Key result
Asian women with PMOS show ~35% lower ASCVD risk compared to White women.
Why the study?
No studies had explored racial differences in atherosclerotic cardiovascular disease in women with polyendocrine metabolic ovarian syndrome or whether social determinants of health drive these associations.
Do racial differences and social determinants of health impact the risk of ASCVD in women with polyendocrine metabolic ovarian syndrome?
Cohort (n=413,450)
Do racial differences and social determinants of health impact the risk of ASCVD in women with polyendocrine metabolic ovarian syndrome?
Hazard Ratio: 0.65 (95% CI 0.56–0.74)
Social determinants of health appear to drive the increased risk of atherosclerotic cardiovascular disease observed in Black women with polyendocrine metabolic ovarian syndrome.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Our work shows that it is imperative for clinicians to closely track and evaluate cardiovascular health in patients with PMOS. It is also important for all individuals with PMOS to care for their heart health and control other factors that can lead to poor cardiovascular health, including smoking, inactivity, obesity, high LDL cholesterol, diabetes and high blood pressure.”
Asian women with PMOS showed lower ASCVD risk than White women; leaves open whether ethnicity modifies outcomes or reflects residual confounding.
CONTEXT: No studies have explored racial differences in atherosclerotic cardiovascular disease (ASCVD) in women with polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS). OBJECTIVE: Compare ASCVD risk by race/ethnicity among women with PMOS and determine whether social determinants of health (SDoH) drive associations. DESIGN: Cohort study. SETTING: Optum's de-identified Clinformatics® Data Mart Database (2000-2022). PARTICIPANTS: Women aged 18-50 with PMOS using PCOS ICD9/10 codes. Race/ethnicity was categorized as White, Black, Asian or Hispanic. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Primary outcome was risk of composite ASCVD (coronary artery disease, cerebrovascular disease, peripheral artery disease). Secondary outcomes included each component. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using cox proportional hazards models that were unadjusted (Model 1), adjusted for medical comorbidities (Model 2) and adjusted for comorbidities plus SDoH: homeownership, net worth and education (Model 3). RESULTS: The sample included 413,450 women with PMOS. Accounting for medical comorbidities (Model 2), Asian women with PMOS were at a lower risk for ASCVD compared to White women (aHR 0.65, 95%CI 0.56-0.74) and Black (aHR 1.10, 95%CI 1.02-1.19) and Hispanic women (aHR 1.21, 95%CI 1.12-1.29) were at a higher risk. After adjusting for SDoH (Model 3), the findings for Asian and Hispanic women remained significant whereas those for Black women did not. When looking at individual components of ASCVD, the higher risk for multiple components among Black women were no longer significant after controlling for SDoH. CONCLUSION: Racial differences exist in risk of ASCVD among women with PMOS.
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Alur-Gupta et al. (2026) conducted a cohort in Polyendocrine metabolic ovarian syndrome (PMOS) (n=413,450). Non-White race/ethnicity (Asian, Black, Hispanic) vs. White race/ethnicity was evaluated on Composite ASCVD (coronary artery disease, cerebrovascular disease, peripheral artery disease) (aHR 0.65, 95% CI 0.56-0.74). Compared to White women with PMOS, Asian women had lower ASCVD risk (aHR 0.65; 95% CI 0.56-0.74) and Hispanic women had higher risk, while higher risk in Black women was explained by SDoH.
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