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Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13 years follow-up in an unselected population

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Abstract

Purpose

Cardiometabolic risk factors are common in women with polycystic ovary syndrome (PCOS) during reproductive years. The aim of this study was to determine the impact of aging on cardiometabolic risk of the syndrome by examining women who had previously been diagnosed to have PCOS or to be healthy in an unselected population in 2009.

Participants

Forty-one women with PCOS who were diagnosed and phenotyped according to the Rotterdam criteria and 43 age- and body mass index (BMI)-matched healthy women from the same unselected cohort.

Methods

All participants were evaluated by structured interview, physical examination, anthropometric, hormonal and biochemical measurements. Additionally, body composition analyses and echocardiographic assessments of 30 women with PCOS and 30 control women were conducted at 13 years of follow-up.

Results

There was no difference between the patient and the control groups in terms of anthropometric and body composition measures and metabolic parameters. Echocardiographic assessment showed similar systolic functions, strain measurements and epicardial fat measurements between the groups. PCOS patients still had higher levels of total testosterone, free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEAS) levels compared to controls. Epicardial fat thickness showed positive correlations with BMI, total and truncal body fat, homeostatic model assessment for insulin resistance (HOMA-IR) and free androgen index (FAI).

Conclusions

Aging women with PCOS in the population have higher androgen levels and similar cardiometabolic risk profile compared to age- and BMI-matched healthy women. Epicardial fat thickness, a marker of cardiometabolic risk, appear to be associated with hyperandrogenism. Further research is needed on larger community-based cohorts where older patients are assessed with a longer follow-up.

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Data availability

The datasets collected and analyzed during this present investigation are available upon reasonable request to the corresponding author.

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Funding

This study supported by Hacettepe University Scientific Research Coordination Unit (Project Number: THD-2022-20214).

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey

    S. Aksun & B. O. Yildiz

  2. Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey

    N. C. Sonu & S. Mumusoglu

  3. Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey

    S. Aygun & U. N. Karakulak

  4. Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey

    B. O. Yildiz

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  1. S. Aksun
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Contributions

B.O.Y. was the corresponding author and formulated the research question. S.M. was in charge for conceptualization and processing, while S.A. and N.C.S. assisted with data collection and interpretation. S.A. and U.N.K. performed cardiological assessments and data analysis on the patients. S.A. created the first draft of the manuscript, and all contributors provided feedback on prior drafts. The final version of the manuscript has been read and approved by all authors.

Corresponding author

Correspondence to B. O. Yildiz.

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The authors state that they have no conflict of interest.

Ethical approval

This study was approved by the ethical committee of Hacettepe University, Ankara, Turkey. The clinical examinations were conducted to the ethical principles outlined in the Helsinki Declaration.

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Written informed consent was obtained from all participants included in this study.

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Aksun, S., Sonu, N.C., Aygun, S. et al. Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13 years follow-up in an unselected population. J Endocrinol Invest 47, 1129–1137 (2024). https://doi.org/10.1007/s40618-023-02230-0

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