Are Older Women with PCOS at Increased Risk of Morbidity and Mortality?
BACKGROUND AND PURPOSE:
Women with polycystic ovary syndrome (PCOS) have increased risk factors for cardiovascular disease (CVD)
Whether this translates to an increased risk for cardiovascular events or related mortality is unknown
Forslund et al. (European Journal of Obstetrics and Gynecology, 2022) assessed morbidity and mortality among women with a diagnosis of PCOS
Prospective cohort study
Follow up in 2019 of a prospective cohort of women with PCOS (1956 to 1965)
Long-term study, with follow-up previously in 1987 and 2008
72 to 91 years
PCOS (Rotterdam criteria)
Age matched non-PCOS reference group
For deceased women register data was used
Interviews were conducted for women, and medical records were studied
Women with PCOS: 35 | Age-matched references: 99
Mean age: 81 years
There was no difference in mortality among women with PCOS
All-cause mortality: HR 1.10 (95% CI, 0.66 to 1.98)
CVD-related mortality: HR 1.65 (95% CI, 0.66 to 4.29)
There was also no difference in cardiovascular-related morbidity among women with PCOS
All CVD: HR 1.21 (95% CI, 0.66 to 2.20)
Hypertension: HR 1.76 (95% CI, 0.99 to 3.52)
Type 2 diabetes: HR 1.65 (95% CI, 0.77 to 3.74)
There were also no differences in the following between the women with PCOS and the reference group
Thyroid hormone levels
Comparing baseline data from the deceased and living women with PCOS, no differences were found regarding
Homeostasis model assessment of insulin resistance
Free androgen index
Deceased women with PCOS had a higher waist to hip ratio at baseline (P<0.01)
There was no increased risk of CVD or mortality in this cohort of elderly women with PCOS
While women with PCOS have risk factors associated with CVD in perimenopause, these do not seem to be linked to increased risk later in life
The authors state
In conclusion, this 32-year follow-up up to a mean age above 80 years of the Gothenburg PCOS cohort and their age-matched controls, similar in BMI, showed no increase in all-cause mortality or CVD morbidity
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