This article is more than 5 years old. Information may no longer be current.
Odds for metabolic syndrome in PCOS vary by study design, age, BMI
Click Here to Manage Email Alerts
Women and adolescents with polycystic ovary syndrome are more likely to develop metabolic syndrome when compared with healthy controls, but the level of risk varied according to study design, disease criteria and confounder controls, according to a meta-analysis published in Clinical Endocrinology.
Some studies report that metabolic syndrome is more common among women with PCOS due to a higher prevalence of insulin resistance, obesity and visceral obesity in the patient population, Samira Behboudi-Gandevani, PhD, of the Reproductive Endocrinology Research Center at Shahid Beheshti University of Medical Sciences in Tehran, Iran, and colleagues wrote in the study background.
“Recent evidence suggests that some confounding factors, including the study method and some anthropometric characteristics, including and BMI, seriously affect results,” Behboudi-Gandevani and colleagues wrote. “The aim of this systematic review and meta-analysis was to provide a more realistic estimate risk of [metabolic syndrome] in women with and without PCOS, and to assess the effect of the study method and potential confounding factors on the risk of [metabolic syndrome] in women with PCOS.”
Researchers analyzed data from 44 studies investigating the prevalence and odds of metabolic syndrome in women of reproductive age with PCOS compared with healthy controls, using primary pooled-effect analysis to estimate odds of metabolic syndrome among study groups. In studies that reported on the prevalence of metabolic syndrome stratified by PCOS phenotypes, researchers calculated the total weighted prevalence of PCOS among the total population.
The researchers noted that some studies used various PCOS and metabolic syndrome criteria — 15 studies defined PCOS by NIH criteria, whereas 27 studies defined PCOS according to the European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine criteria. Metabolic syndrome was defined by American Heart Association criteria, WHO criteria and International Diabetes Federation criteria, among other standards. Studies assessed metabolic syndrome prevalence among adolescents (n = 12), metabolic syndrome prevalence among adults (n = 27) and metabolic syndrome prevalence in reproductive-age adults and adolescents (n = 6). Six studies had a population-based design.
In 72 articles that included 18,259 women with PCOS and 15,891 healthy controls, random-effects models showed women with PCOS were 2.5 times more likely to develop metabolic syndrome vs. controls (pooled OR = 2.5; 95% CI, 2-3.2). However, in subgroup analyses, risks for metabolic syndrome varied by age.
In four studies involving 204 adolescents with PCOS and 537 age-matched controls, girls with PCOS had a 6.1-fold higher risk for developing metabolic syndrome vs. controls (95% CI, 5.5-6.01). In 11 studies involving 2,033 women with PCOS and 1,787 age-matched and BMI-matched controls, the odds for metabolic syndrome were 2.6-fold higher among women with PCOS vs. controls (95% CI, 1.3-5.5). In four studies involving 635 women and adolescents with PCOS and 674 age-matched and BMI-matched controls, odds for developing metabolic syndrome were 1.7-fold higher among those with PCOS vs. controls (95% CI, 1.4-2.2)
In the six population-based studies, adolescents again had an increased risk for metabolic syndrome when compared with healthy adolescent controls (OR = 4.7; 95% CI, 1.8-11.9), but there were no between-group differences for metabolic syndrome risk among adults with and without PCOS, persisting after adjustment for age and BMI.
Additionally, subgroup analyses based on PCOS diagnostic criteria showed that the OR for metabolic syndrome in PCOS using NIH criteria was higher than Androgen Excess and PCOS Society criteria and Rotterdam criteria, according to researchers.
“This meta-analysis demonstrated that adolescents with PCOS had increased odds for [metabolic syndrome] compared to healthy adolescent controls, results not supported by differences among adults with PCOS compared to the general population,” the researchers wrote, noting that the findings “could present the most reliable feature of this syndrome and help clarify some conflicting data.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts