Obesity in women with polycystic ovary syndrome -an individual participant data meta-analysis of well characterised, unselected populations

Johanna Melin; Ricardo Azziz; Larisa Suturina; Xiaomiao Zhao; Alessandra Gambineri; Fahimeh Tehrani; Bulent Yildiz; Kim Jin Ju; Christian Makwe; Helena Teede; Anju Joham

doi:10.1530/endoabs.99.P46

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Endocrine Abstracts (2024) 99 P46 | DOI: 10.1530/endoabs.99.P46

ECE2024 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (130 abstracts)

Obesity in women with polycystic ovary syndrome –an individual participant data meta-analysis of well characterised, unselected populations

Johanna Melin ¹ , Ricardo Azziz ² , Larisa Suturina ³ , Xiaomiao Zhao ⁴ , Alessandra Gambineri ⁵ , Fahimeh Tehrani ⁶ , Bulent Yildiz ⁷ , Jin Ju Kim ⁸ , Christian Makwe ⁹ , Helena Teede ¹⁰ & Anju Joham ¹

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¹, Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Clayton, Australia; ²University of Alabama at Birmingham, Department of Obstetrics and Gynecology, School of Medicine, United States; ³Scientific Center for Family Health and Human Reproduction, Department of Reproductive Health Protection, Russian Federation; ⁴Sun yat-sen University, Department of Reproductive Endocrinology and Infertility, Guangdong, China; ⁵University of Bologna, Italy, Department of Medical and Surgical science –DIMEC endocrinology Unit, Bologna, Italy; ⁶Shahid Beheshti University of Medical Sciences, Reproductive endocrinology Research Center, Research Institute for Endocrine Sciences, Tehran, Iran; ⁷Hacettepe University of Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey; ⁸Division of Reproductive Endocrinology, DeparHealthcare System Gangnam Center, Seoul National University Hospital, Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Seoul, Korea, Rep. of South; ⁹University of Lagos, Department of Obstetrics and Gynecology, Lagos, Nigeria; ¹⁰Monash University, Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Australia

Objective: For women with polycystic ovary syndrome (PCOS) weight gain and obesity exacerbate insulin resistance and increase the risk of type 2 diabetes and cardiometabolic diseases. The PCOS Phenotype in Unselected Populations (P-PUP) study includes individual participant data (IPD) from eleven well characterised, multiethnic and unselected populations globally. The aim of this study was to assess risk of obesity in women with and without PCOS according to ethnicity and age.

Methods: The dataset consisted of 9,930 unselected women, aged 15 to 60 years from Italy, Turkey, China, Iran, South Korea, United States of America, Russia and Nigeria. The women were categorized into those with PCOS (10.7%) and without PCOS (89.3%) according to Rotterdam criteria or National Institutes of Health Criteria (NIH). Multiple logistic regression was used to estimate odd ratios (ORs) with 95% confidence intervals (CI) for obesity (BMI >30 kg/m²) comparing women with and without PCOS, adjusting for age and ethnicity. We performed sub-analyses according to ethnicity and age.

Results: Obesity was more common in women with PCOS (17.9%), compared to women without PCOS (14.4%) (aOR 1.6, 95% CI 1.3-1.9). We observed significant differences in the prevalence of obesity according to ethnic groups, being lowest for Asian (3.8%), followed by Middle Eastern (24.1%), Caucasian (29.1%) and Black women (33.8%). After adjusting for age, compared to Asian women with PCOS, the odds for obesity were higher for Middle Eastern women (aOR 6.3, 95% CI 3.6-11.9), Caucasians (aOR 9.5, 95% CI 4.8-18.9) and Black women (aOR 10.3, 95% CI 5.0-21.5) with PCOS. The risk for obesity in women with PCOS increased with age, being 14.5% for women aged 15-39 years and 48.6% for women aged 40-60 years (aOR 4.0, 95% CI 2.6-6.2).

Conclusion: In a large, unselected, multiethnic population obesity was more common in women with PCOS compared to women without PCOS. We observed significant differences in obesity by ethnicity, with Asian women with PCOS having the lowest odds and Middle Eastern, Caucasian and Black women all having higher odds for obesity. Compared to younger individuals with PCOS, those aged 40 to 60 years had a 4-fold risk for obesity.