Polycystic ovarian syndrome (PCOS) is characterized by chronic anovulation, clinical and/or biochemical hyperandrogenism, which can be associated with altered insulin action. Symptoms usually begin around menarche, but onset after puberty may also occur as a result of environmental modifiers such as weight gain. The consequences of PCOS extend beyond the reproductive axis; there is a substantial risk for development of metabolic and cardiovascular abnormalities similar to the metabolic syndrome. Currently, the treatment is targeted to the patient's primary complaint such as hirsutism, restoration of regular menses or pregnancy. Pharmacological agents available for the treatment of hirsutism include androgen suppressors and peripheral androgen blockers. Recently, our understanding of the role of insulin resistance has led to the use of insulin-sensitizing medications as first-choice therapy. In conjunction with weight reduction and exercise, a pharmacologic reduction in insulin levels by either metformin or thiazolidinediones ameliorates both hyperinsulinemia and hyperandrogenism.
Vitamin D deficiency is becoming increasingly common in the USA. In this review we provide estimates of the prevalence of deficiency, and review the risk factors and the evidence of clinical consequences of vitamin D deficiency. Vitamin D deficiency causes the pediatric disease rickets. In addition, there is some evidence that vitamin D deficiency may lead to other diseases including diabetes mellitus, hypertension, infections, asthma and dyslipidemia.
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