Fertility and sterility · 2026
Sex-stratified reproductive and cardiometabolic traits among young adult offspring of Chinese women with polycystic ovary syndrome.
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Ng Noel Y H, Tsang Atta Y T, Tam Claudia H T, Ng Karen, Zhang Yingchai, Cheung Lai Ping, Chung Jacqueline P W, Chan Michael H M, Ho Chung Shun, Kong Alice P S, Luk Andrea O Y, Chan Juliana C N, Wang Chi Chiu, Tam Wing Hung, Ma Ronald C W
Аннотация
OBJECTIVE: To compare reproductive and cardiometabolic traits in young adult offspring of women with polycystic ovary syndrome (PCOS) and examine sex-specific differences.
DESIGN: Prospective cohort study.
SUBJECTS: Forty-two sons (mean age 19.05 ± 4.36 years) and 44 daughters (18.09 ± 2.94 years) of Chinese women with PCOS, compared with 242 sons (18.03 ± 0.73 years) and 264 daughters (18.14 ± 0.80 years) of Chinese women without PCOS.
EXPOSURE: Maternal PCOS diagnosed according to 2003 Rotterdam criteria.
MAIN OUTCOME MEASURES: Anthropometry, blood pressure, metabolic syndrome, oral glucose tolerance test-derived indices, insulin sensitivity, and β-cell function in all the offspring, and reproductive characteristics in daughters.
RESULTS: Offspring of women with PCOS had greater central obesity, indicated by increased waist-to-hip-ratio (WHR), in both sons (mean difference: 0.03, 95% confidence interval [CI], 0.01-0.05) and daughters (mean difference 0.06, 95% CI, 0.04-0.08), which persisted after adjusting for maternal and offspring factors. Sons of women with PCOS showed higher unadjusted proportion of hypertension (14.3% vs. 3.7%) and metabolic syndrome (14.3% vs. 3.7%), although these differences were attenuated after adjustment. Glucose homeostasis and insulin sensitivity were similar between groups in both sexes. After adjustment for WHR, basal β-cell secretory indices were significantly lower in both sons and daughters than their control counterparts, whereas oral disposition index remained similar, suggesting preserved β-cell compensation despite subtle basal secretory alterations masked by central adiposity. Daughters of women with PCOS demonstrated prominent reproductive abnormalities, including higher proportion of menstrual irregularity (58.3% vs. 16.2%), biochemical hyperandrogenism (50% vs. 25.5%), and PCOS diagnosis (11.1% vs. 0%), together with higher antimüllerian hormone levels, free androgen index and luteinizing hormone, after adjustment for offspring and maternal factors.
CONCLUSIONS: Offspring of women with PCOS exhibited early cardiometabolic and reproductive alterations in young adulthood, characterized by reproductive hormonal abnormalities in daughters and a less favorable cardiometabolic profiles in sons. Although insulin sensitivity is largely preserved, subtle impairments in β-cell secretory function emerge after accounting for central adiposity in both sexes. These findings highlight the relevance of early cardiometabolic and reproductive assessment in this population.
DESIGN: Prospective cohort study.
SUBJECTS: Forty-two sons (mean age 19.05 ± 4.36 years) and 44 daughters (18.09 ± 2.94 years) of Chinese women with PCOS, compared with 242 sons (18.03 ± 0.73 years) and 264 daughters (18.14 ± 0.80 years) of Chinese women without PCOS.
EXPOSURE: Maternal PCOS diagnosed according to 2003 Rotterdam criteria.
MAIN OUTCOME MEASURES: Anthropometry, blood pressure, metabolic syndrome, oral glucose tolerance test-derived indices, insulin sensitivity, and β-cell function in all the offspring, and reproductive characteristics in daughters.
RESULTS: Offspring of women with PCOS had greater central obesity, indicated by increased waist-to-hip-ratio (WHR), in both sons (mean difference: 0.03, 95% confidence interval [CI], 0.01-0.05) and daughters (mean difference 0.06, 95% CI, 0.04-0.08), which persisted after adjusting for maternal and offspring factors. Sons of women with PCOS showed higher unadjusted proportion of hypertension (14.3% vs. 3.7%) and metabolic syndrome (14.3% vs. 3.7%), although these differences were attenuated after adjustment. Glucose homeostasis and insulin sensitivity were similar between groups in both sexes. After adjustment for WHR, basal β-cell secretory indices were significantly lower in both sons and daughters than their control counterparts, whereas oral disposition index remained similar, suggesting preserved β-cell compensation despite subtle basal secretory alterations masked by central adiposity. Daughters of women with PCOS demonstrated prominent reproductive abnormalities, including higher proportion of menstrual irregularity (58.3% vs. 16.2%), biochemical hyperandrogenism (50% vs. 25.5%), and PCOS diagnosis (11.1% vs. 0%), together with higher antimüllerian hormone levels, free androgen index and luteinizing hormone, after adjustment for offspring and maternal factors.
CONCLUSIONS: Offspring of women with PCOS exhibited early cardiometabolic and reproductive alterations in young adulthood, characterized by reproductive hormonal abnormalities in daughters and a less favorable cardiometabolic profiles in sons. Although insulin sensitivity is largely preserved, subtle impairments in β-cell secretory function emerge after accounting for central adiposity in both sexes. These findings highlight the relevance of early cardiometabolic and reproductive assessment in this population.