Polycystic Ovary Syndrome Might Spell Trouble for Middle-Aged Women
New Research from Carrie Karvonen-Gutierrez and Mia Peng
Women with polycystic ovary syndrome develop metabolic syndrome earlier than women without the condition—likely putting them at higher risk of developing diabetes and cardiovascular disease, according to a new study by the University of Michigan.
Unlike other studies that examined polycystic ovary syndrome and metabolic syndrome at only one point in time, the new study followed women for more than 20 years to observe new cases of metabolic syndrome. This provided a longer-term view of women's experiences and how women with polycystic ovary syndrome might be at increased risk of cardiovascular and metabolic disorders.
The study is published in The Journal of Clinical Endocrinology & Metabolism.
"Knowing that women with polycystic ovary syndrome are at greater risk for metabolic syndrome earlier in their life warrants more careful follow up by their health care providers," said senior author Carrie Karvonen-Gutierrez, assistant professor of epidemiology at U-M's School of Public Health. "Polycystic ovary syndrome is a condition diagnosed among women during their childbearing years, before the life stage commonly associated with increased risk for cardiovascular disease and diabetes.
"However, given that metabolic syndrome is a risk factor for health outcomes such as heart attack, heart failure and diabetes, our data suggests that women with polycystic ovary syndrome should be monitored more closely, and earlier in their life, for these major health outcomes."
Polycystic ovary syndrome is a hormonal disorder that can affect a women's periods, making them infrequent, irregular or prolonged, and can also make it difficult to get pregnant. It affects 1 in 10 women of childbearing age. Metabolic syndrome is usually defined as the presence of three or more of the following health conditions: excess body fat around the waist; elevated blood pressure; elevated triglycerides—a type of fat in your blood; elevated blood sugar and low HDL (good cholesterol).
The more of those conditions a person has, the higher the risk of a heart attack, stroke, heart failure and diabetes.
While previous studies have shown that women with polycystic ovary syndrome have a higher prevalence of metabolic syndrome, most of those looked at women clinically diagnosed with polycystic ovary syndrome, who tend to have more frequent and severe symptoms.
"The contribution of our study is that by looking at women in a community-based sample, we are able to include a broader spectrum of women with polycystic ovary syndrome," said lead author Mia (Qing) Peng, a doctoral student at U-M's School of Public Health. "Thus, our estimates are likely more representative of the true impact of polycystic ovary syndrome on metabolic syndrome."
Researchers used data from the Michigan Bone Health and Metabolism Study, a longitudinal, community-based study of white women in southeast Michigan started at U-M in 1988. Researchers identified women with polycystic ovary syndrome-like status based on their history of irregular menstrual cycles, high free-androgen index and high levels of anti-müllerian hormone.
Among the 496 women in the analysis, 12 percent were determined to likely have polycystic ovary syndrome. Over a mean follow-up of 11 years, women with polycystic ovary syndrome developed metabolic syndrome nearly three years earlier than did women without the condition, even after accounting for differences in smoking, education, physical activity and body size. However, in both groups, increased body size was associated with greater risk of metabolic syndrome.
"Although our study suggests that polycystic ovary syndrome predicts earlier onset of metabolic syndrome independent of body size, weight is still a substantial risk factor for poor health outcomes," Peng said. "This means that regardless of whether you have polycystic ovary syndrome or not, maintaining a healthy weight is very important, but maintaining a healthy weight may be even more relevant for women with polycystic ovary syndrome."