MON-160 Prevalence And Correlates Of Polycystic Ovary Syndrome Among Participants Of The Nurses' Health Study II

Abstract Disclosure: M. Kazemi: None. M. Mitsunami: None. S.A. Missmer: None. J.W. Rich-Edwards: None. J.E. Chavarro: None. Background: Estimates of the prevalence of polycystic ovary syndrome (PCOS) and associated comorbidities are limited in large, unselected population-based studies despite major public health impacts of this condition. Here, we report the prevalence of PCOS and its reproductive and cardiometabolic correlates in the Nurses' Health Study II (NHS II), a large US-based cohort. Methods: We conducted a cross-sectional analysis of n=114,907 reproductive-age women (median[IQR] age:34[31–38]y; BMI:22.7[20.8–25.8]kg/m²) in the NHS II. PCOS was defined according to NIH 1990 criteria (NIH-PCOS) or self-reported physician diagnosis (self-reported PCOS). Baseline PCOS-defining reproductive traits (menstrual irregularity, anovulatory infertility, hirsutism, severe teenage acne) and cardiometabolic comorbidities (obesity [body mass index[BMI]≥30kg/m2], diabetes, hypertension, hypercholesterolemia, history of major adverse cardiovascular events [MACE; myocardial infarction, venous thrombosis, stroke]) were compared across PCOS groups using age- and BMI-adjusted log-binomial regression models to estimate prevalence ratios (PRs) and 95% CIs.Results: PCOS prevalence was 9.8% (n=11,108/114,907), including 1.7%[n=1,987] NIH-defined and 7.9%[n=9,121] self-reported. A gradient in the prevalence of PCOS-defining reproductive traits was evident, with the highest prevalence in NIH-PCOS, intermediate for self-reported PCOS, and lowest for no PCOS. The pattern was observed for irregular cycles (62.4%,15.3%,6.9%), anovulatory infertility (57.3%,16.1%,5.0%), hirsutism (48.3%,4.3%,1.4%), and acne (57.7%,7.8%,5.9%). Similar prevalence gradients were observed for cardiometabolic comorbidities, including obesity (27.0%,14.6%,10.9%), diabetes (9.1%,4.8%,2.9%), hypertension (27.4%,23.0%,17.3%), and MACE (7.2%,7.5%,4.0%). The prevalence gradient for reproductive traits persisted after age and BMI adjustment. The adjusted PR (95%CI) of irregular menstrual cycles was 8.85(8.18,9.57) for NIH-PCOS and 2.18(2.01,2.37) for self-reported PCOS relative to no PCOS, with a significant difference in the frequency of irregular cycles between NIH and self-reported PCOS (PR[95%CI]: 4.05[3.65,4.50]). The gradient, however, attenuated after these adjustments for cardiometabolic comorbidities. The adjusted PR (95%CI) of diabetes comparing NIH and self-reported PCOS to no PCOS was 1.95(1.67,2.27) and 1.46(1.32,1.62), respectively, without differences when comparing PCOS groups (NIH and self-reported PCOS:1.31[1.10,1.57]). Similarly, the corresponding estimates for MACE were 1.62(1.37,1.91) and 1.86(1.72,2.02), respectively, without differences when comparing NIH and self-reported PCOS (0.86[0.72,1.03]).Conclusions: PCOS is highly prevalent and associated with clinically significant adverse reproductive and cardiometabolic risk profiles. Presentation: Monday, July 14, 2025