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OBJECTIVE: To establish the prevalence of symptoms associated with polycystic ovary syndrome (PCOS) in a population-based sample of women from Northern Sweden, and to relate symptoms of PCOS to features of metabolic syndrome. METHODS: A population-based survey of 147 women under 40 years of age sampled from 267 eligible women from the Northern Sweden component of the World Health Organization's MONICA study. The study involved questionnaires, physical examination, and assays of testosterone and sex hormone-binding globulin. RESULTS: The estimated prevalence of symptoms associated with PCOS was 4.8% in the study population. Features of metabolic syndrome were more common in women with signs of hyperandrogenism than in healthy controls. CONCLUSION: The estimated prevalence of PCOS in Northern Sweden corresponds with other prevalence studies. A simple questionnaire and analysis of the free androgen index are sufficient to detect the subgroup with the highest risk for metabolic syndrome.

Objective: Disturbances in the fibrinolytic system are predictors of future cardiovascular events. The aim of the present study was to compare PAI-1 activity and tPA mass concentration between patients with polycystic ovary syndrome (PCOS) and control subjects.

Design: 135 PCOS patients (lean and overweight) and 81 healthy controls were recruited for the study. Blood samples for PAI-1 activity and tPA mass were collected together with anthropometric measures.

Results: Overweigth PCOS patients displayed increased tPA mass concentration in comparison with controls (p < 0.05), and this finding was consistent regardless of whether patients displayed signs of hyperandrogenism or not. When hyperandrogenism was introduced as a prerequisite for the PCOS diagnosis, overweight PCOS patients displayed increased PAI-1 activity as well, p < 0.05. Lean PCOS patients did not differ in terms of PAI-1 activity or tPA mass concentration in comparison to controls.

Conclusion: Overweight women with PCOS have impaired fibrinolysis, in particular if they also display objective biochemical markers of hyperandrogenism.

OBJECTIVE: To examine the efficacy of sibutramine together with brief lifestyle modification for weight reduction in obese women with polycystic ovary syndrome (PCOS). DESIGN: Investigator-initiated, multicenter, double-blind, randomized, parallel-group clinical trial. SETTING: Departments of Obstetrics and Gynecology in primary care, referral centers, and private practice. PATIENT(S): Forty-two patients with confirmed PCOS were included in the study, and 34 patients completed the study. INTERVENTION: Sibutramine 15 mg once daily together with brief lifestyle modification was compare with placebo together with brief lifestyle modification. MAIN OUTCOME MEASURE(S): The primary endpoint was to assess weight loss. Secondary endpoints included the efficacy of sibutramine for treatment of menstrual pattern and cardiovascular risk factors. RESULT(S): After 6 months the sibutramine group had lost 7.8 +/- 5.1 kg compared with a weight loss of 2.8 +/- 6.2 kg in the placebo group. Sibutramine treatment resulted in significant decreases in apolipoprotein B, apolipoprotein B/apolipoprotein A ratio, triglycerides, and cystatin C levels. CONCLUSION(S): Sibutramine in combination with lifestyle intervention results in significant weight reduction in obese patients with PCOS. In addition to the weight loss, sibutramine seems to have beneficial effects on metabolic and cardiovascular risk factors.

Context: Previous studies have indicated that peripheral circulating markers of inflammation are elevated in women with polycystic ovary syndrome (PCOS). Thus far, no studies concerning adipose tissue expression of inflammatory markers have been conducted in PCOS patients.

Objectives: The aim of the study was to investigate if PCOS patients display increased adipose tissue expression of inflammatory markers.

Design and Settings: Cross-sectional study at three out-patient gynecologic departments.

Participants and Approach: Ten lean PCOS patients, 20 overweight PCOS patients, and 20 overweight controls underwent subcutaneous fat biopsies and blood samples.

Main Outcome Measures: Adipose tissue gene expression of inflammatory markers, circulating markers of inflammation, and obesity-related metabolic disturbances.

Results: Overweight PCOS patients had higher relative amounts of adipose tissue CCL2, CCR2, TNF-a, IL-18, CD14 and CD163 mRNA expression compared to lean PCOS women. There were no differences between overweight PCOS patients and overweight control subjects in this respect. Within the PCOS group, markers of adipose tissue inflammation correlated significantly with obesity-related metabolic disturbances, but when data were adjusted for age and BMI most correlations were lost.

Conclusion: Overweight, rather than the PCOS diagnosis per se, appears to be the main explanatory variable for elevated adipose tissue inflammation in PCOS patients. Our findings suggest that lean PCOS patients carry less risk for metabolic complications later on in life.