Summary
Objective
To compare age-associated changes in cardiovascular risk markers in lean and obese reproductive-aged women with polycystic ovary syndrome (PCOS) with community controls
Design
Longitudinal study at an academic medical centre.
Patients
Patients diagnosed with PCOS by 2004 Rotterdam criteria in a multi-disciplinary clinic were systematically enrolled from 2006-2014 in a PCOS cohort study and subsequently agreed to participate in a longitudinal study. The comparison controls were from the prospective, longitudinal Ovarian Aging (OVA) study, which consists of healthy women with regular menstrual cycles recruited from 2006 to 2011.
Measurements
Cardiovascular risk markers and hormone parameters at baseline and follow-up.
Results
Obese and lean PCOS (n=38) and control women (n=296) completed two study visits. The follow-up time (3.5+1.5 vs 4.0±0.8 years, p=0.06) and magnitude of BMI gain (+0.1 kg/m2/year [-0.11, 0.36] vs +0.26 [-0.18, 0.87] p=0.19) did not differ between obese and lean PCOS and controls. In PCOS subjects, total testosterone decreased in both obese and lean, but the decrease was greater in obese subjects (-0.09nmol/l per year; 95% CI:-0.16,-0.02 versus -0.04 nmol/l per year; 95%CI:-0.11, 0.03). Compared to their respective controls, obese and lean PCOS saw worsening triglyceride (TG) levels (p<0.05) and HOMA-IR (p<0.05) over time, but there was no difference in change in LDL, HDL, fasting glucose, C- reactive protein or ALT.
Conclusions
In a longitudinal study, reproductive-aged women with PCOS demonstrated declines in biochemical hyperandrogenaemia over time. Despite this, PCOS subjects experienced steeper increases in cardiovascular risk factors associated with insulin resistance, including triglycerides and HOMA-IR.
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