title: Prevalence of metabolic syndrome is higher among non-obese PCOS women with hyperandrogenism and menstrual irregularity in Korea.
abstract: BACKGROUND
  Hyperandrogenism (HA) has been linked with several components of metabolic syndrome (MetS). Few studies in Asian women have evaluated the important risk factors for and prevalence of MetS according to PCOS subtype. In this study, we investigated differences in metabolic parameters and the prevalence of MetS in two major phenotypic subgroups of PCOS in Korea. Furthermore, we investigated the relationship between HA-associated parameters and MetS.
  
  
  METHODS
  This cross-sectional observational study was conducted from May 2010 to December 2011 in Korea. A total of 837 females with PCOS, aged 15-40, were recruited from Departments of Obstetrics and Gynecology at 13 hospitals. Of those, 700 subjects with either polycystic ovaries (PCO)+HA+oligomenorrhea/amenorrhea (O) or PCO+O were eligible for this study. MetS was diagnosed according to the modified National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines and the International Diabetes Federation (IDF) criteria.
  
  
  RESULTS
  MetS was more prevalent in the PCO+HA+O group (19.7%) than in the PCO+O (11.9%) group. There were statistically significant trends for an increased risk of MetS in the PCO+HA+O group compared to the PCO+O group. After adjustment for age, the odds ratio of MetS was 2.192 in non-obese subjects with PCO+HA+O compared to those with PCO+O, whereas the risk of MetS was not different in obese patients. Multivariate logistic regression analysis showed that high free androgen index and low sex hormone-binding globulin were significantly associated with MetS in non-obese women with PCOS, with odds ratios of 4.234 (95% CI, 1.893-9.474) and 4.612 (95% CI, 1.978-10.750), respectively. However, no associations were detected between MetS and SHBG and FAI in obese PCOS subjects.
  
  
  CONCLUSIONS
  Our results indicate that HA and its associated parameters (FAI and SHBG) are significantly associated with MetS in non-obese PCOS subjects, whereas this association was not observed in obese subjects.
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, Korea National Institute of Health, Chungbuk, Korea.
authors.forename: Min-Ju
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, Korea National Institute of Health, Chungbuk, Korea.
authors.forename: Nam-Kyoo
authors.initials: NK
authors.lastname: Lim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea; Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea; Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jin-Ju
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea; Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Kyu-Ri
authors.initials: KR
authors.lastname: Hwang
authors.affiliation: Department of Obstetrics and Gynecology, Maria Fertility Hospital, Seoul, Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Chae
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea.
authors.forename: Chan-Woo
authors.initials: CW
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, Seoul Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Doo-Seok
authors.initials: DS
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Byung-Moon
authors.initials: BM
authors.lastname: Kang
authors.affiliation: Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Byung-Seok
authors.initials: BS
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Tak
authors.initials: T
authors.lastname: Kim
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, Korea National Institute of Health, Chungbuk, Korea.
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications*; D016015:Logistic Models; D008597:Menstrual Cycle; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology*; D016017:Odds Ratio; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D055815:Young Adult
chemical_list: D012738:Sex Hormone-Binding Globulin