Impact of Metformin on Cardiometabolic risk factors in Polycystic Ovary Syndrome: Comparison between races

Abstract

Purpose: Polycystic Ovary Syndrome (PCOS), the most common endocrine disorder in reproductive-age women, is characterized by androgen excess and ovarian dysfunction. PCOS women have an increased prevalence of metabolic syndrome components, such as an increased blood pressure (BP), insulin resistance (IR), and obesity. Metformin is the most frequently prescribed insulin sensitizer in women with PCOS. Recent evidence suggests that Black Women (BW) with PCOS have an increased incidence of cardiometabolic (CM) risk factors compared to their White Women (WW) counterparts. It is unclear if metformin has a different effect in BW versus WW with PCOS. Thus, the aim of the current study is to elucidate whether the effect of metformin on CM risk factors is different between BW with PCOS and WW with PCOS at the University of Mississippi Medical Center (UMMC). Hypothesis: CM risk factors will be more pronounced in BW with PCOS compared to WW with PCOS. There will be no difference in the impact of metformin on CM risk factors when comparing BW with PCOS to WW with PCOS. Methods Used: UMMC de-identified patient data from 2013-2022 were obtained from electronic medical records (EMR) using UMMC's Research Data Warehouse. The ICD-10 code of PCOS, E28.2, and code for Type 2 Diabetes Mellitus (T2DM), E11.9, were used to filter patients and encounters. Metformin users were then identified. CM risk factors were analyzed and compared between BW and WW with PCOS. Data are expressed as averages and statistical analysis was performed using SPSS, with p <0.05 considered significant. Summary of Results: From 2013 to 2022, EMRs of 3,260 PCOS patients were analyzed. Of these, 322 patients were co-diagnosed with T2DM. A total of 169 patients were identified as metformin users. BW with PCOS were younger than WW with PCOS (27 yo versus 34 yo). Compared to WW with PCOS, BW women with PCOS have significantly higher body mass index (45.5 vs. 41.16, p<0.001). There was no difference in BP between groups. The rate of current or former smoking doubled in WW with PCOS compared to BW with PCOS. BW with PCOS presented with an HbA1c of 7.5% whereas WW with PCOS presented with an HbA1c of 7.1%. Conclusions: BW with PCOS on metformin have a significantly higher body mass index than WW with PCOS. In contrast, former and current smoking status was more prevalent in WW with PCOS. Race/ethnicity plays a significant role in the CM risk factors in women with PCOS. Implementing strategies to ameliorate cardiovascular diseases in women with PCOS should consider the impact of race in clinical manifestations. No external funding sources This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.