Higher Incidence of Metabolic Syndrome in Black Women With Polycystic Ovary Syndrome: A Longitudinal Study

Context Cross-sectional studies have identified an increased risk of metabolic syndrome (MetSyn) in women with polycystic ovary syndrome (PCOS), but longitudinal data are limited and primarily include White and European cohorts. Objective To compare the longitudinal risk of MetSyn in Black and White women with PCOS and to identify potential factors mediating the risk of MetSyn. Methods Longitudinal cohort study with a follow-up of 5.3 years at an academic medical center of 247 adult women with hyperandrogenic PCOS phenotype with 2 or more visits at least 3 years apart. The main outcome measure was incidence of MetSyn in Black and White women with PCOS. Results Using a mixed-effects model over time, the incidence of MetSyn was higher in Black women (45.9 +/- 4.74 per 100 person-years) than in White women (31.3 +/- 3.03 per 100 person-years) (P < .01) after adjusting for age and medication status. This difference persisted among women under age 30. Among Black women who did not have MetSyn at their prior visit, 28.0% had MetSyn at the next visit, compared with 12.1% of White women after adjusting for age and medication status (P < .01). In both races, the model-based estimated rates of MetSyn increased significantly with increase in body mass index and free testosterone. Conclusion We describe a persistent higher incidence of MetSyn in Black than in White women with PCOS. In addition to early cardiometabolic screening at the time of diagnosis, our findings highlight the need for ongoing and frequent screening in this population.