Markers assessing bone and metabolic health in polycystic ovary syndrome

The thesis work dealt with the effects of polycystic ovary syndrome (PCOS) on bone health and intestinal permeability. PCOS is a common endocrine disorder affecting 5-20% of reproductive-aged women. The main features of the syndrome include menstrual irregularities, hyperandrogenism and polycystic ovaries. The exact etiology of PCOS is still under debate and is considered to be a multifactorial disorder. The focus of studies in PCOS has been largely on the reproductive and metabolic aspects of the syndrome, with few studies focusing on skeletal health even though women with PCOS show altered hormonal changes which can affect bone metabolism and bone mass.

Bone turnover in women with PCOS was assessed by analyzing circulating markers that reflect underlying changes in bone mass and provide a simple assessment of bone turnover. The intestinal permeability markers and adipokine retinol binding protein-4 were also analyzed for their possible associations with hormonal and metabolic parameters. The study population consisted of women with PCOS and control women derived from a Nordic multi-center study and from the Northern Finland Birth Cohort 1966.

The study showed that women with PCOS under the age of 30 showed decreased bone formation, which could have a negative impact on bone health in these women. However, treatment with metformin, one of the widely used drugs in the treatment of PCOS, was associated with reduced bone turnover preventing bone loss. The results highlight the importance of further longitudinal studies with fracture-incidence as there is limited data on the long-term skeletal health of women with PCOS. Further, the role of adipokine retinol-binding protein 4 and altered intestinal permeability in the pathogenesis of the syndrome could not be ascertained.