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https://www.arca.fiocruz.br/handle/icict/11115
PROPOSED CRITERIA FOR THE IDENTIFICATION OF POLYCYSTIC OVARY SYNDROME FOLLOWING MENOPAUSE: AN ANCILLARY STUDY OF THE BRAZILIAN LONGITUDINAL STUDY OF ADULT HEALTH (ELSA-BRASIL).
Author
Affilliation
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Bahia State Center for Diabetes and Endocrinology. Salvador, BA, Brasil
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Abstract
Objectives: To propose plausible criteria with which to identify menopausal women with PCOS. Study design: A cross-sectional study involving the baseline data of 713 menopausal women at admission to the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) in Salvador, Bahia, Brazil. Main outcome measures: PCOS was identified by the presence oftwo ofthree criteria.(1)Ahistory of amenorrhea or oligomenorrhea (OL) (regular intermenstrual intervals ≥35 days during reproductive life); (2) clinical or biochemical hyperandrogenism (HA), identified by a score ≥5 points in a hirsutism questionnaire constructed and validated for women in this age group, or total or free testosterone ≥the 95th percentile for women considered normal; (3) insulin resistance (IR) (a homeostatic model assessment [HOMA] index ≥ 2.2). Validation was performed using probable epidemiological endpoints. Results: According to these criteria, 7.6% of the women in the sample had PCOS. Of these, 7.4% had HA and OL, 72.2%hadHAand IR, 14.8%had OL and IRand 5.6%,hadHA, OL and IR.Women withPCOS were younger, had had fewer pregnancies and entered menopause earlier. Positive associations were found between PCOS and overweight (PR: 1.31; 95%CI: 1.18–1.46), obesity (1.44; 1.01–2.06), carbohydrate metabolism disorders (impaired glucose tolerance and diabetes mellitus) (1.30; 1.03–1.65), and with diabetes alone (1.41; 0.83–2.39), although this latter association failed to reach statistical significance. Conclusion: The women selected in accordance with these criteria had the characteristics of PCOS that are not only expected, but also widely associated with this disorder.
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