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Obesity and metabolism

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Obesity – threat to the reproductive potential of Russia

https://doi.org/10.14341/omet10340

Abstract

Obesity is a recurring polyetiological disease. Overweight are 30–60% of women of reproductive age, and 25–27% are obese. By 2025, it is expected that 50% of women on our planet will be obese. Obesity in women of reproductive age is accompanied by a high frequency of anovulation, hyperandrogenism, menstrual irregularities, endometrial pathology, infertility. During pregnancy, this group of women has a higher risk of short term loss, including pregnancy in the outcome of assisted reproductive technologies. Weight gain and obesity can lead to decreased fertility in women. The body mass index of a woman of reproductive age negatively affects the course of pregnancy, namely: the risk of gestational diabetes, increased blood pressure, eclampsia, the pathological course of the birth act and the pathology of the newborn increase. Obesity in women of reproductive age is an independent risk factor for cancer: breast cancer and endometrial cancer, and also leads to a decrease in the survival rate for ovarian cancer. Obesity often accompanies polycystic ovary syndrome, which occurs in every 10th patient of reproductive age. The combination of these diseases increases the risk of cardiometabolic conditions such as impaired glucose tolerance, type 2 diabetes and dyslipidemia. Weight loss in these patients is a necessary component of complex therapy aimed at improving reproductive potential.

About the Authors

Elena N. Andreeva
Endocrinology Research Centre; A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

MD, PhD, Professor



Ekaterina V. Sheremetyeva
Endocrinology Research Centre
Russian Federation

MD, PhD



Valentina A. Fursenko
Endocrinology Research Centre
Russian Federation

MD, postgraduate student



References

1. American Society for Metabolic and Bariatric Surgery. 2015 Year end review. ASMBS; 2015.

2. Hurtado Del Pozo C, Ruiz HH, Arivazhagan L, et al. A Receptor of the Immunoglobulin Superfamily Regulates Adaptive Thermogenesis. Cell Rep. 2019;28(3):773-791 e777. DOI:10.1016/j.celrep.2019.06.061

3. Ryan DH, Kahan S. Guideline Recommendations for Obesity Management. Med Clin North Am. 2018;102(1):49-63. DOI:10.1016/j.mcna.2017.08.006

4. Reis ECD, Passos SRL, Santos M. Quality assessment of clinical guidelines for the treatment of obesity in adults: application of the AGREE II instrument. Cad Saude Publica. 2018;34(6):e00050517. DOI:10.1590/0102-311X00050517

5. Who.int [интернет]. Ожирение и избыточный вес [доступ от ١٥.١١.٢٠١٩]. Доступ по ссылке: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight. Who.int [Internet]. Obesity and overweight [cited 2019 Nov 15]. Available from: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight. (In Russ).]

6. National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes Res. 1998;6(Suppl 2):51S-209S.

7. Anand P, Kunnumakkara AB, Sundaram C, et al. Cancer is a preventable disease that requires major lifestyle changes. Pharm Res. 2008;25(9):2097-2116. DOI:10.1007/s11095-008-9661-9

8. Министерства здравоохранения Российской Федерации. Женское бесплодие (современные подходы к диагностике и лечению. Клинические рекомендации (протокол лечения). ٢٠١٨. [Ministerstva zdravookhraneniya Rossiyskoy Federatsii. Zhenskoe besplodie (sovremennye podkhody k diagnostike i lecheniyu. Klinicheskie rekomendatsii (protokol lecheniya). 2018. (In Russ).]

9. Broughton DE, Moley KH. Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril. 2017;107(4):840-847. DOI:10.1016/j.fertnstert.2017.01.017

10. Benedetto C, Salvagno F, Canuto EM, Gennarelli G. Obesity and female malignancies. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):528-540. DOI:10.1016/j.bpobgyn.2015.01.003

11. Yang S, Thiel KW, Leslie KK. Progesterone: the ultimate endometrial tumor suppressor. Trends Endocrinol Metab. 2011;22(4):145-152. DOI:10.1016/j.tem.2011.01.005

12. Gottschau M, Kjaer SK, Jensen A, et al. Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study. Gynecol Oncol. 2015;136(1):99-103. DOI:10.1016/j.ygyno.2014.11.012

13. Jacobsen BK, Knutsen SF, Oda K, Fraser GE. Obesity at age 20 and the risk of miscarriages, irregular periods and reported problems of becoming pregnant: the Adventist Health Study-2. Eur J Epidemiol. 2012;27(12):923-931. DOI:10.1007/s10654-012-9749-8

14. Who.int [Internet]. Maternal Mortality (WHD 98.1) [cited 2019 Nov 15]. Available from: https://www.who.int/docstore/world-health-day/en/pages1998/whd98_01.html.

