The role of polycystic ovary syndrome (PCOS) and overweight/obesity in women’s metabolic and cardiovascular risk factors and related morbidities

• Main Author: Ollila, M.-M. (Meri-Maija)
• Other Authors: Morin-Papunen, L. (Laure), Piltonen, T. (Terhi)
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Oulun yliopisto 2019
• Subjects: autonomic nervous system; body mass index; cardiovascular diseases; hyperandrogenism; hypertension; metabolism; polycystic ovary syndrome; prediabetes; type 2 diabetes; aineenvaihdunta; autonominen hermosto; hyperandrogenismi; munasarjojen monirakkulatauti; painoindeksi; sydän- ja verisuonitaudit; tyypin 2 diabetes; verenpainetauti; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526222592

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive aged women, with reproductive, metabolic and cardiovascular implications across the life span. The typical features of PCOS include irregular menstruation, androgen excess and polycystic ovaries in ultrasonography. The majority of women with PCOS are overweight or obese, and, at least partly, obesity-driven metabolic abnormalities often coexist with PCOS. Despite intensive research, it has remained unclear whether PCOS per se is a risk factor of metabolic abnormalities, and cardiovascular disease and events. The main aim of the current work was to investigate whether PCOS is an independent risk factor of metabolic abnormalities and cardiovascular diseases. The study population consisted of the prospective population-based Northern Finland Birth Cohort 1966, and we used data collected at ages 14, 31 and 46. The definition of PCOS was based on self-reported PCOS symptoms at age 31 and/or PCOS diagnosis by age 46. The results revealed that weight gain in early life was a risk factor for the development of PCOS. As for metabolic outcomes, at age 46, normal-weight women with PCOS did not display increased odds of abnormal glucose metabolism. However, weight gain during early adulthood was significantly associated with abnormal glucose metabolism in women with PCOS by age 46. Interestingly, PCOS per se was already associated with elevated blood pressure at age 31 and hypertension at age 46, independently of obesity. Women with PCOS also displayed reduced cardiac vagal activity, which was associated with metabolic abnormalities and hypertension. Furthermore, even though no major anatomical or functional impairments were observed in echocardiography, women with PCOS displayed a significantly greater prevalence of myocardial infarction and a two-fold higher prevalence of cardiovascular events than controls. In conclusion, our findings indicate that even though PCOS is an independent risk factor of metabolic ...