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Metabolic Cardiovascular Disease Risk Factors in Women with Self-Reported Symptoms of Oligomenorrhea and/or Hirsutism: Northern Finland Birth Cohort 1966 Study

Departments of Clinical Chemistry (S.T., A.R.) and Obstetrics and Gynecology (S.T., H.M., A.-L.H.), University of Oulu and Oulu University Hospital; and Department of Public Health Science and General Practice, University of Oulu (S.T., M.-R.J., A.P.), 90014 Oulu, Finland; Oulu Regional Institute of Occupational Health (J.L.) and National Public Health Institute (M.P.), 90220 Oulu, Finland; Department of Epidemiology and Public Health, Imperial College London (M.-R.J., U.S.), London, United Kingdom W2 1PG; Oxford Center for Diabetes, Endocrinology, and Metabolism (M.I.M.), Oxford, United Kingdom OX3 7LJ; Wellcome Trust Centre for Human Genetics (M.I.M.), Oxford, United Kingdom OX3 7BN; and Institute of Reproductive and Developmental Biology, Imperial College London (S.F.), London, United Kingdom W12 0NN

Address all correspondence and requests for reprints to: Dr. Saara Taponen, Department of Clinical Chemistry, University of Oulu, PL 5000, 90014 Oulu, Finland. E-mail: saara.taponen{at}mail.suomi.net.

The metabolic cardiovascular disease (CVD) risk factors of women with self-reported oligomenorrhea and/or hirsutism, which are symptoms of polycystic ovary syndrome (PCOS), were investigated in a general population-based Northern Finland Birth Cohort 1966 Study to determine whether women with PCOS symptoms at 31 yr would be distinguishable from asymptomatic controls in terms of CVD risk factors. A total of 518 cases with oligomenorrhea and/or hirsutism and 1036 randomly selected controls were analyzed. C-Reactive protein (CRP; median, 0.70 vs. 0.60 mg/liter; P = 0.026), triglycerides (mean, 0.97 vs. 0.91 mmol/liter; P = 0.039), body mass index (BMI; mean, 25.1 vs. 24.2 kg/m²; P < 0.001), and waist/hip ratio (mean, 0.82 vs. 0.81; P = 0.001) were significantly higher, and high-density lipoprotein cholesterol levels were lower (mean, 1.60 vs. 1.66 mmol/liter; P = 0.002) in the cases compared with the controls. Total cholesterol, low-density lipoprotein cholesterol, and blood pressure showed no statistically significant differences between the cases and the controls. In terms of metabolic CVD risk factors, women reporting hirsutism alone were indistinguishable from the control group, and those who reported both oligomenorrhea and hirsutism had the most severe changes in risk factor profiles. Because obesity is strongly related to PCOS symptoms, the analyses were stratified by BMI. After stratification into normal weight (BMI, <25 kg/m²), overweight (25 kg/m² BMI <30 kg/m²), and obese (BMI, 30 kg/m²) groups, the waist/hip ratio was significantly higher among the overweight cases (mean, 0.84 vs. 0.83; P = 0.04). Among the obese women, high-density lipoprotein cholesterol was significantly lower (mean, 1.32 vs. 1.48 mmol/liter; P = 0.002) among the cases, and triglycerides tended to be higher (mean, 1.43 vs. 1.27 mmol/liter; P = 0.068) than in controls. In conclusion, these results indicate that self-reported symptoms of oligomenorrhea and/or hirsutism, particularly in the presence of both symptoms, may be helpful to identify women with metabolic cardiovascular risk factor accumulation associated with PCOS.

This work was supported by the Academy of Finland, the European Commission Quality of Life and Management of Living Sources Program (Contract QLG1-CT-2000-01643), the Foundation of the University of Oulu, the Oskar Öflund Foundation, and the Finnish Gynecological Association.

Abbreviations: BMI, Body mass index; BP, blood pressure; CRP, C-reactive protein; CVD, cardiovascular disease; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PCOS, polycystic ovary syndrome; WHR, waist/hip ratio.

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