Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome

Glintborg, Dorte; Rubin, Katrine Hass; Nybo, Mads; Abrahamsen, Bo; Andersen, Marianne

doi:10.1530/endoabs.56.gp127

Cited by 38 publications

(70 citation statements)

References 11 publications

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“…Inclusion of women aged 30 years or more did not change significant results. Some limitations may apply to the present study design . Education level in immigrants could be underestimated, as their education must be individually reported to Statistics Denmark whereas education completed in Denmark is already in the registers.…”

Section: Discussionmentioning

confidence: 99%

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Socioeconomic status in Danish women with polycystic ovary syndrome: A register‐based cohort study

Rubin

Andersen

Abrahamsen

et al. 2018

Acta Obstet Gynecol Scand

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| INTRODUC TI ONPolycystic ovary syndrome (PCOS) can be diagnosed in around 10% of premenopausal women. 1,2 PCOS is characterized by irregular menses, polycystic ovaries and hyperandrogenism. 1 Quality of life may be impaired in PCOS and the risk of depression and development of medical and psychiatric diseases is increased. 3,4 More than 50% women with PCOS are obese. 5 Obesity is associated with a more severe PCOS phenotype including more irregular menses, infertility and hirsutism, 6,7 and obesity is associated with impaired quality of life and depression in PCOS. 8,9 In the general population, Newton et al reported a consistent association between lower life course socioeconomic status (SES) and obesity among Abstract Introduction: Low socioeconomic status (SES) may be associated with increased risk of polycystic ovary syndrome (PCOS) and vice versa. Possible associations between SES, obesity and ethnicity in PCOS are undetermined. Material and methods: National register-based study including women with PCOS aged 25 years or above (PCOS Denmark and an embedded cohort; PCOS Odense University Hospital [OUH]) and one control population. PCOS Denmark (n = 13 891) included women with PCOS in the Danish National Patient Register. Women in PCOS OUH underwent clinical examination (n = 814). Three age-matched controls were included per patient (n = 41 584). The main outcome measure was SES (personal income, occupational status and education).Results: The median (Q1; Q3) age of women in PCOS Denmark and controls was 33 (29; 39) years. Women with personal income in the lower tertile had a higher probability of a PCOS diagnosis than women in the high-income tertile (adjusted odds ratio[aOR] 1.5, 95% confidence interval [CI] 1.4-1.6). Women who were unemployed or on welfare payment (aOR 1.5, 95% CI 1.4-1.6), or who retired early (OR 1.8, 95% CI 1.7-2.0) had a higher probability of a PCOS diagnosis than women affiliated to the labor market. Women originating from the Middle East more often had PCOS (aOR 3.2, 95% CI 2.8-3.7) compared with women originating from Europe. In PCOS OUH, SES was lower in obese than in normal weight women.Conclusions: A diagnosis of PCOS was associated with lower SES. In PCOS, women of foreign origin and women with obesity more often had low SES. K E Y W O R D Sethnicity, nationwide, polycystic ovary syndrome, register-based, socioeconomic status | 441 RUBIN et al.

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Section: Discussionmentioning

confidence: 99%

“…The study design and baseline data for this study cohort have been reported in detail earlier . Data regarding development of type 2 diabetes, cardiovascular disease and incident fractures in the study cohort have been published recently. We included two patient populations with PCOS and one control population (Figure ).…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic status in Danish women with polycystic ovary syndrome: A register‐based cohort study

Rubin

Andersen

Abrahamsen

et al. 2018

Acta Obstet Gynecol Scand

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“…107 Additionally, in a recently published national register-based study with over 70 000 participants, authors from Denmark noted significantly higher incidence rate of CVD in PCOS women than in controls respectively 22.6 and 13.2 per 1000 person-years. 108 Moreover, incidence rate of CVD excluding AH and dyslipidaemia was estimated at 6.4 per 1000 person-years in PCOS group and 4.5 in controls, that was still statistically significant, and the median age at the diagnosis of CVD was significantly lower in PCOS than in controls (35 vs 36 years). It was also demonstrated that obesity, T2DM, infertility, and previous use of oral contraceptives were associated with increased risk of CVD in PCOS women.…”

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confidence: 89%

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Jacewicz-Święcka

Kowalska

2018

Diabetes Metabolism Res

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The purpose of this study was to perform a review of the longitudinal studies to determine whether polycystic ovary syndrome is associated with higher prevalence of metabolic complications and cardiovascular morbidity and mortality. The primary outcomes included body mass index, metabolic syndrome and its components (waist circumference, lipid profile, arterial hypertension, abnormal glucose metabolism (impaired fasting glucose, impaired glucose tolerance, type 2 diabetes), insulin resistance, and cardiovascular diseases like stroke, angina, and coronary heart disease. Complications in pregnant women were beyond the scope of this review. PubMed database (1992-2018) was searched to identify proper publications. Finally, data from 47 articles were analysed. Studies differed in the design (prospective, retrospective, cohort, observational), research methods, polycystic ovary syndrome diagnostic criteria, studied populations, race, and ethnicity of the participants. Based on the data collected, it appears that women with polycystic ovary syndrome have higher prevalence of obesity, abdominal fat distribution, dyslipidaemia and deterioration of glucose metabolism, but increased prevalence of cardiovascular diseases is not proven.

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“…PCOS may also be associated with increased incidence of cardiovascular disease and this risk should be considered even in young women with PCOS [11]. Surrogate markers of cardiovascular disease are already altered in adolescent PCOS ladies and metformin treatment positively modified these markers leading to the proposal of a preventive treatment [12].…”

Section: Introductionmentioning

confidence: 99%

Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women

Schiuma¹,

Costantino²,

Bartolotti³

et al. 2019

J Endocrinol Invest

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Purpose Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alternative approach. Methods This was a prospective, randomized, parallel group, open label, controlled versus no treatment clinical study. PCOS women aged > 18, free from systemic diseases and from pharmacological treatments were randomized with a 2:1 ratio for treatment with activated micronutrients in support to the carbon cycle (Impryl, Parthenogen, Switzerland-n = 22) or no treatment (n = 10) and followed-up for 3 months. Fasting blood homocysteine, AMH, testosterone, SHBGs, and the resulting FTI were tested before and at the end of the follow-up. Results The mean baseline fasting blood homocysteine was above the normal limit of 12 μMol/L and inversely correlated with SHBG. AMH was also increased, whereas testosterone, SHBG, and FTI were within the normal limit. The treatment achieved a significant reduction of homocysteine, that did not change in the control group, independently of the starting value. The treatment also caused an increase of AMH and a decrease of SHBGs only in the subgroup with a normal homocysteine at baseline. Conclusions In PCOS ladies, blood homocysteine is increased and inversely correlated with the SHBGs. Physiologic amounts of activated micronutrients in support to the carbon cycle achieve a reduction virtually in all exposed patients. Whether this is of clinical benefit remains to be established.

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Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome

Cited by 38 publications

References 11 publications

Socioeconomic status in Danish women with polycystic ovary syndrome: A register‐based cohort study

Socioeconomic status in Danish women with polycystic ovary syndrome: A register‐based cohort study

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women

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