title: The association between Polycystic Ovary Syndrome (PCOS) and metabolic syndrome: a statistical modelling approach.
abstract: OBJECTIVE
  Polycystic ovary syndrome (PCOS) affects 12-21% of women. Women with PCOS exhibit clustering of metabolic features. We applied rigorous statistical methods to further understand the interplay between PCOS and metabolic features including insulin resistance, obesity and androgen status.
  
  
  METHODS
  Retrospective cross-sectional analysis.
  
  
  METHODS
  Women with PCOS attending reproductive endocrine clinics in South Australia for the treatment of PCOS (n = 172). Women without PCOS (controls) in the same Australian region (n = 335) from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), a national population-based study (age- and BMI-matched within one standard deviation of the PCOS cohort).
  
  
  METHODS
  The factor structure for metabolic syndrome for women with PCOS and control groups was examined, specifically, the contribution of individual factors to metabolic syndrome and the association of hyperandrogenism with other metabolic factors.
  
  
  RESULTS
  Women with PCOS demonstrated clustering of metabolic features that was not observed in the control group. Metabolic syndrome in the PCOS cohort was strongly represented by obesity (standardized factor loading = 0·95, P < 0·001) and insulin resistance factors (loading = 0·92, P < 0·001) and moderately by blood pressure (loading = 0·62, P < 0·001) and lipid factors (loading = 0·67, P = 0·002). On further analysis, the insulin resistance factor strongly correlated with the obesity (r = 0·70, P < 0·001) and lipid factors (r = 0·68, P < 0·001) and moderately with the blood pressure factor (loading = 0·43, P = 0·002). The hyperandrogenism factor was moderately correlated with the insulin resistance factor (r = 0·38, P < 0·003), but did not correlate with any other metabolic factors.
  
  
  CONCLUSIONS
  PCOS women are more likely to display metabolic clustering in comparison with age- and BMI-matched control women. Obesity and insulin resistance, but not androgens, are independently and most strongly associated with metabolic syndrome in PCOS.
authors.affiliation: Women's Reproductive Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Vic, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Ranasinha
authors.affiliation: Women's Reproductive Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Vic, Australia.|Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Vic, Australia.
authors.forename: A E
authors.initials: AE
authors.lastname: Joham
authors.affiliation: Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, North Adelaide, SA, Australia.
authors.forename: R J
authors.initials: RJ
authors.lastname: Norman
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Vic, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Shaw
authors.affiliation: Women's Reproductive Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Vic, Australia.|Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Vic, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Zoungas
authors.affiliation: Women's Reproductive Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Vic, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Boyle
authors.affiliation: Women's Reproductive Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Vic, Australia.|Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, North Adelaide, SA, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Moran
authors.affiliation: Women's Reproductive Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Vic, Australia.|Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Vic, Australia.
authors.forename: H J
authors.initials: HJ
authors.lastname: Teede
mesh_terms: D000328:Adult; D001315:Australia; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D024821:Metabolic Syndrome / Q000378:metabolism*; D015233:Models, Statistical; D009765:Obesity / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000378:metabolism*; D012189:Retrospective Studies