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Stavroula A Paschou Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece

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Eleni Palioura Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece

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Dimitrios Ioannidis Department of Endocrinology and Diabetes, Sismanoglio-Amalia Fleming Hospital, Athens, Greece

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Panagiotis Anagnostis Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

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Argyro Panagiotakou Department of Endocrinology and Diabetes, Sismanoglio-Amalia Fleming Hospital, Athens, Greece

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Vasiliki Loi Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece

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Georgios Karageorgos Department of Endocrinology and Diabetes, Sismanoglio-Amalia Fleming Hospital, Athens, Greece

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Dimitrios G Goulis Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

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Andromachi Vryonidou Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece

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Introduction Polycystic ovary syndrome (PCOS) is characterized by chronic anovulation and hyperandrogenism ( 1 ). It is often accompanied by insulin resistance ( 2 ) and abnormal lipid profile ( 3 , 4 ). Several studies have shown that

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Vittorio Unfer Health Department, UniPoliSi – Institut des Etudes Universitaires, Disentis, Switzerland

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Fabio Facchinetti Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy

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Beatrice Orrù Medical Affairs Department, Lo.Li. Pharma, Rome, Italy

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Barbara Giordani Medical Affairs Department, Lo.Li. Pharma, Rome, Italy

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John Nestler Departments of Medicine and Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia, USA

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prevent and/or treat a number of metabolic disorders related to IR, such as the metabolic syndrome ( 4 , 5 ), gestational diabetes mellitus ( 6 , 7 , 8 , 9 , 10 ) and the polycystic ovary syndrome (PCOS) ( 11 , 12 , 13 ). PCOS is a heterogeneous

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N K Stepto Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
Australian Institute for Musculoskeletal Science, Victoria University, Melbourne, Victoria, Australia
Medicine-Western Health, Faculty of Medicine, Dentistry and Health Science, Melbourne University, Melbourne, Victoria, Australia

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D Hiam Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia

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M Gibson-Helm Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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S Cassar Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia

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C L Harrison Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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S K Hutchison Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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A E Joham Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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B J Canny School of Medicine, University of Tasmania, Hobart, Tasmania, Australia

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A Moreno-Asso Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
Australian Institute for Musculoskeletal Science, Victoria University, Melbourne, Victoria, Australia

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B J Strauss Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
Division of Diabetes, Endocrinology & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK

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N Hatzirodos The Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, Australia

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R J Rodgers The Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, Australia

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H J Teede Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
Diabetes and Endocrine Units, Monash Health, Clayton, Victoria, Australia

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Introduction Polycystic ovary syndrome (PCOS) affects 8–13% of women of reproductive age ( 1 ) has major metabolic (increased type 2 diabetes mellitus (T2D) and cardiovascular risk factors) ( 2 , 3 , 4 ), reproductive (leading cause of

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Sarantis Livadas Endocrine Unit, Athens Medical Centre, Athens, Greece

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Christina Bothou Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland

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Justyna Kuliczkowska-Płaksej Department of Endocrinology, Diabetology and Isotope Therapy, University of Medicine, Wrocław, Poland

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Ralitsa Robeva Ushate ‘acad. IV. Penchev’, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria

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Andromahi Vryonidou Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece

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Jelica Bjekic Macut Department of Endocrinology, UMC Bežanijska Kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Ioannis Androulakis Endocrine Unit, Athens Medical Centre, Athens, Greece

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Milica Opalic Clinic of Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Zadalla Mouslech 1st Medical Propedeutic, Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

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Andrej Milewicz Department of Endocrinology, Diabetology and Isotope Therapy, University of Medicine, Wrocław, Poland

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Alessandra Gambineri Department of Medical and Surgical Science-DIMEC Endocrinology Unit, University of Bologna – S. Orsola-Mapighi Hospital, Italy

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Dimitrios Panidis Gynaecological Endocrinology Infirmary of the Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece

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Djuro Macut Clinic of Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Introduction Polycystic ovary syndrome (PCOS), a multifaceted, ever-changing disease, constitutes a common disorder in women of reproductive age. The standard view is that during the first decades of reproductive life, hyperandrogenic symptoms

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Charissa van Zwol-Janssens Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Aglaia Hage Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Kim van der Ham Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Birgitta K Velthuis Department of Radiology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands

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Ricardo P J Budde Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands

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Maria P H Koster Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Arie Franx Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Bart C J M Fauser Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht & University of Utrecht, Utrecht, the Netherlands

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Eric Boersma Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Daniel Bos Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Joop S E Laven Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Yvonne V Louwers Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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the CREW consortium
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Introduction Reproductive disorders, such as premature ovarian insufficiency (POI) and polycystic ovary syndrome (PCOS), are associated with hormonal and metabolic changes, which can impact changes in bone density (BD). Women with POI are at

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Christian Trummer Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Stefan Pilz Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Verena Schwetz Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Barbara Obermayer-Pietsch Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Elisabeth Lerchbaum Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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). Infertility is a complex disorder with significant medical, psychosocial and economic aspects ( 7 ), which affects about 15% of couples ( 8 ). One major cause of female infertility is polycystic ovary syndrome (PCOS). Women affected by PCOS frequently suffer

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M A Webb NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK

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H Mani Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
Diabetes and Endocrinology Department, Kettering General Hospital NHS Foundation Trust, Kettering, UK

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S J Robertson The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK

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H L Waller Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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D R Webb NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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C L Edwardson NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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D H Bodicoat NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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T Yates NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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K Khunti NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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M J Davies NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK

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Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine condition in women of reproductive age with a reported prevalence of up to 18% ( 1 ). Symptoms of PCOS include excess hair, irregular/absent periods and infertility

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Hong Tang Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Xiaomei Jiang Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Yu Hua Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Heyue Li Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Chunlan Zhu Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Xiaobai Hao Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Minhui Yi Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Linxia Li Departments of Gynaecology and Obstetrics Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Introduction Polycystic ovary syndrome (PCOS) is an androgen disorder and ovarian dysfunction disease in women of reproductive age. PCOS is responsible for more than 90% of adult and adolescent hyperandrogenism ( 1 , 2 ). The pathogenesis of

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Zheng Chen Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Haixia Zeng Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Qiulan Huang Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Cuiping Lin Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Xuan Li Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Shaohua Sun Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Jian-ping Liu Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China

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Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of childbearing age, with an estimated global prevalence of 4–21% ( 1 ). PCOS is a heterogeneous disease that is clinically characterized by oligo

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Xiying Zeng The Third Clinical Medical College, Fujian Medical University, Fuzhou, China

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Yinxiang Huang Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China

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Mulin Zhang Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China

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Yun Chen The Third Clinical Medical College, Fujian Medical University, Fuzhou, China

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Jiawen Ye The Third Clinical Medical College, Fujian Medical University, Fuzhou, China

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Yan Han School of Medicine, Xiamen University, Xiamen, China

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Danyan Ma School of Medicine, Xiamen University, Xiamen, China

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Xin Zheng Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China

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Xiaohong Yan Reproductive Medicine Center, The First Affiliated Hospital of Xiamen University, Xiamen, China

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Changqin Liu The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China
Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China

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Introduction Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine–metabolic disorder afflicting women of reproductive age ( 1 ). It is associated with reproductive, metabolic, and psychological disorders including anovulatory

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