title: Metabolic implications of menstrual cycle length in non-hyperandrogenic women with polycystic ovarian morphology.
abstract: This cross-sectional study aimed to investigate the association between menstrual cycle lenght and metabolic parameters in non-hyperandrogenic women with polycystic ovarian morphology, n = 250. Metabolic profiles of all participants were evaluated using anthropometric parameters (body mass index, waist circumference), parameters of dyslipidemia (total cholesterol, HDL-cholesterol, triglycerides) and markers of insulin resistance (fasting insulin, homeostasis model assessment for insulin resistance index). The associations between menstrual cycle lenght and cardiometabolic risk factors such as insulin resistance, dyslipidemia, and obesity were investigated. In non-hyperandrogenic women with polycystic ovarian morphology, menstrual cycle lenght was associated with hypertriglyceridemia and insulin resistance independently of body mass index. Moreover, menstrual cycle lenght added value to body mass index in predicting hypertriglyceridemia. The optimal menstrual cycle lenght cut-off value for identifying of non-hyperandrogenic women with polycystic ovarian morphology at metabolic risk was found to be 45 days. Metabolic profile of non-hyperandrogenic women with polycystic ovarian morphology (n = 75) with menstrual cycle lenght >45 days was similar to that of hyperandrogenic women with polycystic ovarian morphology (n = 138) while metabolic profile of non-hyperandrogenic women with polycystic ovarian morphology with menstrual cycle lenght ≤45 days (n = 112) was similar to that of controls (n = 167). Non-hyperandrogenic women with polycystic ovarian morphology with menstrual cycle lenght >45 days had higher prevalence of cardiometabolic risk factors compared to those with menstrual cycle lenght ≤45 days. Non-hyperandrogenic women with polycystic ovarian morphology are not metabolically homogeneous. Menstrual cycle lenght is an easy-to-obtain clinical parameter positively associated with the probability of unfavorable metabolic status in non-hyperandrogenic women with polycystic ovarian morphology. Menstrual cycle lenght cut-off value of 45 days was found to have the best capacity in discriminating non-hyperandrogenic women with polycystic ovarian morphology with and without metabolic derangement(s) corroborating in favor of the cardiometabolic risk factors screening and management in non-hyperandrogenic women with polycystic ovarian morphology with menstrual cycle lenght >45 days through strategies for prevention of cardiovascular disease.
authors.affiliation: Division of Reproductive Medicine, Podobnik Maternity and Gynecology Outpatient Clinic, Sveti Duh 112, 10 000, Zagreb, Croatia.
authors.forename: Miro Šimun
authors.initials: MŠ
authors.lastname: Alebić
authors.affiliation: Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zajčeva 19, 10 000, Zagreb, Croatia.
authors.forename: Nataša
authors.initials: N
authors.lastname: Stojanović
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Clinical Hospital Centre, School of Medicine, University of Zagreb, Petrova 13, 10 000, Zagreb, Croatia. dpbaldani@gmail.com.
authors.forename: Dinka Pavičić
authors.identifier: http://orcid.org/0000-0002-3412-8024
authors.initials: DP
authors.lastname: Baldani
authors.affiliation: University Clinic for Diabetes, Endocrinology and Metabolic Diseases Vuk Vrhovac, Merkur University Hospital, Zajčeva 19, 10 000, Zagreb, Croatia.
authors.forename: Lea Smirčić
authors.initials: LS
authors.lastname: Duvnjak
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications; D007333:Insulin Resistance; D008597:Menstrual Cycle; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology
keywords: Anovulation; Insulin resistance; Menstrual cycle; Polycystic ovary syndrome; Triglycerides