15. Jungheim ES, Travieso JL, Carson KR, Moley KH. Obesity and reproductive function. Obstet Gynecol Clin North Am. 2012;39(4):479-493. DOI:10.1016/j.ogc.2012.09.002

16. Pasquali R, Gambineri A. Metabolic effects of obesity on reproduction. Reprod Biomed Online. 2006;12(5):542-551. DOI:10.1016/s1472-6483(10)61179-0

17. Pasquali R, Pelusi C, Genghini S, et al. Obesity and reproductive disorders in women. Hum Reprod Update. 2003;9(4):359-372. DOI:10.1093/humupd/dmg024

18. Jain A, Polotsky AJ, Rochester D, et al. Pulsatile luteinizing hormone amplitude and progesterone metabolite excretion are reduced in obese women. J Clin Endocrinol Metab. 2007;92(7):2468-2473. DOI:10.1210/jc.2006-2274

19. Castillo-Martínez L, López-Alvarenga J, Villa A, González-Barranco J. Menstrual cycle length disorders in 18- to 40-y-old obese women. Nutrition. 2003;19(4):317-320. doi:10.1016/s0899-9007(02)00998-X

20. Polotsky AJ, Hailpern SM, Skurnick JH, et al. Association of adolescent obesity and lifetime nulliparity--the Study of Women’s Health Across the Nation (SWAN). Fertil Steril. 2010;93(6):2004-2011. DOI:10.1016/j.fertnstert.2008.12.059

21. Kuchenbecker WK, Groen H, Zijlstra TM, et al. The subcutaneous abdominal fat and not the intraabdominal fat compartment is associated with anovulation in women with obesity and infertility. J Clin Endocrinol Metab. 2010;95(5):2107-2112. DOI:10.1210/jc.2009-1915

22. Moran C, Hernandez E, Ruiz JE, et al. Upper body obesity and hyperinsulinemia are associated with anovulation. Gynecol Obstet Invest. 1999;47(1):1-5. DOI:10.1159/000010052

23. Gesink Law DC, Maclehose RF, Longnecker MP. Obesity and time to pregnancy. Hum Reprod. 2007;22(2):414-420. DOI:10.1093/humrep/del400

24. Jensen TK, Scheike T, Keiding N, et al. Fecundability in relation to body mass and menstrual cycle patterns. Epidemiology. 1999;10(4):422-428. DOI:10.1097/00001648-199907000-00011

25. Zaadstra BM, Seidell JC, Van Noord PA, et al. Fat and female fecundity: prospective study of effect of body fat distribution on conception rates. BMJ. 1993;306(6876):484-487. DOI:10.1136/bmj.306.6876.484

26. Rich-Edwards JW, Spiegelman D, Garland M, et al. Physical activity, body mass index, and ovulatory disorder infertility. Epidemiology. 2002;13(2):184-190. DOI:10.1097/00001648-200203000-00013

27. Mahutte N, Kamga-Ngande C, Sharma A, Sylvestre C. Obesity and Reproduction. J Obstet Gynaecol Can. 2018;40(7):950-966. DOI:10.1016/j.jogc.2018.04.030

28. Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health. 2007;7(1):168. DOI:10.1186/1471-2458-7-168

29. Беременность и ожирение // Ожирение и метаболизм. - 2009. - Т. 6. - №4. - C. 9-13. [Komshilova KA, Dzgoeva FK. Beremennost’ i ozhirenie. Obesity and metabolism. 2009;6(4):9-13. (In Russ).] DOI:10.14341/2071-8713-4872

30. Савельева И.В., Баринов С.В. Предгравидарная подготовка и ее влияние на исходы беременности у пациенток с метаболическим синдромом // РМЖ. МАТЬ И ДИТЯ. — 2014. — Т.22. - №19. — С.1412-1415 [Savel`eva IV, Barinov SV, Predgravidarnaya podgotovka i ee vliyanie na isxody` beremennosti u pacientok s metabolicheskim sindromom. RMŽ. Mat´ i ditâ. 2014.22(19):1412-1415 (In Russ).]

