Hyperandrogenaemia in premenopausal women is associated with impaired metabolic health and physical fitness as well as increased risk of cardiovascular disease in later adulthood
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Auditorium 4, at Oulu University Hospital
Topic of the dissertation
Hyperandrogenaemia in premenopausal women is associated with impaired metabolic health and physical fitness as well as increased risk of cardiovascular disease in later adulthood
Doctoral candidate
Licentiate of Medicine Katri Tuorila
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine
Subject of study
Medicine
Opponent
Professor Oskari Heikinheimo, Helsinki University Hospital
Custos
Professor Laure Morin-Papunen, Oulu University Hospital
Hyperandrogenaemia in premenopausal women is associated with impaired metabolic health and physical fitness as well as increased risk of cardiovascular disease in later adulthood
Hyperandrogenaemia (HA) is a common endocrine condition in premenopausal women that is associated in most, but not all, studies with metabolic disturbances, cardiovascular disease (CVD) and increased mortality. At the same time, androgens exert anabolic effects that potentially enhance physical fitness, thereby protecting against CVD and mortality. HA is a pivotal feature of polycystic ovary syndrome (PCOS) that is associated with metabolic risks. Thus, whether HA independently contributes to the development of metabolic abnormalities in women remains unclear.
This study aimed to investigate the association of premenopausal HA with cardiometabolic risk factors, including abnormal glucose metabolism (AGM), blood pressure (BP), physical fitness and risk of CVD events. For this purpose, we took advantage of the Northern Finland Birth Cohort 1966, which includes 5889 women from whom data were collected at ages 31 and 46 through postal questionnaires and clinical examinations, and links to national registers. For the evaluation of HA, total testosterone (TT) levels (measured using liquid chromatography-tandem mass spectrometry) and the free androgen index (FAI) were used.
The main findings were that TT and FAI at age 31 were associated with the risk of AGM at age 46. Additionally, TT and FAI at age 31 were positively associated with higher systolic and diastolic BP at ages 31 and 46. Moreover, TT and FAI were positively associated with poorer cardiorespiratory fitness. All these associations were independent of body mass index (BMI) and remained after the exclusion of women with PCOS. TT did not show any significant association with CVD events, but there was a positive association between FAI and CVD events, which remained after excluding women with PCOS. However, the significance disappeared after adjusting for BMI.
These findings suggest that HA in early adulthood may be an independent cardiometabolic risk factor, independent of PCOS diagnosis. However, the magnitude of the increased CVD risk in women with premenopausal HA remains to be better defined, and a longer follow-up of this cohort is needed to clarify this issue.
This study aimed to investigate the association of premenopausal HA with cardiometabolic risk factors, including abnormal glucose metabolism (AGM), blood pressure (BP), physical fitness and risk of CVD events. For this purpose, we took advantage of the Northern Finland Birth Cohort 1966, which includes 5889 women from whom data were collected at ages 31 and 46 through postal questionnaires and clinical examinations, and links to national registers. For the evaluation of HA, total testosterone (TT) levels (measured using liquid chromatography-tandem mass spectrometry) and the free androgen index (FAI) were used.
The main findings were that TT and FAI at age 31 were associated with the risk of AGM at age 46. Additionally, TT and FAI at age 31 were positively associated with higher systolic and diastolic BP at ages 31 and 46. Moreover, TT and FAI were positively associated with poorer cardiorespiratory fitness. All these associations were independent of body mass index (BMI) and remained after the exclusion of women with PCOS. TT did not show any significant association with CVD events, but there was a positive association between FAI and CVD events, which remained after excluding women with PCOS. However, the significance disappeared after adjusting for BMI.
These findings suggest that HA in early adulthood may be an independent cardiometabolic risk factor, independent of PCOS diagnosis. However, the magnitude of the increased CVD risk in women with premenopausal HA remains to be better defined, and a longer follow-up of this cohort is needed to clarify this issue.
Last updated: 13.10.2025