Metabolic syndrome in women with polycystic ovary syndrome

Key content The risk factors for metabolic syndrome include central obesity, hypertension, atherogenic dyslipidaemia and insulin resistance. Metabolic syndrome affects 33% of women with polycystic ovary syndrome (PCOS) and has been less well researched than other features such as infertility, anovulation and hirsutism. Consequences of metabolic syndrome include cardiovascular disease, type II diabetes, cancer, sleep apnoea and psychological problems. Cardiometabolic risk screening involves obtaining data on smoking history, weight, body mass index, waist circumference, blood pressure, lipid profile, and taking an oral glucose tolerance test. Management of metabolic syndrome should focus on risk factors and individual components. Lifestyle modification is the only recommended intervention at present. Learning objectives To know the pathogenesis and consequences of metabolic syndrome in women with PCOS. To understand the diagnostic criteria and screening procedures for metabolic syndrome. To learn how to manage metabolic syndrome in women with PCOS. Ethical issues Potential preventive long-term medication raises two issues: duration of therapy and unwarranted adverse effects. Advocating bariatric surgery without availability of robust evidence in PCOS women.