Modifiable cardiovascular risk factors in people with polycystic ovarian syndrome (PCOS): Findings from the endocrine and mental health study.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a chronic multi-system condition, affecting up to 5 million reproductive aged females in the United States. Research points to significant cardiovascular (CV) risk burden among people with PCOS, even after controlling for body composition. This study sought to evaluate modifiable CV risk factors for a community sample of non-treatment seeking females with and without PCOS. METHODS: Participants completed validated surveys measuring depression, anxiety, sleep (insomnia, sleepiness, obstructive sleep apnea risk), and physical activity. PCOS status and body mass index (BMI) were self-reported. Data were summarized with descriptive statistics; linear regressions were used to assess differences between groups stratified by PCOS status and BMI category (above or below 25). RESULTS: Among 1,574 participants (95% identified as female, 72.7% White, 7% Black/African American, 7% Asian, mean age 30.6), 24% of participants with PCOS (N = 881) had a BMI < 25, while 51% of non-PCOS participants' BMI was normal or underweight. Independent of BMI, participants with self-reported PCOS indicated greater depression, anxiety, insomnia, and worse quality of life, compared to participants without PCOS. While PCOS status in those with BMI > 25 was associated with higher sleep apnea risk, most PCOSxBMI interactions were nonsignificant, indicating no difference between BMI groups in the effect of PCOS on outcomes. CONCLUSIONS: Regardless of BMI, people with PCOS report greater rates of modifiable psychosocial and behavioral CV risk factors. Given the multifactorial risk of PCOS for CV diseases, screening and treatment is essential for CV prevention in people with PCOS.