31. Подзолкова Н.М., Агеева М.И., Скворцова М.Ю., и др. Течение беременности и перинатальные исходы у женщин с нарушениями жирового обмена // Акушерство и гинекология. — 2011. — № 6. — С. 86-92. [Podzolkova NM, Ageeva MI, Skvortsova MY, et al. Pregnancy course and perinatal outcomes in women with impaired fat metabolism. Akush Ginekol (Mosk). 2011;(6):86-92. (In Russ).]

32. Выкидыш в ранние сроки беременности: диагностика и тактика ведения клинические рекомендации (протокол лечения). Клинические рекомендации (протокол лечения). – М.; ٢٠١٦. [Vykidysh v rannie sroki beremennosti: diagnostika i taktika vedeniya klinicheskie rekomendatsii (protokol lecheniya). Klinicheskie rekomendatsii (protokol lecheniya). Moscow; 2016. (In Russ).]

33. Kaur R, Gupta K. Endocrine dysfunction and recurrent spontaneous abortion: An overview. Int J Appl Basic Med Res. 2016;6(2):79-83. DOI:10.4103/2229-516X.179024

34. Siddiqui A, Azria E, Howell EA, et al. Associations between maternal obesity and severe maternal morbidity: Findings from the French EPIMOMS population-based study. Paediatr Perinat Epidemiol. 2019;33(1):7-16. DOI:10.1111/ppe.12522

35. Aune D, Saugstad OD, Henriksen T, Tonstad S. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA. 2014;311(15):1536-1546. DOI:10.1001/jama.2014.2269

36. Gaudet L, Ferraro ZM, Wen SW, Walker M. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. Biomed Res Int. 2014;2014:640291. DOI:10.1155/2014/640291

37. Kong L, Norstedt G, Schalling M, et al. The Risk of Offspring Psychiatric Disorders in the Setting of Maternal Obesity and Diabetes. Pediatrics. 2018;142(3). DOI:10.1542/peds.2018-0776

38. Holton S, Fisher J, Nguyen H, Brown WJ, Tran T. Pre-pregnancy body mass index and the risk of antenatal depression and anxiety. Women and Birth. 2019;32(6):e508-e514. DOI:10.1016/j.wombi.2019.01.007

39. Maged AM, Fahmy RM, Rashwan H, et al. Effect of body mass index on the outcome of IVF cycles among patients with poor ovarian response. Int J Gynaecol Obstet. 2019;144(2):161-166. DOI:10.1002/ijgo.12706

40. Pantasri T, Norman RJ. The effects of being overweight and obese on female reproduction: a review. Gynecol Endocrinol. 2014;30(2):90-94. DOI:10.3109/09513590.2013.850660

41. Jungheim ES, Travieso JL, Hopeman MM. Weighing the impact of obesity on female reproductive function and fertility. Nutr Rev. 2013;71(6):S3-S8. DOI:10.1111/nure.12056

42. Broughton DE, Moley KH. Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril. 2017;107(4):840-847. DOI:10.1016/j.fertnstert.2017.01.017

43. Koning AM, Mutsaerts MA, Kuchenbecker WK, et al. Complications and outcome of assisted reproduction technologies in overweight and obese women. Hum Reprod. 2012;27(2):457-467. DOI:10.1093/humrep/der416

44. Banker M, Mehta V, Sorathiya D, et al. Pregnancy outcomes and maternal and perinatal complications of pregnancies following in vitro fertilization/intracytoplasmic sperm injection using own oocytes, donor oocytes, and vitrified embryos: A prospective follow-up study. J Hum Reprod Sci. 2016;9(4):241-249. DOI:10.4103/0974-1208.197666

45. Frankenthal D, Hirsh-Yechezkel G, Boyko V, et al. The effect of body mass index (BMI) and gestational weight gain on adverse obstetrical outcomes in pregnancies following assisted reproductive technology as compared to spontaneously conceived pregnancies. Obes Res Clin Pract. 2019;13(2):150-155. DOI:10.1016/j.orcp.2018.11.239

46. Selter J, Wen T, Palmerola KL, et al. Life-threatening complications among women with severe ovarian hyperstimulation syndrome. Am J Obstet Gynecol. 2019;220(6):575 e571-575 e511. DOI:10.1016/j.ajog.2019.02.009

47. Kouhkan A, Khamseh ME, Moini A, et al. Diagnostic Accuracy of Body Mass Index and Fasting Glucose for The Prediction of Gestational Diabetes Mellitus after Assisted Reproductive Technology. Int J Fertil Steril. 2019;13(1):32-37. DOI:10.22074/ijfs.2019.5505

