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. 2021 Dec;44(12):2725-2733.
doi: 10.1007/s40618-021-01594-5. Epub 2021 Jun 5.

Effect of aging on clinical features and metabolic complications of women with polycystic ovary syndrome

P Falcetta #  1 , E Benelli #  2 , A Molinaro  2 , C Di Cosmo  2 , B Bagattini  2 , S Del Ghianda  2 , G Salvetti  2 , E Fiore  2 , E Pucci  2 , F Fruzzetti  3 , M Tonacchera  2
Affiliations

Effect of aging on clinical features and metabolic complications of women with polycystic ovary syndrome

P Falcetta et al. J Endocrinol Invest. 2021 Dec.

Abstract

Purpose: To assess the distribution of clinical features and metabolic abnormalities of polycystic ovary syndrome (PCOS) women according to their age.

Methods: Retrospective study on 602 women (mean age 23.9 ± 6.2 years), diagnosed according to International PCOS Network Guidelines criteria as having PCOS in a University-based Hospital. Anthropometric features, hormonal and metabolic parameters were measured and compared between the different age groups (group A ≤ 20 years; group B 21-30 years; group C > 30 years).

Results: Patients in group A were more often hyperandrogenic, while in group C hypertension, dyslipidemia, obesity, impaired fasting glucose, and insulin resistance (IR) were more prevalent. After adjusting for BMI, age correlated positively with sex hormone-binding globulin (SHBG), IR, total- and LDL-cholesterol, and negatively with DHEAS, insulin, and free androgen index (FAI). SHBG was significantly associated with IR and atherogenic dyslipidemia, while FAI levels were linked to hypertension, independently of other factors considered. Furthermore, the regression analysis showed a stronger relationship between BMI and metabolic outcomes, regardless of age.

Conclusion: Polycystic ovarian syndrome (PCOS) phenotype changes with age. Clinical and biochemical hyperandrogenism are a major concern in young PCOS women, while metabolic burden tends to increase with aging. Some of the cardiovascular risk factors are dependent on FAI and SHBG levels, whereas BMI confirms its key role in the genesis of most of the metabolic sequelae in PCOS, independently of age.

Keywords: Aging; Hyperandrogenism; Insulin resistance; Metabolic syndrome; Phenotype; Polycystic ovary syndrome.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Distribution of clinical features in PCOS women according to the age at diagnosis. CA chronic anovulation, HA hyperandrogenism, PCOM polycystic ovarian morphology. P values: Pearson’s Chi-squared or Fisher’s exact test, when appropriate. °Mantel–Haenszel test of trend
Fig. 2
Fig. 2
Distribution of metabolic alterations in PCOS women according to the age at diagnosis. AH arterial hypertension, ATS DL atherogenic dyslipidemia, DL dyslipidemia, IFG impaired fasting glucose, IR insulin resistance. P values: Pearson’s Chi-squared or Fisher’s exact test, when appropriate. °Mantel–Haenszel test of trend
See this image and copyright information in PMC

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