J Clin Endocrinol Metab. 2021 Nov 19; doi: 10.1210/clinem/dgab838. Epub 2021 Nov 19.
Evidence From Men for Ovary-independent Effects of Genetic Risk Factors for Polycystic Ovary Syndrome.
The Journal of clinical endocrinology and metabolism
Jia Zhu, Natàlia Pujol-Gualdo, Laura B L Wittemans, Cecilia M Lindgren, Triin Laisk, Joel N Hirschhorn, Yee-Ming Chan
Affiliations
Affiliations
- Division of Endocrinology, Boston Children's Hospital, Boston, MA 02115, USA.
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.
- Estonian Genome Centre, Institute of Genomics, University of Tartu 51010, Tartu, Estonia.
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital, University of Oulu FI-90014, Oulu, Finland.
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 ZFZ, UK.
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK.
- The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7FZ, UK.
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.
PMID: 34969092
DOI: 10.1210/clinem/dgab838
Abstract
CONTEXT: Polycystic ovary syndrome (PCOS) is characterized by ovulatory dysfunction and hyperandrogenism and can be associated with cardiometabolic dysfunction, but it remains unclear which of these features are inciting causes and which are secondary consequences.
OBJECTIVE: To determine whether ovarian function is necessary for genetic risk factors for PCOS to produce nonreproductive phenotypes.
DESIGN, SETTING, AND PARTICIPANTS: Cohort of 176 360 men in the UK Biobank and replication cohort of 37 348 men in the Estonian Biobank.
MAIN OUTCOME MEASURES: We calculated individual PCOS polygenic risk scores (PRS), tested for association of these PRS with PCOS-related phenotypes using linear and logistic regression and performed mediation analysis.
RESULTS: For every 1 SD increase in the PCOS PRS, men had increased odds of obesity (odds ratio [OR]: 1.09; 95% CI, 1.08-1.10; P = 1 × 10-49), type 2 diabetes mellitus (T2DM) (OR: 1.08; 95% CI, 1.05-1.10; P = 3 × 10-12), coronary artery disease (CAD) (OR: 1.03; 95% CI, 1.01-1.04; P = 0.0029), and marked androgenic alopecia (OR: 1.03; 95% CI, 1.02-1.05; P = 3 × 10-5). Body mass index (BMI), hemoglobin A1c, triglycerides, and free androgen index increased as the PRS increased, whereas high-density lipoprotein cholesterol and SHBG decreased (all P < .0001). The association between the PRS and CAD appeared to be completely mediated by BMI, whereas the associations with T2DM and marked androgenic alopecia appeared to be partially mediated by BMI.
CONCLUSIONS: Genetic risk factors for PCOS have phenotypic consequences in men, indicating that they can act independently of ovarian function. Thus, PCOS in women may not always be a primary disorder of the ovaries.
© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society.
Keywords: PCOS; obesity; polycystic ovary syndrome; polygenic risk score
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