Introduction: Previous studies have shown that PCOS (first described 1935) increases the future risk of hypertension and coronary artery disease.
Aims: We investigated in women with PCOS, the link between social disadvantage and markers of cardiometabolic risk and how weight gain over time related to social disadvantage.
Methods: In a primary care-based study, 1797 women were identified from patients attending one of 40/42 GP practices located in Central/Eastern Cheshire and Derbyshire, UK. The search was performed with the assistance of the EMISWeb® database.
Results: Descriptive: Mean age of the 1797 women at diagnosis with PCOS/PCO was 24.6 (standard deviation 6.5) years (age range 11-69 years). Of group studied, 46.1% of women had a BMI of 30 or more. 1646 out of 1797 (91.6%) had at least one BMI measurement and 1726 (96.0%) had at least one blood pressure check over the follow-up period.
Relation of BMI, SHBG and glucose level to social disadvantage: A higher BMI (closest BMI to diagnosis date with PCOS) associated with a higher Townsend index (indicative of higher social disadvantage) (r2=0.04; P=0.005) as did lower SHBG (r2=0.013; P=0.009). This relation held when adjustment was made for age, BMI, and systolic BP. There was no relation of fasting glucose/random glucose with Townsend Index.
BMI trends over time: BMI increased more in women with a higher Townsend Index. Specifically for the most disadvantaged women, BMI increase (latest compared with earliest recorded BMI) was 18.6% compared with the most advantaged quintile at 13.7%.
Conclusion: Higher BMI and lower SHBG levels in women with PCOS were associated with greater socioeconomic disadvantage. The greater increase of BMI in more socially disadvantaged women suggests that socioeconomic situation influences obesity risk in PCOS women. The corollary is that measures that reduce inequality may impact on longer term cardiometabolic outcome in PCOS women