Changes in clinical and biochemical characteristics of polycystic ovary syndrome with advancing age

Sebastião Freitas de Medeiros, Márcia Marly Winck Yamamoto, Matheus Antônio Souto de Medeiros, Bruna Barcelo Barbosa, José Maria Soares, Edmund Chada Baracat, Sebastião Freitas de Medeiros, Márcia Marly Winck Yamamoto, Matheus Antônio Souto de Medeiros, Bruna Barcelo Barbosa, José Maria Soares, Edmund Chada Baracat

Abstract

Objective: To verify whether aging can modify the clinical and biochemical characteristics of women with polycystic ovary syndrome (PCOS).

Material and methods: This observational cross-sectional study was conducted at the reproductive endocrinology clinics of Julio Muller University Hospital and Tropical Institute of Reproductive Medicine in Cuiabá, MT, Brazil, between 2003 and 2017. Both, 796 PCOS and 444 non-PCOS normal cycling women underwent the same examination. PCOS was diagnosed using the Rotterdam criteria as recommended for adolescent and adult subjects. Anthropometric, metabolic, and endocrinological modifications with aging were initially examined in the two groups: control and PCOS. Further analyses were performed after a 5-year age stratification of data throughout the reproductive period. All participants signed a consent form approved by the local ethical committee.

Results: Biomarkers of adiposity were more remarkable in African descendant PCOS women. Body weight, waist/hip ratio, fat mass, and BMI were higher in PCOS women and tended to increase at all 5 age-strata, between ≤19 and 35 years of age. Serum androgen levels decreased with aging, markedly in PCOS subjects (P < 0.01 for all age-strata comparisons), but remained elevated when compared with the levels found in controls. Carbohydrate markers, triglycerides, and total cholesterol tended to increase over time in PCOS (P < 0.01 for all age-strata comparisons). Total cholesterol also tended to increase with age in non-PCOS women (P = 0.041).

Conclusion: The present study has shown that the advancing age influences many features of PCOS women. Biochemical hyperandrogenism, the core criterion recommended in the current systems to define the syndrome, showed statistically significant tendencies to decrease with aging progression but did not normalize. The use of age-adjusted features for the diagnosis of PCOS are recommended.

Keywords: age groups; biological aging; body weight changes; endocrine trends; polycystic ovary syndrome.

Figures

Figure 1
Figure 1
Comparison of the modifications in the anthropometric parameters between normal cycling women and PCOS patients with advancing age. Results are given in x̅ ± s.d. δTrend analysis, from ≤19 years to 39 years in controls and in PCOS women using Ancova with Bonferroni post hoc test. a = P < 0.001, for controls and PCOS within group comparison. b = P < 0.05, for controls and PCOS within group comparison.
Figure 2
Figure 2
Comparison of the modifications in the carbohydrate and lipid markers between normal cycling women and women with PCOS with advancing age. Results are given in x̅ ± s.d. δTrend analysis, from ≤19 years to 39 years of aging in controls and in PCOS women using Ancova with Bonferroni post hoc test. a = P < 0.001, for controls and PCOS within group comparison. b = P < 0.05, for controls and PCOS within group comparison.
Figure 3
Figure 3
Comparison of the modifications in the androgen markers between normal cycling women and women with PCOS with advancing age. Results are given in x̅ ± s.d. δTrend analysis, from ≤19 years to 39 years of aging in controls and in PCOS women using Ancova with Bonferroni post hoc test. a = P < 0.001, for controls and PCOS within group comparison. b = P < 0.05, for controls and PCOS within group comparison.

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