Endocrine Abstracts

Background: The polycystic ovary syndrome (PCOS) is a condition defined by hyperandrogenism and ovulatory dysfunction. It is also known to be associated with insulin resistance and has many features in common with the metabolic syndrome (MS) - a cluster of risk factors that have been shown to predict a greater risk of future cardiovascular events and type 2 diabetes. While there are studies confirming that the MS is more common in PCOS, none have systematically compared the relative prevalence of the MS in PCOS as defined by the World Health Organisation (WHO), National Cholesterol Education Program Adult Treatment Panel 3 (ATPIII), and the International Diabetes Federation (IDF).

Aim: To investigate the prevalence of the MS in women with PCOS and to compare the metabolic and hormonal profiles in PCOS women with and without the MS.

Methods: A retrospective chart review of 261 women (as defined by the 1990 National Institutes for Health consensus statement) with comparison to an age matched selection of 584 female subjects from the AusDiab study.

Results: Mean age of PCOS subjects was 29 (±8.8yrs). The prevalence of the MS in women with PCOS was 31% by IDF, 30% by WHO, and 24% by ATPIII definitions. The average risk ratio of the MS was 4.2, (4.9 by WHO, 3.6 by IDF, and 4.0 by ATPIII definitions, P values<0.001), compared with the control group. The most frequent components of the MS in women with PCOS were: elevated waist circumference (WC>79 cm in 80%), reduced HDL (HDL<1.3 mmol/L in 66%), and insulin resistance (HOMA-IR>2.2 in 61%). Among the PCOS subjects, those with the MS were older and had lower sex hormone binding globulin (SHBG) levels, compared with those without the MS (P values <0.05).

Conclusion: There is a four fold increase in the prevalence of the MS in a clinic population of women with PCOS compared with age matched controls from the general population, and its presence is associated with older age and lower SHBG. These results imply greater cardiovascular risk in women with PCOS.