title: Polycystic ovary syndrome and risk for long-term diabetes and dyslipidemia.
abstract: OBJECTIVE
  To estimate whether women aged 20-32 years who fulfilled National Institutes of Health criteria for polycystic ovary syndrome (PCOS) would be at higher risk for subsequent development of incident diabetes, dyslipidemia, and hypertension, and to estimate whether normal-weight women with PCOS would have the same degree of cardiovascular risk as overweight women with PCOS.
  
  
  METHODS
  We estimated the association of PCOS with incident diabetes, dyslipidemia, and hypertension over a period of 18 years among 1,127 white and African-American women in the Coronary Artery Risk Development in Young Adults cohort. We classified women at baseline (ages 20-32 years) based on self-reported symptoms and serum androgen measures using National Institutes of Health PCOS criteria. We estimated the association of PCOS and subsequent cardiovascular risk factors, independent of baseline body mass index (BMI), using multivariable logistic regression. Additionally, among 746 women with a second assessment of PCOS at ages 34-46 years, we estimated the association of persistent PCOS with cardiovascular risk factors.
  
  
  RESULTS
  Of 1,127 women, 53 (4.7%) met criteria for PCOS at ages 20-32 years. Polycystic ovary syndrome was associated with a twofold higher odds of incident diabetes (23.1% compared with 13.1%, adjusted odds ratio [AOR] 2.4, confidence interval [CI] 1.2-4.9) and dyslipidemia (41.9% compared with 27.7%, AOR 1.9, CI 1.0-3.6) over the course of 18 years; the association with incident hypertension was not significant (26.9% compared with 26.3%, AOR 1.7, CI 0.8-3.3). Normal-weight women with PCOS (n=31) had a threefold higher odds of incident diabetes compared with normal-weight women without PCOS (AOR 3.1, CI 1.2-8.0). Compared with those without PCOS, women with persistent PCOS (n=11) had the highest odds of diabetes (AOR 7.2, CI 1.1-46.5).
  
  
  CONCLUSIONS
  Polycystic ovary syndrome is associated with subsequent incident diabetes and dyslipidemia, independent of BMI. Diabetes risk may be greatest for women with persistent PCOS symptoms.
  
  
  METHODS
  II.
authors.affiliation: From the University of California, San Francisco, San Francisco, California; the Hadassah-Hebrew University, Jerusalem, Israel; the University of California, San Francisco, San Francisco, California; Northwestern University, Chicago, Illinois; the University of California, Los Angeles, Los Angeles, California; the University of Minnesota, Minneapolis, Minnesota; Kaiser Permanente, Oakland, California; the University of Alabama at Birmingham, Birmingham, Alabama; and the University of Washington, Seattle, Washington.
authors.forename: Erica T
authors.initials: ET
authors.lastname: Wang
authors.forename: Ronit
authors.initials: R
authors.lastname: Calderon-Margalit
authors.forename: Marcelle I
authors.initials: MI
authors.lastname: Cedars
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.forename: Sharon S
authors.initials: SS
authors.lastname: Merkin
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
authors.forename: Melissa
authors.initials: M
authors.lastname: Wellons
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: O Dale
authors.initials: OD
authors.lastname: Williams
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult