Epidemiology and Adverse Cardiovascular Risk Profile of Diagnosed Polycystic Ovary Syndrome

Abstract

Context: Polycystic ovary syndrome (PCOS) is associated with menstrual and reproductive abnormalities, insulin resistance, and obesity. Objective: The objective of this study was to determine the prevalence of diagnosed PCOS and its association with cardiovascular risk factors. Setting: The study is set in an integrated health care delivery system in northern California. Patients: A total of 11,035 women with PCOS were identified by one or more outpatient diagnoses of PCOS using health plan databases. An age-matched sample of women without PCOS was also selected. Outcome Measures: Prevalence of PCOS and targeted cardiovascular risk factors [hypertension, dyslipidemia, diabetes mellitus, and body mass index (BMI)] were measured. Results: During 2002–2004, the prevalence of diagnosed PCOS among female members aged 25–34 yr was 2.6% (95% confidence interval 1.6–1.7%). Women with diagnosed PCOS were more likely than those without PCOS to be obese [BMI ≥ 30 mg/m2; odds ratio (OR) 4.21, 3.96–4.47]. Furthermore, PCOS was associated with diabetes (OR 2.45, confidence interval 2.16–2.79), hypertension (OR 1.41, 1.31–1.51) and known dyslipidemia (OR 1.53, 1.39–1.68), even after adjusting for BMI and known confounders. Among women with PCOS, compared with whites, Blacks and Hispanics were more likely and Asians less likely to be obese; Asians and Hispanics were more likely to have diabetes; and Blacks were more likely and Hispanics less likely to have hypertension. Conclusions: Within a large, community-based population receiving health care, diagnosed PCOS was highly prevalent and associated with a much higher frequency of cardiovascular risk factors that varied by race/ethnicity. Our prevalence estimates likely underestimate the true prevalence of PCOS. Further studies are needed to explore racial/ethnic differences and the extent to which PCOS contributes to future cardiovascular risk.