Abstract
BACKGROUND: Polycystic ovarian syndrome (PCOS) is associated with the metabolic health of racially and ethnically diverse women globally, but limited research exists on the association of PCOS and metabolic syndrome (MetS) among women in the United States. OBJECTIVE: To examine the association of PCOS features and MetS in a racially/ethnically diverse population of reproductive-aged women in the United States. METHODS: Cross-sectional data from 2,172 women (12-49 years) from the 2011-2016 National Health and Nutrition Examination Survey were analyzed. Univariate logistic regression models determined unadjusted associations of MetS and its components (elevated central obesity, glucose, blood pressure and triglyceride, and low high-density lipoprotein cholesterol) with PCOS features (log-transformed total testosterone (LTT), sex-hormone binding globulin (LSHBG), amenorrhea, and oral contraceptive pills (OCP) use). Multivariable logistic models examined age-adjusted associations stratified by race and ethnicity. RESULTS: The analytical sample (mean age = 30.3 years, 59% non-Hispanic White, 12.4% non-Hispanic Black, 18.7% Hispanic/Latina, 6.2% non-Hispanic Asian, 3.7% Other/multi-race) had a MetS prevalence of 14.5%. Overall, MetS was associated with age, body mass index, race/ethnicity, LTT and LSHBG concentrations, amenorrhea, and OCP use (p < 0.01 for all), and many of the PCOS features were protective against individual MetS components. Most race/ethnicities showed significantly lower odds of MetS with an increase in LSHBG, with varying impacts on individual MetS features. CONCLUSIONS: Findings suggest significant associations between PCOS features and MetS among a racially and ethnically diverse population of reproductive-aged women in the United States. More robust and longitudinal studies are needed to further understand the underlying mechanism linking PCOS and MetS.