Highlights from the Androgen Excess & PCOS Society's 9th Meeting
Last week, I had the pleasure of being one of 130 international experts in the field of PCOS who attended the Androgen Excess & PCOS Society's annual meeting in Orlando, Florida. Most years, this meeting does not take place in the U.S. The majority of PCOS experts in attendance were reproductive or pediatric endocrinologists, who treat patients and/or conduct research in the areas of androgen excess and PCOS. I was the only registered dietitian at the conference.
The pace of the conference was very quick, covering a total of 33 presentations in 10 hours. A Q & A session was held after every 3rd or 4th presentation followed by a brief discussion.
It was a very exciting day for several reasons. The first was that it was great to meet and put faces to the names of researchers whose studies I have read which has taught me so much about this syndrome. Secondly, it was thrilling to hear about the new research many of the physicians are conducting on PCOS for it is research that will give us more insight into treating this most complex endocrine disorder.
Here is a brief summary of some topics presented:
Metabolic Dysfunction of PCOS
Women with PCOS are at high risk for Obstructive sleep apnea (OSA), evidenced by low slow wave activity, sleep loss, and hypoxia. It has been found that OSA can affect the sympathetic nervous system and hypothalamic adrenal axis, influencing weight. OSA may lead to the development of metabolic dysfunction. Sleep apnea should not be overlooked in PCOS. Treatment for OSA can improve insulin and reduce risk for IGT and metabolic syndrome.
Dyslipidemia of PCOS
Women with PCOS have higher levels of triglycerides and LDL cholesterol (the bad kind), lower HDL (good kind) compared to women without the syndrome. Insulin, not testosterone, is linked as the main influencer to abnormal lipid levels. Life-long metabolic dysfunction exaggerates the risk for heart disease as women with PCOS age. Women with PCOS need to know their lipid levels now and do something about it. Lifestyle is first strategy recommended to improve lipids.
Inflammation in PCOS
PCOS is a state of inflammation. Dietary triggers such as glucose are capable of causing an inflammatory response of women with PCOS. A Pro-inflammatory state of obesity also contributes to IR and atherogenesis in PCOS.
Medical Management of Metabolic Dysfunction in PCOS
It was great to hear vitamin D mentioned as a medical way to manage the metabolic aspects of PCOS, including insulin. Old and new mediations for treating PCOS (mostly insulin sensitizers and statins) were discussed. Almost all of them have significant side effects.
A genetic link to PCOS has been identified, leading some to hypothesize that PCOS is an ancient disorder. Androgen excess is the primary defect in PCOS. Research shows baby girls born from PCOS moms have androgen levels similar to that of baby boys. Large scale approaches to gene discovery have been conducted in the last year and have the potential to dramatically advance the field of PCOS genetics.
In all, the conference was terrific with lots of information presented and topics discussed. The only aspect I didn't like was that there was hardly any mention of the role of diet, even though lifestyle was stated as the primary treatment method for managing PCOS. I would hope future conferences would include more medical nutrition therapy strategies for PCOS.
About the Androgen Excess and PCOS Society
The Androgen Excess and PCOS Society is an international organization dedicated to promoting knowledge, and original clinical and basic research, in every aspect of androgen excess disorders, such as the polycystic ovary syndrome, non-classical adrenal hyperplasia, idiopathic hirsutism, and premature adrenarche. Members include basic and clinical scientists, and clinicians, whose major interest is the etiology, diagnosis, treatment and prevention of androgen excess disorders. The Society disseminates information to the medical and scientific community, and the lay public.
The society has a great patient section with information on treatment options, frequently asked questions about PCOS and other related androgen excess conditions, locations of research centers and regularly updated fact sheets written by its members. For more information visit http://ae-society.org/patients.
If you are a physician, dietitian, nurse or other health care provider who works with the PCOS population, I encourage you to join the Androgen Excess & PCOS Society. For more information about becoming a member, please visit http://www.ae-society.org.
The next Androgen Excess & PCOS Society Meeting will be September 2012 in Beijing.