Endocrine Abstracts (2017) 49 EP1110 | DOI: 10.1530/endoabs.49.EP1110

Hyperandrogenism and overweight/obesity, independently and interactively, increase the risk of metabolic syndrome and type 2 diabetes in women - a Prospective, Population-based Cohort Study

Meri-Maija Ollila1, Kari Kaikkonen2, Sirkka Keinänen-Kiukaanniemi3,4, Katri Puukka5, Aimo Ruokonen5, Marjo-Riitta Järvelin3,6, Juha Tapanainen1,7, Steve Franks8, Terhi Piltonen1 & Laure Morin-Papunen1

1Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland; 2Division of Cardiology, Department of Clinical Medicine, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland; 3Institute of Health Sciences, University of Oulu, Oulu, Finland; 4Unit of General Practice, Oulu, Finland; 5NordLab Oulu, Department of Clinical Chemistry, University of Oulu and Oulu University Hospital, Medical Research Center Oulu, Oulu, Finland; 6Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; 7Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 8Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.

The significance of hyperandrogenism (HA) as a metabolic risk factor in women is controversial. HA can be defined as either clinical (hirsutism) or biochemical (elevated androgen levels). We aimed to investigate whether HA at age 31 associates with metabolic syndrome (MetS), type 2 diabetes mellitus (DM2) or carotid intima media thickness (CIMT) by age 46. In a prospective, general population-based follow-up birth cohort (n=5889 women) blood samples were collected at age 31 in 3127 women and at age 46 in 3280 women. HA was defined as presence of hirsutism, serum testosterone >2.3 nmol/l (determined by LC-MS/MS) or free-androgen-index (FAI) >5.6 at age 31. MetS was defined according to IDF criteria. An oral glucose tolerance test (OGTT) was performed at age 46 in 2780 women. Glucose metabolism was defined according to the WHO standards. Diagnosis of DM2 was also verified and completed from the national drug and hospital discharge registers. Regression models were used to study if HA associates with cardiovascular risk factors at age 46. As expected, women with HA had significantly greater BMI at age 46 (27.54±6.2 vs 26.58±5.23 kg/m2, P=0.018), compared to controls. HA at age 31 was significantly associated with MetS (OR=1.5, 95%CI: 1.1–2.0) and DM2 (OR=3.1, 95%CI: 1.8–5.2) at age 46. The significance remained in the multivariate regression analysis including BMI at age 31 (for MetS: HA: OR=1.4, 95%CI: 1.1–2.0; BMI: OR=4.0, 95%CI: 3.1–5.2; for DM2: HA: OR=2.7, 95%CI: 1.6–4.6; BMI: OR=4.1, 95%CI: 2.4–7.0). There were no significant differences in the CIMT between women with HA compared to controls. These results indicate that HA per se may increase the prevalence of MetS and DM2 in a general population. However, BMI seems to have a greater impact on the presence of these metabolic risks, with two-fold higher odds ratios than HA.