The role of polycystic ovary syndrome (PCOS) and overweight/obesity in women’s metabolic and cardiovascular risk factors and related morbidities

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Auditorium 4 of Oulu University Hospital

Topic of the dissertation

The role of polycystic ovary syndrome (PCOS) and overweight/obesity in women’s metabolic and cardiovascular risk factors and related morbidities

Doctoral candidate

Licentiate of Medicine Meri-Maija Ollila

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, PEDEGO Research Unit

Subject of study

Obstetrics and Gynecology

Opponent

Professor Joop Laven, Erasmus Medical Centre, Rotterdam, The Netherlands.

Custos

Docent Laure Morin-Papunen, Obstetrics and Gynecology, Oulu University Hospital

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Excess weight has a major impact on the metabolic health of women with polycystic ovary syndrome

Doctoral thesis research revealed that even thought polycystic ovary syndrome (PCOS) is an independent risk factor of metabolic abnormalities, overweight/obesity that often coexist with the syndrome, is a more important modifier of the metabolic health that PCOS per se. The results highlight the importance of weight management as the first-line treatment of PCOS.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive-aged women and the typical features of PCOS include irregular menstruation, androgen excess and polycystic ovaries in ultrasonography. The majority of women with PCOS are overweight or obese, and, at least partly, obesity-driven metabolic abnormalities often coexist with PCOS. Despite intensive research, it has remained unclear whether PCOS per se is a risk factor of metabolic abnormalities, and cardiovascular disease and events. The main aim of the current work was to investigate whether PCOS is an independent risk factor of metabolic abnormalities and cardiovascular diseases. The study population consisted of the prospective population-based Northern Finland Birth Cohort 1966, and we used data collected at ages 14, 31 and 46.

The results revealed that weight gain in early life was a risk factor for the development of PCOS. As for metabolic outcomes, at age 46, normal-weight women with PCOS did not display increased odds of abnormal glucose metabolism. However, weight gain during early adulthood was significantly associated with abnormal glucose metabolism in women with PCOS by age 46. Interestingly, PCOS per se was already associated with elevated blood pressure at age 31 and hypertension at age 46, independently of obesity. Women with PCOS also displayed reduced cardiac vagal activity, which was associated with metabolic abnormalities and hypertension. Furthermore, even though no major anatomical or functional impairments were observed in echocardiography, women with PCOS displayed a significantly greater prevalence of myocardial infarction and a two-fold higher prevalence of cardiovascular events than controls. However, a more detailed evaluation of the association between PCOS and cardiovascular diseases requires the follow-up of this cohort.
Last updated: 28.5.2019