Metabolic Cardiovascular Disease Risk Factors in Women with Self-Reported Symptoms of Oligomenorrhea and/or Hirsutism: Northern Finland Birth Cohort 1966 Study
Saara Taponen,
Hannu Martikainen,
Marjo-Riitta Järvelin,
Ulla Sovio,
Jaana Laitinen,
Anneli Pouta,
Anna-Liisa Hartikainen,
Mark I. McCarthy,
Stephen Franks,
Mika Paldanius and
Aimo Ruokonen
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 womenwith self-reported oligomenorrhea and/or hirsutism, which aresymptoms of polycystic ovary syndrome (PCOS), were investigatedin a general population-based Northern Finland Birth Cohort1966 Study to determine whether women with PCOS symptoms at31 yr would be distinguishable from asymptomatic controls interms of CVD risk factors. A total of 518 cases with oligomenorrheaand/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 significantlyhigher, and high-density lipoprotein cholesterol levels werelower (mean, 1.60 vs. 1.66 mmol/liter; P = 0.002) in the casescompared with the controls. Total cholesterol, low-density lipoproteincholesterol, and blood pressure showed no statistically significantdifferences between the cases and the controls. In terms ofmetabolic CVD risk factors, women reporting hirsutism alonewere indistinguishable from the control group, and those whoreported both oligomenorrhea and hirsutism had the most severechanges in risk factor profiles. Because obesity is stronglyrelated 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 significantlyhigher among the overweight cases (mean, 0.84 vs. 0.83; P =0.04). Among the obese women, high-density lipoprotein cholesterolwas 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 symptomsof oligomenorrhea and/or hirsutism, particularly in the presenceof both symptoms, may be helpful to identify women with metaboliccardiovascular risk factor accumulation associated with PCOS.
This work was supported by the Academy of Finland, the EuropeanCommission Quality of Life and Management of Living SourcesProgram (Contract QLG1-CT-2000-01643), the Foundation of theUniversity of Oulu, the Oskar Öflund Foundation, and theFinnish Gynecological Association.
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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. 
