Irregular Cycles, Ovulatory Disorders, and Cardiometabolic Conditions in a US-Based Digital Cohort
Authors' conclusion
These findings suggest that PCOS and irregular cycles may be independent markers for cardiometabolic conditions. Early screening and intervention among individuals with irregular menstrual cycles may be beneficial.
Study context
- Population
- US users of the Apple Research application who had ever menstruated, aged ≥18 years (age of consent), English-speaking, enrolled November 14, 2019–December 13, 2022; mean (SD) age 34.5 (11.1) years
- Participants
- 60,789 users
- Exposure
- Polycystic ovary syndrome (PCOS), prolonged time to regularity and irregular cycles vs their absence
- Outcome
- Self-reported cardiometabolic conditions (obesity, prediabetes, T1D and T2D, high cholesterol, hypertension, metabolic syndrome, arrhythmia, congestive HF, coronary artery disease, heart attack, heart valve disease, stroke, transient ischemic attack (TIA), DVT, PE); prevalence odds ratios (PORs)
Methodological detailsUS-based digital cohort (Apple Research application)
- US-based digital cohort (Apple Research application)
Main finding
As reported in the abstract
Cardiometabolic conditions with PCOS (covariate-adjusted)
Estimate (95% CI)
PCOS
POR (arrhythmia) 1.37(1.20–1.55)
PCOS
POR (coronary artery disease) 2.92(1.95–4.29)
PCOS
POR (heart attack) 1.79(1.23–2.54)
PCOS
POR (stroke) 1.66(1.21–2.24)
- PCOS prevalence
- 12.3%
Observational data: associations, not effects.
Further findings
Prolonged time to regularity, participants without PCOS (covariate-adjusted)
| Estimate | ||
|---|---|---|
| Prolonged time to regularity | POR (T2D) 1.24 (95% CI 1.05–1.46) | |
| Prolonged time to regularity | POR (hypertension) 1.09 (95% CI 1.01–1.19) | |
| Prolonged time to regularity | POR (arrhythmia) 1.20 (95% CI 1.06–1.35) | |
| Prolonged time to regularity | POR (TIA) 1.33 (95% CI 1.01–1.73) | |
| 0.512Ratio (log scale) |
Irregular cycles, participants without PCOS (covariate-adjusted)
| Estimate | ||
|---|---|---|
| Irregular cycles | POR (T2D) 1.36 (95% CI 1.08–1.69) | |
| Irregular cycles | POR (high cholesterol) 1.17 (95% CI 1.05–1.30) | |
| Irregular cycles | POR (arrhythmia) 1.21 (95% CI 1.02–1.43) | |
| Irregular cycles | POR (TIA) 1.56 (95% CI 1.06–2.26) | |
| 0.512Ratio (log scale) |
- Prolonged time to regularity, participants without PCOS (covariate-adjusted) — Prolonged time to regularity prevalence
- 26.3%
- Irregular cycles, participants without PCOS (covariate-adjusted) — Irregular cycles reported (hormonal symptoms survey subset)
- 25.6%
- Irregular cycles, participants without PCOS (covariate-adjusted): subset of 25 399 who completed hormonal symptoms survey
Effect modification by lifestyle factors
- Some associations modified by high vs low BMI or low vs high physical activity
Original publication
Irregular Cycles, Ovulatory Disorders, and Cardiometabolic Conditions in a US-Based Digital Cohort. JAMA Netw Open. Published 1 May 2024. doi:10.
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