48. Wise MR, Jordan V, Lagas A, et al. Obesity and endometrial hyperplasia and cancer in premenopausal women: A systematic review. Am J Obstet Gynecol. 2016;214(6):689 e681-689 e617. DOI:10.1016/j.ajog.2016.01.175

49. Bellver J, Martinez-Conejero JA, Labarta E, et al. Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome. Fertil Steril. 2011;95(7):2335-2341, 2341 e2331-2338. DOI:10.1016/j.fertnstert.2011.03.021

50. Dessolle L, Darai E, Cornet D, et al. Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of 450 frozen-thawed embryo transfers. Hum Reprod. 2009;24(12):3082-3089. DOI:10.1093/humrep/dep303

51. Kolotkin RL, Zunker C, Ostbye T. Sexual functioning and obesity: a review. Obesity (Silver Spring). 2012;20(12):2325-2333. DOI:10.1038/oby.2012.104

52. Steffen KJ, King WC, White GE, et al. Changes in Sexual Functioning in Women and Men in the 5 Years After Bariatric Surgery. JAMA Surg. 2019;154(6):487-498. DOI:10.1001/jamasurg.2018.1162

53. ru.wikipedia.org [интернет]. Сексуальность человека [доступ от ١٥.١١.٢٠١٩]. Доступ по ссылке: https://ru.wikipedia.org/wiki/Сексуальность_человека [Ru.wikipedia.org [Internet]. Human sexuality [cited 2019 Nov 15]. Available from: https://ru.wikipedia.org/wiki/Сексуальность_человека (In Russ).]

54. Указ Президента РФ № 204 от ٧ мая ٢٠١٨ г. «О национальных целях и стратегических задачах развития Российской Федерации на период до ٢٠٢٤ года» [Decree of the President of the Russian Federation № 204 of 2018 May 7. «O natsional’nykh tselyakh i strategicheskikh zadachakh razvitiya Rossiyskoy Federatsii na period do 2024 goda». (In Russ).]

55. Демография. Gks.ru. https://www.gks.ru/folder/12781. Опубликовано в 2019. Доступ по ссылке 18 августа, 2019. https://www.gks.ru/storage/mediabank/Edn.xlsx

56. Demography. Gks.ru. https://www.gks.ru/folder/12781. Published 2019. Accessed August 18, 2019. https://www.gks.ru/storage/mediabank/Edn.xlsx

57. MacKintosh ML, Crosbie EJ. Prevention Strategies in Endometrial Carcinoma. Curr Oncol Rep. 2018;20(12):101. DOI:10.1007/s11912-018-0747-1

58. Benedetto C, Salvagno F, Canuto EM, Gennarelli G. Obesity and female malignancies. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):528-540. DOI:10.1016/j.bpobgyn.2015.01.003

59. Yang S, Thiel KW, Leslie KK. Progesterone: the ultimate endometrial tumor suppressor. Trends Endocrinol Metab. 2011;22(4):145-152. DOI:10.1016/j.tem.2011.01.005

60. Gottschau M, Kjaer SK, Jensen A, et al. Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study. Gynecol Oncol. 2015;136(1):99-103. DOI:10.1016/j.ygyno.2014.11.012

61. Provost MP, Acharya KS, Acharya CR, et al. Pregnancy outcomes decline with increasing recipient body mass index: an analysis of 22,317 fresh donor/recipient cycles from the 2008-2010 Society for Assisted Reproductive Technology Clinic Outcome Reporting System registry. Fertil Steril. 2016;105(2):364-368. DOI:10.1016/j.fertnstert.2015.10.015

62. Forte V, Pandey A, Abdelmessih R, et al. Obesity, Diabetes, the Cardiorenal Syndrome, and Risk for Cancer. Cardiorenal Med. 2012;2(2):143-162. DOI:10.1159/000337314

63. Carter JC, Church FC. Obesity and breast cancer: the roles of peroxisome proliferator-activated receptor-gamma and plasminogen activator inhibitor-1. PPAR Res. 2009;2009:345320. DOI:10.1155/2009/345320

64. Teede HJ, Misso ML, Costello MF, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2018;89(3):251-268. DOI:10.1111/cen.13795

65. Министерство здравоохранения Российской Федерации. Синдром поликистозных яичников в репродуктивном возрасте (современные подходы к диагностике и лечению). Клинические рекомендации (протокол лечения). – М.; 2016. [Ministerstvo zdravookhraneniya Rossiyskoy Federatsii. Sindrom polikistoznykh yaichnikov v reproduktivnom vozraste (sovremennye podkhody k diagnostike i lecheniyu). Klinicheskie rekomendatsii (protokol lecheniya). Moscow; 2016. (In Russ).]

