Cardiometabolic risks in polycystic ovary syndrome: long-term population-based follow-up study

Objective: To evaluate the incidence of hypertension, metabolic syndrome, dyslipidemia, and obesity in comparing women with polycystic ovary syndrome (PCOS) and a control group of healthy women.

Design: Prospective cohort study with the median and interquartile range of 12.9 (10.8-13.9) years.

Setting: Population-based cohort of the Tehran Lipid and Glucose Study.

Patient(s): A total of 1,702 reproductive-age women including 178 women with PCOS and 1,524 controls.

Intervention(s): None.

Main outcome measure(s): Cumulative incidence of each outcome estimated using the Kaplan-Meier method and compared using the log-rank statistic; univariate and multiple extended Cox proportional hazards regression with age as the time scale to estimate the adjusted hazard ratio (HR) of developing outcomes in relation to PCOS and ages ≤40 years and >40 years with heavyside functions.

Result(s): The incidence rates of hypertension, metabolic syndrome, dyslipidemia, and obesity were 13.9, 21.0, 46.1, 24.6, and 50.6, respectively, per 1,000 person-years for women with PCOS; and 13.8, 22.7, 46.0, and 24.0, respectively, per 1,000 person-years for the healthy control women. Women with PCOS aged ≤40 years had an adjusted higher risk of developing hypertension (HR 2.08; 95% confidence interval, 1.0-3.9) and the metabolic syndrome (HR 1.81; 95% confidence interval, 1.1-2.9), but the risk disappeared after age 40. The risks of central obesity and obesity had borderline statistical significance and were higher in women with PCOS aged ≤40 than in healthy controls. The risk of developing dyslipidemia showed no statistically significant difference between the two groups in the unadjusted or multiple adjusted models at any age.

Conclusion(s): In this long-term population-based cohort study, the risk of developing hypertension and the metabolic syndrome in young women with PCOS was higher than in controls, but these risks were diluted in the late reproductive period.