Screening women with polycystic ovary syndrome for metabolic syndrome.
OBJECTIVE
Women with polycystic ovary syndrome (PCOS) are at an increased risk for insulin resistance and hyperlipidemia. Metabolic syndrome is a cluster of risk factors that confers an increased risk for cardiovascular disease. The objectives of this study were to compare the prevalence of metabolic syndrome in women with PCOS and controls and to identify the role of androgens or insulin resistance in the development of metabolic syndrome.


METHODS
Women with PCOS (n = 129) and women with regular menses and no hirsutism seen for an annual examination (n = 177) were studied.


RESULTS
The age-adjusted prevalence of metabolic syndrome was higher in women with PCOS (47.3%, 95% confidence interval 35.3-56.9%) compared with controls (4.3%, 95% confidence interval 1.9-7.6%, P < .001). Compared by age group, the risk of metabolic syndrome in women with PCOS was higher for all groups (P < .001). There were no significant differences in serum androgen levels between women with PCOS with or without metabolic syndrome. In contrast, all markers of insulin resistance were abnormal in women with PCOS with metabolic syndrome compared with those without metabolic syndrome (P < .001). We found serum triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio correlated with insulin resistance in this population (P < .001). Serum TG/HDL-C > 3.2 has a high sensitivity and specificity for the detection of metabolic syndrome in women with PCOS.


CONCLUSIONS
Women with PCOS have a 11-fold increase in the prevalence of metabolic syndrome compared with age-matched controls. The risk of metabolic syndrome is high even at a young age, highlighting the importance of early and regular screening. The TG/HDL-C ratio may serve as a screening tool and needs to be prospectively validated in this group.


METHODS
II-2.
Department of Obstetrics and Gynecology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242, USA. anuja-dokras@uiowa.edu
Anuja
A
Dokras
Melinda
M
Bochner
Elizabeth
E
Hollinrake
Sanford
S
Markham
Bradley
B
Vanvoorhis
Dinesh H
DH
Jagasia
D000328:Adult; D017677:Age Distribution; D001774:Blood Chemical Analysis; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index