Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disorder that affects 5-10% of women of reproductive age world wide. Women with PCOS are known to have a higher prevalence of metabolic syndrome and cardiovascular risk factors compared to the general population. However data on PCOS and cardiovascular risk factors amomg Sri Lankan women is limited.

Methodology: A case control study was conducted among 172 women from Colombo, Sri Lanka. 86 women aged <45 years diagnosed with PCOS according to Rotterdam criteria were compared to 86 age matched controls from the community with no history or evidence of PCOS. Biometric data, biochemical, and endocrine parameters were compared between groups using approprite statistical tests.

Results: Among 86 women with PCOS, 41 (47.7%) were overweignt and 28 (32.6%) were obese. Prevalence of obesity (P=0.002) and overweight (P=0.01)among women with PCOS were significantly higher compared to the control group. Acanthosis nigricans was present among 59.3% (n=51) of women with PCOS. Women with PCOS had significantly higher levels of fasting insulin (P=0.001), fasting blood glucose (P=0.015), and 2 h blood glucose level following 75g oral glucose load (P=0.002). Prevalence of type 2 diabetes mellitus among women with PCOS was 26.7% while prevalence was 12.8% in the control group. Further 24.4% of women with PCOS had prediabetes. Women with PCOS had significantly higher triglyceride levels (P=0.01), total cholesterol levels (0.02) and lower HDL levels (P=0.02) compared to control group. Systolic (P=0.05) and diastolic (P=0.01) blood pressures were significantly elevated among women with PCOS compared to the control group. Prevalence of hypertension among women with PCOS was 11.6%. 34.9% (n=30) of women with PCOS fulfilled diagnostic criteria for metabolic syndrome. Women with PCOS had higher odds of obesity, insulin resistance, hyperglycemia, dyslipidemia, hypertension and metabolic syndromeare compared to age matched controlls.

Conclusion: Women with PCOS often have multiple cardiovascular risk factors including obesity, diabetes mellitus, dyslipidemia, and hypertension. Management of cardiovascular risk factors should be prioratized in the long term care of women with PCOS. Further research is required to assess implications of PCOS on longterm cardiovascular morbidity and mortality among Sri Lankan women.