Abstract：
BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a common female cardio-metabolic-reproductive disorder. It is unclear whether the global obesity epidemic is impacting the high PCOS prevalence.
OBJECTIVE: To determine the extent to which obesity contributes to the PCOS development globally.
METHODS: A systematic review was conducted to identify population studies on PCOS prevalence globally, through July 2023. Linear regression and random-effect models were applied to examine the association of mean body mass index (BMI) or obesity prevalence with the prevalence of PCOS diagnosed by 1990 National Institute of Health (NIH), 2003 Rotterdam (Rotterdam), and 2006 Androgen Excess-PCOS (AE-PCOS) criteria. Subgroup analyses were also conducted for recruitment methods and study quality.
RESULTS: Fifty-eight studies with 85,956 adults from 24 countries were included. Considering all available data, a borderline association was observed between PCOS and obesity prevalence when using the AE-PCOS, but not the NIH or Rotterdam criteria. Alternatively, subgroup analysis of studies with better recruitment methods demonstrated a significant positive association of population mean BMI or obesity prevalence with PCOS prevalence when using the Rotterdam or AE-PCOS criteria, while using only high-quality studies revealed an association using NIH as well as Rotterdam and AE-PCOS criteria. Overall, we observed that a 1% increase in obesity prevalence resulted in an approximately 0.4% increase in PCOS prevalence by the Rotterdam criteria.
CONCLUSIONS: These data indicate that obesity increases the development of PCOS, although the effect is modest. Our data also emphasizes the need to undertake only high-quality studies in assessing PCOS epidemiology.
OBJECTIVE: To determine the extent to which obesity contributes to the PCOS development globally.
METHODS: A systematic review was conducted to identify population studies on PCOS prevalence globally, through July 2023. Linear regression and random-effect models were applied to examine the association of mean body mass index (BMI) or obesity prevalence with the prevalence of PCOS diagnosed by 1990 National Institute of Health (NIH), 2003 Rotterdam (Rotterdam), and 2006 Androgen Excess-PCOS (AE-PCOS) criteria. Subgroup analyses were also conducted for recruitment methods and study quality.
RESULTS: Fifty-eight studies with 85,956 adults from 24 countries were included. Considering all available data, a borderline association was observed between PCOS and obesity prevalence when using the AE-PCOS, but not the NIH or Rotterdam criteria. Alternatively, subgroup analysis of studies with better recruitment methods demonstrated a significant positive association of population mean BMI or obesity prevalence with PCOS prevalence when using the Rotterdam or AE-PCOS criteria, while using only high-quality studies revealed an association using NIH as well as Rotterdam and AE-PCOS criteria. Overall, we observed that a 1% increase in obesity prevalence resulted in an approximately 0.4% increase in PCOS prevalence by the Rotterdam criteria.
CONCLUSIONS: These data indicate that obesity increases the development of PCOS, although the effect is modest. Our data also emphasizes the need to undertake only high-quality studies in assessing PCOS epidemiology.
摘要：
背景：多囊卵巢综合征（PCOS）是一种常见的女性心脏代谢生殖疾病。目前尚不清楚全球肥胖流行是否正在影响PCOS的高患病率。
目的：确定肥胖对全球PCOS发展的影响程度。
方法：进行了系统评价，以确定全球PCOS患病率的人群研究，到2023年7月。线性回归和随机效应模型用于检查平均体重指数（BMI）或肥胖患病率与1990年美国国立卫生研究院（NIH）诊断的PCOS患病率之间的关系。2003鹿特丹（鹿特丹），和2006雄激素过量-PCOS(AE-PCOS)标准。还对招募方法和研究质量进行了亚组分析。
结果：纳入了来自24个国家的85,956名成年人的58项研究。考虑到所有可用的数据，当使用AE-PCOS时，观察到PCOS和肥胖患病率之间的边界关联，但不是NIH或鹿特丹标准。或者，采用较好招募方法的亚组研究分析显示,使用鹿特丹或AE-PCOS标准时,人群平均BMI或肥胖患病率与PCOS患病率呈显著正相关,而仅使用高质量的研究揭示了使用NIH以及鹿特丹和AE-PCOS标准的相关性。总的来说,我们观察到,按照鹿特丹标准,肥胖患病率增加1%导致PCOS患病率增加约0.4%.
结论：这些数据表明肥胖增加了PCOS的发展，虽然效果不大。我们的数据还强调了在评估PCOS流行病学时只需要进行高质量的研究。
目的：确定肥胖对全球PCOS发展的影响程度。
方法：进行了系统评价，以确定全球PCOS患病率的人群研究，到2023年7月。线性回归和随机效应模型用于检查平均体重指数（BMI）或肥胖患病率与1990年美国国立卫生研究院（NIH）诊断的PCOS患病率之间的关系。2003鹿特丹（鹿特丹），和2006雄激素过量-PCOS(AE-PCOS)标准。还对招募方法和研究质量进行了亚组分析。
结果：纳入了来自24个国家的85,956名成年人的58项研究。考虑到所有可用的数据，当使用AE-PCOS时，观察到PCOS和肥胖患病率之间的边界关联，但不是NIH或鹿特丹标准。或者，采用较好招募方法的亚组研究分析显示,使用鹿特丹或AE-PCOS标准时,人群平均BMI或肥胖患病率与PCOS患病率呈显著正相关,而仅使用高质量的研究揭示了使用NIH以及鹿特丹和AE-PCOS标准的相关性。总的来说,我们观察到,按照鹿特丹标准,肥胖患病率增加1%导致PCOS患病率增加约0.4%.
结论：这些数据表明肥胖增加了PCOS的发展，虽然效果不大。我们的数据还强调了在评估PCOS流行病学时只需要进行高质量的研究。
