Socioeconomic Status and Polycystic Ovary Syndrome

Merkin, Sharon Stein; Azziz, Ricardo; Seeman, Teresa E.; Calderon‐Margalit, Ronit; Daviglus, Martha L.; Kiefe, Catarina I.; Matthews, Karen A.; Sternfeld, Barbara; Siscovick, David S.

doi:10.1089/jwh.2010.2303

Cited by 50 publications

(61 citation statements)

References 44 publications

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“…Furthermore, a study carried out in Brazil [40] confirms that schooling is associated with greater care in reproductive life, later sexual debut and fewer children, possibly explaining part of the effect found in the present study. Exploring socioeconomic status in women with PCOS, Merkin et al recently found that the risk of the syndrome and its components is higher in the presence of a combined effect of poor parental education/high personal education [41]. …”

Section: Discussionmentioning

confidence: 99%

Polycystic ovary syndrome in Salvador, Brazil: a prevalence study in primary healthcare

Gabrielli

Aquino

2012

Reprod Biol Endocrinol

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BackgroundPolycystic ovary syndrome (PCOS) is a common condition in women of reproductive age. It is characterized by hyperandrogenism, oligomenorrhea/amenorrhea and polycystic ovaries. It is associated with obesity, diabetes, dyslipidemia and cardiovascular disease. No studies have been conducted on the prevalence of PCOS in Brazilian or South American women. Few studies using the Rotterdam criteria have been published. The objective of the present study was to calculate the prevalence of PCOS at primary healthcare level in Salvador, Brazil based on these criteria.MethodsThis was a cross-sectional, two-phase study conducted in a probability sample of women of 18–45 years of age screened for cervical cancer in the primary healthcare network of the city of Salvador, Brazil. In the first phase, interviews were conducted, weight, height, waist circumference, blood pressure and random blood sugar levels were measured, and the presence of acne and hirsutism was investigated. Women with at least one diagnostic criterion were referred for the second phase, which consisted of specialist consultation, pelvic ultrasonography and hormone measurements for differential diagnosis and/or investigation of a second criterion.ResultsOf the 859 women interviewed, 88.5% were black and 58.7% had 11 years of schooling or less. A diagnosis of PCOS was excluded in 84.4%, undetermined in 7.1% and confirmed in 8.5% (95%CI: 6.80–10.56). There were no statistically significant differences between these three groups with respect to weight, body mass index, waist circumference, blood sugar levels or arterial blood pressure. Women with PCOS were younger (p = 0.00), taller (p = 0.04), had fewer children (p = 0.00), were better educated (p = 0.01), and had higher total testosterone levels (p = 0.01) and a higher LH/FSH ratio (p = 0.01).ConclusionAccording to the Rotterdam criteria, the prevalence of PCOS in women seeking primary healthcare in Salvador, Brazil, was 8.5%.

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Section: Discussionmentioning

confidence: 99%

Polycystic ovary syndrome in Salvador, Brazil: a prevalence study in primary healthcare

Gabrielli

Aquino

2012

Reprod Biol Endocrinol

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“…We utilized data from the CARDIA cohort (11,12), and the CARDIA Women’s Study (CWS) (13,14), an ancillary study to CARDIA. The CARDIA cohort is a multicenter community-based longitudinal study of cardiovascular disease in young African American and Caucasian adults aged 18–30 years.…”

Section: Methodsmentioning

confidence: 99%

Testosterone Levels in Pre-Menopausal Women are Associated With Nonalcoholic Fatty Liver Disease in Midlife

Sarkar

Wellons

Cedars

et al. 2017

American Journal of Gastroenterology

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OBJECTIVES Young women with hyperandrogenism have high risk of metabolic co-morbidities, including increased risk of nonalcoholic fatty liver disease (NAFLD). Whether testosterone (the predominant androgen) is associated with NAFLD independent of metabolic co-factors is unclear. Additionally, whether testosterone confers increased risk of NAFLD in women without hyperandrogenism is unknown. METHODS Among women in the prospective population-based multicenter Coronary Artery Risk Development in Young Adults (CARDIA) study, we assessed whether free testosterone levels measured at Year 2 (1987–1988) were associated with prevalent NAFLD at Year 25 (2010–2011) (n=1052). NAFLD was defined using noncontrast abdominal CT scan with liver attenuation≤40 Hounsfield units after excluding other causes of hepatic fat. The association of free testosterone with prevalent NAFLD was assessed by logistic regression. RESULTS Increasing quintiles of free testosterone were associated with prevalent NAFLD at Year 25 (adjusted odds ratio (AOR) 1.25, 95% confidence interval (CI) 1.04–1.50, P=0.015), independent of insulin resistance, body mass index, waist circumference, and serum lipids. Importantly, the association persisted among n=955 women without androgen excess (AOR 1.27, 95% CI 1.05–1.53, P=0.016). Visceral adipose tissue (VAT) volume partially mediated the association of free testosterone with NAFLD (mediating effect 41.0%, 95% CI 22–119%). CONCLUSIONS Increasing free testosterone is associated with prevalent NAFLD in middle age, even in women without androgen excess. Visceral adiposity appears to play an important role in the relationship between testosterone and NAFLD in women. Testosterone may provide a potential novel target for NAFLD therapeutics, and future studies in pre-menopausal women should consider the importance of testosterone as a risk factor for NAFLD.

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“…The research suggests that education and income play a role in the development of PCOS across the life course. For instance, low socioeconomic status in childhood (measured by parental education) has been found to increase the risk of PCOS in adulthood (measured by educational level), particularly among obese women with high socioeconomic status in adulthood 55. Additionally, symptoms of PCOS such as anovulation (ie, menstrual problems) can differ according to socioeconomic status, and these differences are associated with clinical and endocrine factors.…”

Section: Life Course Perspective and Study Of Pcosmentioning

confidence: 99%

A life course perspective on polycystic ovary syndrome

Sanchez¹

2014

IJWH

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Polycystic ovary syndrome (PCOS) is a major public health problem in the US. Worldwide, the public is largely unaware of the condition and health care providers do not seem to fully understand it. Research on PCOS has primarily focused on its etiology and clinical characteristics and less on the psychosocial aspects of human development associated with PCOS. This paper posits that a life course perspective provides a framework for further understanding the psychosocial experiences of women with PCOS and the contexts in which they live. The paper discusses how life course principles of human development, constraints on agency, interdependence of lives, time and place, and timing of events and experiences are relevant to the management of PCOS and prevention of its complications.

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Socioeconomic Status and Polycystic Ovary Syndrome

Cited by 50 publications

References 44 publications

Polycystic ovary syndrome in Salvador, Brazil: a prevalence study in primary healthcare

Polycystic ovary syndrome in Salvador, Brazil: a prevalence study in primary healthcare

Testosterone Levels in Pre-Menopausal Women are Associated With Nonalcoholic Fatty Liver Disease in Midlife

A life course perspective on polycystic ovary syndrome

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