10.1093/humrep/dew348

Ni Z, Mei S, You S, Lin Y, Cheng W, Zhou L, Kuang Y, Yu C (2022). Adverse effects of polycystic ovarian syndrome on pregnancy outcomes in women with frozen-thawed embryo transfer: propensity score-matched study. Front Endocrinol: 13. https://doi.org/10.3389/fendo.2022.878853

Niu Y, Wang X, Wang D, Jiang X (2020). Changes of serum vitamin D levels in infertile patients with polycystic ovarian syndrome and its significance. Int J Clin Exp Med, 13(5), 3442-3448. www.ijcem.com

Oladipupo I, Ali T, Hein DW, Pagidas K, Bohler H, Doll MA, Mann ML, et al. (2022). Association between cigarette smoking and ovarian reserve among women seeking fertility care. PLoS ONE. 17(12 December). https://doi.org/10.1371/journal.pone.0278998

Özay ÖE, Özay AC (2020). Smoking reduces ovarian stromal blood flow in polycystic ovary syndrome patients. Ginekol Pol. 91(4): 201–206. https://doi.org/10.5603/GP.2020.0041

Peeva M, Badeghiesh A, Baghlaf H, Dahan MH (2022). Association between obesity in women with polycystic ovary syndrome and adverse obstetric outcomes. RBMO. 45(1): 159–167. https://doi.org/10.1016/j

Rakic D, Joksimovic J, Jakovljevic V, Zivkovic V, Nikolic M, Sretenovic J, Nikolic M, et al. (2023). High fat diet exaggerates metabolic and reproductive PCOS Features by promoting oxidative stress: an improved EV model in rats. Med Lith, 59(6). https://doi.org/10.3390/medicina59061104

Rizvi M, Islam MA, Aftab MT, Naqvi AA, Jahangir A, Ishaqui AA, Iqbal MZ, Iqbal MS (2023). Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students. PLoS ONE, 18(5). https://doi.org/10.1371/journal.pone.0285284

Shan B, Cai JH, Yang SY, Li ZR (2015). Risk factors of polycystic ovarian syndrome among Li People. Asian Pac J Trop Med, 8(7), 590–593. https://doi.org/10.1016/j.apjtm.2015.07.001

Simon V, Peigné M, Dewailly D (2023). The psychosocial impact of polycystic ovary syndrome. J Reprod Med 4(1): 57–64. https://doi.org/10.3390/reprodmed4010007

Sirmans SM, Pate KA (2013). Epidemiology, diagnosis, and management of polycystic ovary syndrome. J Clin Epidemiol, 6(1), 1–13. https://doi.org/10.2147/clep.s37559

Stokkeland LMT, Giskeødegård GF, Ryssdal M, Jarmund AH, Steinkjer B, Madssen TS, Stafne SN, Stridsklev S, Løvvik TS, Iversen AC, Vanky E (2022). Changes in serum cytokines throughout pregnancy in women with polycystic ovary syndrome. J Clin Endocrinol Metab, 107(1): 39–52. https://doi.org/10.1210/clinem/dgab684

Tahir H, Hassan A, Khan QU, Hafeez F (2020). Prevalence of polycystic ovary syndrome awareness among female medical students. Discover Rep, 3, e10. doi: https://doi.org/10.15190/drep.2020.4

Tao Y, Liu B, Chen Y, Hu Y, Zhu R, Ye D, Mao Y, Sun X (2021). Genetically predicted cigarette smoking in relation to risk of polycystic ovary syndrome. J Clin Epidemiol, 13, 527–532. https://doi.org/10.2147/CLEP.S311785

Tay CT, Loxton D, Khomami MB, Teede H, Harrison CL, Joham AE (2023). High prevalence of medical conditions and unhealthy lifestyle behaviors in women with PCOS during preconception: findings from the Australian Longitudinal Study on Women’s Health. Hum Reprod, 38(11): 2267–2276. https://doi.org/10.1093/humrep/dead190

West S, Lashen H, Bloigu A, Franks S, Puukka K, Ruokonen A, Järvelin MR, Tapanainen JS, Morin-Papunen L (2014). Irregular menstruation and hyperandrogenaemia in adolescence are associated with polycystic ovary syndrome and infertility in later life: Northern Finland Birth Cohort 1986 study. Hum Reprod, 29(10): 2339–2351. https://doi.org/10.1093/humrep/deu200

Witchel SF, Oberfield SE, Peña AS (2019). Polycystic ovary syndrome: pathophysiology, presentation, and treatment with emphasis on adolescent girls. J Endocr Soc. 3(8): 1545–1573. https://doi.org/10.1210/js.201900078

World Health Organization. (2021, June 9). Obesity. WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

World Health Organization. (2023a, June 28). Polycystic ovary syndrome. WHO. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

World Health Organization. (2023b, July 31). Tobacco. WHO. https://www.who.int/news-room/fact-sheets/detail/tobacco

Yang R, Li Q, Zhou Z, Qian W, Zhang J, Wu Z, Jin L, et al. (2022). Changes in the prevalence of polycystic ovary syndrome in China over the past decade. Lancet Reg Health West Pac, 25, 100494. https://doi.org/10.1016/j

Zeidan K, Hassoon, Ahmed S (2022). Polycystic ovary syndrome risk factors among women in baghdad: a case-control study. J Health Educ Health Promot, 10(3), 483–487.

Zhang B, Zhou W, Shi Y, Zhang J, Cui L, Chen ZJ (2020). Lifestyle and environmental contributions to ovulatory dysfunction in women of polycystic ovary syndrome. BMC Endocr Disord, 20(1). https://doi.org/10.1186/s1290202004976.

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Published

2024-05-16

How to Cite

Pramukawati, D. A., Ayu Rachmawati, R., Levi Rismawati, N., Murti, B., & Mar’atul Munawaroh , S. (2024). What is the Evaluating the Roles of Lifestyle, Genetics, and Menstrual Cycle in Polycystic Ovarian Syndrome: A Meta-Analysis. Journal of Maternal and Child Health, 9(3), 364–384. https://doi.org/10.26911/thejmch.2024.09.03.08

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