Premicroalbuminuria in Women with Polycystic Ovary Syndrome: A Metabolic Risk Marker

Abstract

To determine the relationship between urinary albumin excretion and features of the metabolic syndrome in women with polycystic ovary syndrome (PCOS). We retrospectively analyzed the medical records of 189 premenopausal women (mean age +/- SD, 28.9 +/- 7.7 years) with PCOS and 81 control patients (mean age +/- SD, 37.9 +/- 8.6 years) from a single endocrinology practice. Exclusion criteria were diabetes, heart disease, kidney disease, use of lipid-lowering agents, and use of antihypertensive agents (except spironolactone). The urine albumin-to-creatinine ratio (ACR) was measured in a random single-voided urine sample. Premicroalbuminuria was defined as an ACR >7 mg/g. The prevalence of ACR >7 mg/g was 31.2% in the PCOS group (N = 189) and 35.8% in the control group (N = 81). The metabolic syndrome was noted in 16.3% (27 of 166) of patients with PCOS and in 2.9% (2 of 69) of control subjects. Nine percent of patients with PCOS who had an ACR <or=7 mg/g but 30.9% of those with an ACR >7 mg/g had the metabolic syndrome. Patients with PCOS who had an ACR >7 mg/g had significantly higher blood pressure and alanine aminotransferase levels than did those with an ACR <or=7 mg/g. In the patients with PCOS who had an ACR <or=7 mg/g versus those who had an ACR >7 mg/g, no significant difference was found in frequency of use of metformin, spironolactone, or oral contraceptives. In women with PCOS, an ACR >7 mg/g was strongly associated with the metabolic syndrome, high blood pressure, and elevated alanine aminotransferase levels. It may be useful to consider ACR >7 mg/g as an associated sign of the presence of metabolic syndrome in women with PCOS.