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Polycystic Ovary Syndrome Study Group
Hospital Universitario Ramón y Cajal (Madrid, Spain)
Principal investigator Héctor Francisco Escobar Morreale Associate researcher Francisco
Álvarez, Manuel Luque, María Belén Roldán, José Luis San Millán Postdoctoral fellow María Rosa
Insenser, María Ángeles Martínez PhD student Macarena Alpañés, Raúl Sanchón
metabolomics; 2) the clinical- and population-based Polycystic ovary syndrome (PCOS) is the most com- molecular genetics of PCOS, insulin resistance, diabe- mon metabolic disorder in women of reproductive age. tes and related metabolic disorders.
It is a disorder of complex multigenic aetiology in which predisposing and protective genomic variants interfere with strong environmental influences, PCOS is charac- terized by the association of androgen excess with dis- Clinical research. Statistics. Clinical biochemistry. ordered ovarian function and/or morphology. Androgen Molecular biology. Molecular genetics. Genomics. excess determines an abnormal deposition of body fat Proteomics.
which, by favouring abdominal adiposity and insulin re-sistance, predisposes women to develop diabetes later in life.
Achievements in 2008We have completed the recruitment and phenotyping of subjects for population-based studies on PCOS in the Mediterranean area in the context of an ongoing The influence of the balance between androgens and collaboration with highly-reputed groups from Italy and oestrogens on the development of abdominal adipos- ity and visceral adipose tissue dysfunction in humans We have finished the analysis of data of the impact of as pathogenetic factors of insulin resistance and dia- treatment with antiandrogenic oral contraceptives as betes, including 1) an integrated approach to the influ- compared with insulin sensitizers on non-classic car- ence of sex hormones on the amount and dysfunction diovascular risk factors of PCOS patients. Finally, we of visceral and subcutaneous fat as studied by clinical have established and standardized a proteomics plat-research, molecular biology, genomics, proteomics and form for the study of human plasma, fat and muscle samples for the study of insulin-resistant disorders, and Escobar-Morreale HF, Sanchón R, San Millán JL. A continued with case-control molecular genetic studies prospective study of the prevalence of nonclassic con-in PCOS and associated disorders.
genital adrenal hyperplasia (NCAH) among women
presenting with hyperandrogenic symptoms and signs.
J Clin Endocr Metab, 93, 527-533 (2008)
Future challengesTo standardize imaging techniques (CT scan and ul- Luque-Ramírez M, Álvarez-Blasco F, Uriol Rivera MG, trasonography) for the accurate measurement, in our Escobar-Morreale HF. Serum uric acid concentration lab, of the amount and distribution of body fat, and of as non-classic cardiovascular risk factor in women with hepatic steatosis.
polycystic ovary syndrome: effect of treatment with To collaborate with the Metabolomics Platform of ethinyl-estradiol plus cyproterone acetate versus met-
CIBERDEM in conducting comparative studies on formin. Hum Reprod, 23, 1594-1601 (2008)
PCOS plasma samples, and in standardizing LC-MS
and GC-MS tecniques for the correct measurement of
circulating testosterone in children and women.
To complete large population- and clinical-based mo- Abordaje global del estudio del sindrome de ovario lecular genetic studies on PCOS using high-thoughput poliquistico como marcador temprano del sindrome SNP analysis.
metabolico inflamatorio cardiovascularFondo de Investigación Sanitaria, PI050341: 2006-2008Research director: Héctor F Escobar Morreale PublicationsBotella-Carretero JI, Luque-Ramírez M, Álvarez-Blasco F, Peromingo R, San Millán JL, Escobar-Morreale HF. CollaborationsThe increase in serum visfatin after bariatric surgery Mediterranean PCOS Study Groupin morbidly obese women is modulated by weight loss, Renato Pasquali, Università di Bologna (Bologna, Italy), waist circumference and presence or absence of dia- Evanthia Diamanti-Kandarakis, University of Athens betes before surgery. Obes Surg, 18, 1000-1006 (2008)
(Athens, Greece), Anna Maria Fulghesu, Università di Cagliari (Cagliari, Italy) Cortón M, Botella-Carretero JI, López JA, Camafeita E,
San Millán JL, Escobar-Morreale HF, Peral B. Proteomic
analysis of human omental adipose tissue in the poly-
cystic ovary syndrome using two-dimensional differ-
ence gel electrophoresis and mass spectrometry. Hum
, 23, 651-661 (2008)
Escobar-Morreale HF. Polycystic ovary syndrome:
treatment strategies and management. Expert Opin
, 9, 2995-3008 (2008)
Escobar-Morreale HF, Botella-Carretero JI, Martínez-
García MA, Luque-Ramírez M, Álvarez-Blasco F, San
Millán JL. Serum osteoprotegerin concentrations are
decreased in women with the polycystic ovary syn-
drome. Eur J Endocrinol, 159, 225-232 (2008)
Escobar-Morreale HF, Insenser M, Cortón M, San Millán JL, Peral B. Proteomics and genomics: a hypoth- PCOS as the result of a vicious circle whereby androgen ex- esis-free approach to the study of the role of visceral cess induces abdominal adiposity and insulin resistance, re-adiposity in the pathogenesis of the polycystic ovary sulting in hyperinsulinism and further facilitation of androgen secretion (reproduced from Escobar Morreale and San Millán, syndrome. Proteomics - Clinical Applications, 2, 444-
Trend Endocrinol Metab, 18, 266-272 (2007), with permission of
Proteomic approach to the study of the differences for «Comparison of ethinyl-estradiol plus cyprot-between subcutaneous and visceral adipose tissue in erone acetate versus metformin effects on clas-lean and obese subjects sic metabolic cardiovascular risk factors in wom- Joan Vendrell, Hospital Universitari de Tarragona Joan en with the polycystic ovary syndrome». Manuel
XXIII-IISPV (Tarragona, Spain) and CIBERDEM. Rafael Luque-Ramírez et al. J Clin Endocr Metab, 92,
Simó, Hospital Universitari Vall d’Hebron (Barcelona, 2453-2461 (2007)
Spain) and CIBERDEM
The Endocrine Society’s Outstanding Reviewer Recognition Award 2008 - The Journal of Endocrinology 2008 Cardiovascular Risk Factor Prize awarded by and Metabolismthe Spanish Society of Endocrinology and Nutrition Awardee: Héctor F Escobar Morreale ٩ Androgen excess and triggering factors as the cause of PCOS. In some patients (*) androgen excess is severe enough to result in
PCOS even in the absence of triggering environmental factors. At the other extreme (†), a very mild defect in androgen secretion is
amplified by the coexistence of abdominal adiposity, obesity and/or insulin resistance. Between the two extremes, there is a spectrum
in the severity of the primary defect in androgen secretion, explaining the heterogeneity of PCOS patients with regards to the pres-
ence of obesity and metabolic comorbidities. However, all patients share a primary defect in androgen secretion. (reproduced from
Escobar Morreale and San Millán, Trend Endocrinol Met, 18, 266-272 (2007), with permission of Elsevier BV).


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