FRI449 Self-reported Diagnosis Of Polycystic Ovary Syndrome In The Coronary Artery Risk Factor Development in Young Adults (CARDIA) Study
Authors: Kim Catherine , Schreiner Pamela , Siscovick David , Wang Ange , Wellons Melissa , Ebong Imo , Vu Thanh-Huyen , Appiah Duke , Catov Janet , Schisterman Enrique , Yin Zhe , Lewis Cora E 
Published: October 2023

Abstract
Disclosure: C. Kim: None. P. Schreiner: None. D. Siscovick: None. A. Wang: None. M. Wellons: None. I. Ebong: None. T. Vu: None. D. Appiah: None. J. Catov: None. E. Schisterman: None. Z. Yin: None. C.E. Lewis: None.
Background Polycystic ovary syndrome (PCOS) is thought to be common, but may be underrecognized by women and their healthcare providers. Factors related to women’s self-report of PCOS diagnosis are not well-understood, particularly in population-based studies that are not based on specialist referrals. Objective To compare characteristics of women with self-reported PCOS vs. women who may have unrecognized PCOS vs. women without PCOS. We hypothesized that women who have classic PCOS characteristics, including hyperandrogenemia symptoms and cardiometabolic disorders, would be associated with higher self-report of PCOS, and that poorer social determinants of health (SDH), such as barriers to medical care, would be associated with unrecognized PCOS. Study design Analysis of an observational cohort study, the CARDIA Study. CARDIA is a population-based multi-center study that enrolled Black and White participants beginning in 1985-1986. Included in this analysis were women (n=2028) who responded to the question, “Did a doctor or nurse ever tell you that you had polycystic ovarian syndrome or polycystic ovarian disease?” at the Year 15 examination, when they were ages 33-45 years. Women who answered “yes” were defined as having self-reported PCOS. Women who answered “no or not sure” were defined as having unrecognized PCOS if they also had irregular menses between 20-30 years of age and hyperandrogenemia (defined as hirsutism or biochemical elevations in free testosterone or total testosterone) between 20-30 years of age. Exposures of interest included SDH, symptoms including irregular menses and hirsutism, and comorbid conditions including obesity and diabetes. Results: Forty-three (2.1%) of women had self-reported PCOS, 135 (6.7%) had unrecognized PCOS, and 1850 (91%) women were without PCOS. In polychotomous logistic regression models adjusting for age, race, and center, women with self-reported PCOS had greater odds of having obesity (OR 1.83, 95% CI 1.22, 2.75) and diabetes (OR 2.37, 95% CI 1.05, 5.33) compared to women without PCOS. Results were similar when women without biochemical androgens were excluded. Women with unrecognized PCOS were more likely to have hypertension (OR 1.68, 95% CI 1.03, 2.74) and food insecurity (OR 1.94, 95% CI 1.25, 3.01) but had similar likelihood of obesity and diabetes compared to women without PCOS. However, other SDH such as access to care and low education were not associated with self-report of PCOS nor with unrecognized PCOS. Conclusions Unrecognized PCOS is more common than self-reported PCOS. Women with self-reported PCOS have classic metabolic symptoms, while those with unrecognized PCOS have less traditional factors including hypertension and food insecurity.
Presentation: Friday, June 16, 2023