Human Reproduction Update Advance Access originally published online on July 1, 2005
Human Reproduction Update 2005 11(6):631-643; doi:10.1093/humupd/dmi025
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Genetics of polycystic ovary syndrome: searching for the way out of the labyrinth
1 Endocrine section, First Department of Internal Medicine, and 2 Laboratory of Biological Chemistry, University of Athens Medical School, Athens, Greece
3 To whom correspondence should be addressed at: University of Athens Medical School, 1A Zefyrou str., Ekali 17562, Athens, Greece. E-mail: akandara{at}otenet.gr
Submitted on May 17, 2005; accepted on May 24, 2005
Polycystic ovary syndrome (PCOS) is a complex and heterogeneous disorder presenting a challenge for clinical investigators. It is the most common endocrine disorder of women in reproductive age, a multifaceted reproductive, cosmetic and metabolic problem, with an enigmatic pathophysiological and molecular basis. Although the familial segregation has been noticed very early in the description of the syndrome and family studies in first-degree relatives of women diagnosed with PCOS reveal clustering of the disease, the genetic studies have not as yet determine the pattern of heredity. Part of the problem in genetic studies has been the lack of uniform criteria for diagnosis, heterogeneity of phenotypic features and the fact that the disorder is only expressed clinically in women during their reproductive years. Even within affected families and between sisters with polycystic ovaries, there is heterogeneity in presentation. However, regardless of diagnostic criteria used to identify profanes and to determine affected status in the kindred, the foundation of genetic studies suggests a strong familial component. Currently, PCOS is considered a polygenic trait that might result from the interaction of susceptible and protective genomic variants under the influence of environmental factors, whose role is under intensive investigation. Candidate genes cover a broad spectrum of an endless list of molecules which participate on every step of reproductive and metabolic pathways of this syndrome. Focused research in identification of these genes may provide valuable information and shed some light on the way out of the genomic labyrinth, elucidating the underlying pathophysiology and aiming at a more efficient therapeutic approach of this complicated endocrine disorder.
Key words: candidate genes / environmental factors / metabolic abnormalities / molecular factors / PCOS
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