What is the Evaluating the Roles of Lifestyle, Genetics, and Menstrual Cycle in Polycystic Ovarian Syndrome: A Meta-Analysis
DOI:
https://doi.org/10.26911/thejmch.2024.09.03.08Abstract
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, PCOSReferences
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.