From the University of California, San Francisco, San Francisco, California; the Hadassah-Hebrew University, Jerusalem, Israel; the University of California, San Francisco, San Francisco, California; Northwestern University, Chicago, Illinois; the University of California, Los Angeles, Los Angeles, California; the University of Minnesota, Minneapolis, Minnesota; Kaiser Permanente, Oakland, California; the University of Alabama at Birmingham, Birmingham, Alabama; and the University of Washington, Seattle, Washington.
Obstet Gynecol. 2011 Jan;117(1):6-13. doi: 10.1097/AOG.0b013e31820209bb.
To estimate whether women aged 20-32 years who fulfilled National Institutes of Health criteria for polycystic ovary syndrome (PCOS) would be at higher risk for subsequent development of incident diabetes, dyslipidemia, and hypertension, and to estimate whether normal-weight women with PCOS would have the same degree of cardiovascular risk as overweight women with PCOS.
We estimated the association of PCOS with incident diabetes, dyslipidemia, and hypertension over a period of 18 years among 1,127 white and African-American women in the Coronary Artery Risk Development in Young Adults cohort. We classified women at baseline (ages 20-32 years) based on self-reported symptoms and serum androgen measures using National Institutes of Health PCOS criteria. We estimated the association of PCOS and subsequent cardiovascular risk factors, independent of baseline body mass index (BMI), using multivariable logistic regression. Additionally, among 746 women with a second assessment of PCOS at ages 34-46 years, we estimated the association of persistent PCOS with cardiovascular risk factors.
Of 1,127 women, 53 (4.7%) met criteria for PCOS at ages 20-32 years. Polycystic ovary syndrome was associated with a twofold higher odds of incident diabetes (23.1% compared with 13.1%, adjusted odds ratio [AOR] 2.4, confidence interval [CI] 1.2-4.9) and dyslipidemia (41.9% compared with 27.7%, AOR 1.9, CI 1.0-3.6) over the course of 18 years; the association with incident hypertension was not significant (26.9% compared with 26.3%, AOR 1.7, CI 0.8-3.3). Normal-weight women with PCOS (n=31) had a threefold higher odds of incident diabetes compared with normal-weight women without PCOS (AOR 3.1, CI 1.2-8.0). Compared with those without PCOS, women with persistent PCOS (n=11) had the highest odds of diabetes (AOR 7.2, CI 1.1-46.5).
Polycystic ovary syndrome is associated with subsequent incident diabetes and dyslipidemia, independent of BMI. Diabetes risk may be greatest for women with persistent PCOS symptoms.
II.
评估符合美国国立卫生研究院多囊卵巢综合征（PCOS）标准的 20-32 岁女性是否存在更高的发展为糖尿病、血脂异常和高血压的风险，并评估 PCOS 患者中正常体重者的心血管风险是否与超重患者相同。
我们在冠状动脉风险发展青年人群中纳入了 1127 名白人和非裔美国女性，在 18 年的时间里，根据自我报告的症状和血清雄激素测量值，用美国国立卫生研究院的 PCOS 标准来估计 PCOS 与新发糖尿病、血脂异常和高血压之间的关联。我们根据基线（20-32 岁）时的 PCOS 症状和血清雄激素水平，用美国国立卫生研究院的 PCOS 标准对女性进行分类。我们使用多变量逻辑回归来评估 PCOS 与后续心血管危险因素的关联，这种关联与基线体重指数（BMI）无关。此外，在 746 名年龄在 34-46 岁时再次评估 PCOS 的女性中，我们估计了持续性 PCOS 与心血管危险因素的关联。
在 1127 名女性中，有 53 名（4.7%）在 20-32 岁时符合 PCOS 标准。与无 PCOS 女性相比，患有 PCOS 的女性发生糖尿病的风险高出两倍（23.1%比 13.1%，调整后的优势比 [OR] 2.4，95%置信区间 [CI] 1.2-4.9）和血脂异常（41.9%比 27.7%，OR 1.9，CI 1.0-3.6）的风险更高；与新发高血压的相关性不显著（26.9%比 26.3%，OR 1.7，CI 0.8-3.3）。与无 PCOS 的正常体重女性相比，PCOS 正常体重女性发生糖尿病的风险高出三倍（OR 3.1，CI 1.2-8.0）。与无 PCOS 相比，持续性 PCOS 女性（n=11）的糖尿病风险最高（OR 7.2，CI 1.1-46.5）。
PCOS 与新发糖尿病和血脂异常有关，与 BMI 无关。持续性 PCOS 症状的女性糖尿病风险可能最大。
II 级。