66. Conway G, Dewailly D, Diamanti-Kandarakis E, et al. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol. 2014;171(4):P1-29. DOI:10.1530/EJE-14-0253.

67. Андреева Е.Н., Шереметьева Е.В., Дедов И.И. Синдром поликистозных яичников: этиология, патогенез, диагностика и лечение. Научно-практическое руководство. – М.: Видар; 2014. [Andreeva EN, Sheremet’eva EV, Dedov II. Sindrom polikistoznykh yaichnikov: etiologiya, patogenez, diagnostika i lechenie. Nauchno-prakticheskoe rukovodstvo. Moscow: Vidar; 2014. (In Russ).]

68. Yao K, Bian C, Zhao X. Association of polycystic ovary syndrome with metabolic syndrome and gestational diabetes: Aggravated complication of pregnancy. Exp Ther Med. 2017;14(2):1271-1276. DOI:10.3892/etm.2017.4642

69. Jiang S, Kuang Y. Clomiphene citrate is associated with favorable cycle characteristics but impaired outcomes of obese women with polycystic ovarian syndrome undergoing ovarian stimulation for in vitro fertilization. Medicine (Baltimore). 2017;96(32):e7540. DOI:10.1097/MD.0000000000007540

70. Palomba S, Falbo A, Chiossi G, et al. Low-grade chronic inflammation in pregnant women with polycystic ovary syndrome: a prospective controlled clinical study. J Clin Endocrinol Metab. 2014;99(8):2942-2951. DOI:10.1210/jc.2014-1214

71. de Wilde MA, Veltman-Verhulst SM, Goverde AJ, et al. Preconception predictors of gestational diabetes: a multicentre prospective cohort study on the predominant complication of pregnancy in polycystic ovary syndrome. Hum Reprod. 2014;29(6):1327-1336. DOI:10.1093/humrep/deu077

72. Bahri Khomami M, Joham AE, Boyle JA, et al. The role of maternal obesity in infant outcomes in polycystic ovary syndrome-A systematic review, meta-analysis, and meta-regression. Obes Rev. 2019;20(6):842-858. DOI:10.1111/obr.12832.

73. Who.int [интернет]. Избыточный вес и ожирение [доступ от ١٥.١١.٢٠١٩]. Доступ по ссылке: https://www.who.int/topics/obesity/obesity-final.pdf?ua=1. [Who.int [Internet]. Overweight and obesity (In Russ).] [cited 2019 Nov 15]. Available from: https://www.who.int/topics/obesity/obesity-final.pdf?ua=1

74. National Institute for Health and Care Excellence. Weight management before, during and after pregnancy. Public health guideline. NICE; 2018

75. National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children: draft clinical practice guidelines for primary healthcare professionals. Canberra: NHMRC. 2013.

76. Morgante G, Massaro MG, Di Sabatino A, et al. Therapeutic approach for metabolic disorders and infertility in women with PCOS. Gynecol Endocrinol. 2018;34(1):4-9. DOI:10.1080/09513590.2017.1370644

77. Zarrati M, Shidfar F, Moradof M, et al. Relationship between Breast Feeding and Obesity in Children with Low Birth Weight. Iran Red Crescent Med J. 2013;15(8):676-682. DOI:10.5812/ircmj.11120

78. Трошина Е.А., Ершова Е.В. Фармакотерапия ожирения: что нового? // Проблемы эндокринологии. — ٢٠١٨. — Т. ٦٤. — №٤. — С. ٢٧٠-٢٧٦. [Troshina EA, Ershova EV. Pharmacotherapy of obesity: what’s new? Problems of endocrinology. 2018;64(4):270-276. (In Russ.)] DOI:10.14341/probl9315

79. Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22. DOI:10.1056/NEJMoa1411892

80. le Roux C, Astrup A, Fujioka K, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017;389(10077):1399-1409. doi:10.1016/s0140-6736(17)30069-7

81. Astrup A, Carraro R, Finer N, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond). 2012;36(6):843-854. DOI:10.1038/ijo.2011.158

82. Grabovac I, Smith L, Stefanac S, et al. Health Care Providers’ Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016. Am J Med. 2019;132(4):489-497 e481. DOI:10.1016/j.amjmed.2018.11.021


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Andreeva E.N., Sheremetyeva E.V., Fursenko V.A. Obesity – threat to the reproductive potential of Russia. Obesity and metabolism. 2019;16(3):20-28. (In Russ.) https://doi.org/10.14341/omet10340

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