title: Relative contributions of oligomenorrhea and hyperandrogenemia to the risk of metabolic syndrome in midlife women.
abstract: BACKGROUND
  Young reproductive-age women with irregular menses and androgen excess are at high risk for unfavorable metabolic profile; however, recent data suggest that menstrual regularity and hyperandrogenism improve with aging in affected women approaching menopause.
  
  
  OBJECTIVE
  The objective of the study was to determine whether women with hyperandrogenemia (HA) and a history of oligomenorrhea (Oligo) are at an elevated risk for metabolic syndrome (MetS) at the early stages of menopausal transition.
  
  
  METHODS
  Baseline data from 2543 participants (mean age of 45.8 yr) in the Study of Women's Health Across the Nation were analyzed. Women with a lifetime history of more than one 3-month interval of nongestational and nonlactational amenorrhea were classified as having a history of Oligo. The highest tertile of serum testosterone was used to define HA. Women with normal serum androgens and eumenorrhea were used as the reference group. Logistic regression models generated adjusted odds ratios (AOR), controlling for age, ethnicity, body mass index, smoking, and study site.
  
  
  RESULTS
  Oligo was associated with MetS only when coincident with HA [AOR of 1.93 for Oligo and HA [95% confidence interval (CI) 1.17-3.17], AOR of 1.25 for Oligo and normal androgens (95% CI 0.81-1.93)]. In contrast, HA conferred a consistently significant risk for MetS, regardless of the menstrual frequency status [AOR of 1.48 for HA and eumenorrhea (95% CI 1.15-1.90)].
  
  
  CONCLUSIONS
  Our results suggest that HA but not history of Oligo is independently associated with the risk of prevalent MetS in pre- and perimenopausal women in their 40s.
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, Colorado 80045, USA. alex.polotsky@ucdenver.edu
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Polotsky
authors.forename: Amanda
authors.initials: A
authors.lastname: Allshouse
authors.forename: Sybil L
authors.initials: SL
authors.lastname: Crawford
authors.forename: Sioban D
authors.initials: SD
authors.lastname: Harlow
authors.forename: Naila
authors.initials: N
authors.lastname: Khalil
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Richard S
authors.initials: RS
authors.lastname: Legro
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008593:Menopause / Q000502:physiology*; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D009839:Oligomenorrhea / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000728:Androgens