Obesity and extreme obesity, manifest by ages 20-24 years, continuing through 32-41 years in women, should alert physicians to the diagnostic likelihood of polycystic ovary syndrome as a reversible underlying endocrinopathy.
OBJECTIVE
Document obesity-extreme obesity in most 20-24, 25-29, and 32-41 years old women with PCOS as a stimulus for physicians to consider the diagnosis of PCOS, an underlying reversible endocrinopathy.


METHODS
In matched age groups 20-24, 25-29, and 32-41 years, we compared BMI in 84, 129, and 188 Caucasian women with PCOS versus 956, 815, and 815 women in NHANES I (general population), and 25, 36, and 45 non-pregnant women (community obstetrics practice).


RESULTS
At ages 20-24, 25-29, and 32-41 years, mean+/-S.D. BMIs in women with PCOS (35.3+/-7.7, 36.0+/-9.4, 36.7+/-8.2) were much greater than NHANES I (22.8+/-4.6, 23.3+/-5.0, 24.5+/-5.6; p < .0001), and community (26.1+/-6.8, 26.9+/-6.6, 25.2+/-5.2; p < .0001). Classifying BMI <25 (normal), > or =25-30 (overweight), > or =30-40 (obese), > or =40 (extremely obese), at ages 20-24, 25-29, and 32-41 years: 76, 73, and 78% of PCOS women were obese-extremely obese, versus 7, 11, and 14% of NHANES I, and 20, 28, and 15% of community women. At ages 20-24, 25-29, and 32-41 years, only 10, 12, and 7% PCOS women had BMIs <25, versus 78, 74, and 66% NHANES I, and 48, 47, and 58% of community women.


CONCLUSIONS
Obesity-extreme obesity in women, manifest by ages 20-24 years, continuing through 32-41 years, should alert physicians to the likelihood of PCOS, an underlying, heritable, potentially reversible, insulin resistant endocrinopathy that promotes obesity.
Glueck
Charles J
CJ
The Cholesterol Center, Jewish Hospital, ABC Building, Cincinnati, OH 45229, USA. glueckch@healthall.com
Dharashivkar
Swapna
S
Wang
Ping
P
Zhu
Binghua
B
Gartside
Peter S
PS
Tracy
Trent
T
Sieve
Luann
L
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D009749:Nutrition Surveys; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D044465:White People