title: Adverse Long-term Metabolic and Endometrial Consequences in Women with Polycystic Ovarian Syndrome: A Report of Two Cases.
abstract: BACKGROUND
  Little prospective data exist on associations between polycystic ovary syndrome (PCOS) and long-term metabolic disorders/endometrial malignancy in women. We report the cases of 2 obese, infertile women with PCOS who experienced long-term adverse metabolic and endometrial consequences.
  
  
  METHODS
  The first woman developed type 2 diabetes and hypertension after a 10-year history of PCOS and subsequent endometrioid carcinoma after having PCOS for 16 years. The second woman was first diagnosed with endometrial atypical hyperplasia, which failed to respond to high-dose progestin treatment, and then was diagnosed with PCOS after a 10-year history of oligomenorrhea. Laboratory testing revealed dyslipidemia and impaired glucose tolerance. Both women had a family history of diabetes. The second woman was administered oral contraceptives and metformin. Her endometrial atypia regressed and insulin sensitivity improved after 6 months of treatment.
  
  
  CONCLUSIONS
  PCOS may be associated with long-term adverse metabolic and endometrial consequences. Timely diagnosis and appropriate monitoring and management should be emphasized in order to prevent these women from adverse long-term complications. Oral contraceptives in combination with metformin reversed endometrial atypical hyperplasia in the obese, progestin-resistant woman with PCOS. Further clinical studies may be needed to confirm the effectiveness of such treatment on endometrial atypia in obese, progestin-resistant women for fertility sparing.
authors.forename: Salma A
authors.initials: SA
authors.lastname: Mahmoud
authors.forename: Lizhi
authors.initials: L
authors.lastname: Zhang
authors.forename: Chenyu
authors.initials: C
authors.lastname: Jia
authors.forename: Hong
authors.initials: H
authors.lastname: Zang
mesh_terms: D000328:Adult; D018269:Carcinoma, Endometrioid / Q000150:complications* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D050171:Dyslipidemias / Q000150:complications* / Q000378:metabolism; D004714:Endometrial Hyperplasia / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D016889:Endometrial Neoplasms / Q000150:complications* / Q000378:metabolism; D005234:Fatty Liver / Q000150:complications / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007247:Infertility, Female / Q000150:complications* / Q000378:metabolism; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D011372:Progestins / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D007004:Hypoglycemic Agents; D011372:Progestins; D008687:Metformin