Disclosure: D.F. Vine: None. M. Ghosh: None. S. Chambers: None. P. Beckles: None. L. Sadiq: None. M. Kupreeva: None. L. Mereu: None. A. Achi: None. T. Motan: None. C. Lejour: None. B. Sydora: None. J. Robison: None. OBJECTIVE: Polycystic Ovary Syndrome (PCOS) is the most common metabolic-endocrine disorder impacting 15% of females across the lifespan. Despite its high prevalence, those with PCOS in Alberta, Canada have expressed concerns about their health care including prolonged time for diagnosis, insufficient patient information, and lack of management support. Health care providers in Alberta have expressed the need for direction to integrate care of those with PCOS and appropriately address their complex health needs. Our project was to develop an evidence-based primary care clinical pathway to guide providers with diagnosis and management of PCOS, and a patient pathway to educate and guide patients on their health care journey with PCOS. METHODS: In collaboration with the Alberta Health Services Provincial Pathways Unit (AHS PPU) we followed the five phases in the Pathway Development Toolkit; i) Co-define, ii) Co-Design, iii) Validate, iv) Implement, and v) Sustain. A co-design team was established with patient-partners and health care providers including family physicians, researchers, dietitians, endocrinologists and obstetrician-gynecologists. The algorithm pathway was developed using recommendations from the evidence-based literature, the International Guidelines for Assessment and Management of PCOS (2023) and provincial resources. A project charter was co-defined to develop a pathway that did not need additional resources, was usable to primary care providers, supported by specialty care providers, supported patient self-management and shared decision making, and addressed the challenges related to managing PCOS and co-morbidities identified by patients and health care providers. RESULTS: Two pathway-of-care documents were generated: one for patients and one for primary care physicians. The pathway algorithms with expanded detail for patients and primary care physicians were developed based on serial consultation with the co-design team. The algorithms were refined by stepwise iteration and review to meet the project charter outcomes. CONCLUSIONS: The pathway development reflects a patient-centered collaborative multidisciplinary team approach to support primary care providers and those affected by PCOS to improve their health care journey. While the pathway algorithms were developed for provincial use in Alberta, we envision a wider use in Canada, and that it can adapted for use in other countries to establish models of care for improving primary care in those affected by PCOS. Presentation: Monday, July 14, 2025

Early identification of dyslipidemia in children and youth allows for the prevention of cardiovascular diseases (CVD). Emerging evidence in adults suggests that nonfasting remnant cholesterol (RC) is a significant independent risk factor for CVD. Understanding the applicability of nonfasting RC in youth and children may provide greater options for routine and early identification of CVD risk. The purpose of this review is to provide an overview of guidelines for assessing dyslipidemia in practice and to explore whether nonfasting lipid biomarkers and/or RC have been incorporated for children and youth. The Medline database was used to identify clinical practice guidelines published between 2011 and August 2025 in English for children and/or youth aged 2-20 years. Of an initial 2537 citations, 41 met the inclusion criteria for data extraction. Although there is controversy regarding assessing fasting or nonfasting biomarkers in youth, definitions of normal ranges of lipoproteins were less controversial and are typically defined based on the National Heart, Lung, and Blood Institute recommendations. Most guidelines recommend measuring fasting lipid biomarkers (especially low-density lipoprotein cholesterol) in youth. In contrast, a select number of guidelines and statements recommend assessing nonfasting non-high-density lipoprotein cholesterol as the priority. Currently, no guidelines discuss measuring RC in youth. Evidence suggests that nonfasting non-high-density lipoprotein cholesterol is a reliable, practical biomarker for lipid screening in children and youth; however, most guidelines still suggest fasting measurement of low-density lipoprotein cholesterol. We note that nonfasting RC is an important knowledge gap not addressed in the current guidelines, and increasing awareness of nonfasting RC may be valuable.

Disclosure: D.F. Vine: None. X.F. Wu: None. M. Ghosh: None. M. Cree: None. H. Becher: None. P. Raggi: None. J. Windram: None. K. Nadeau: None. Background: Polycystic ovary syndrome (PCOS) is associated with increased cardiometabolic risk and cardiovascular disease (CVD). We have shown high-risk young adolescents and women with and without PCOS exhibit atherogenic dyslipidemia and atherosclerotic CVD (ACVD), and impaired cardiac function compared to healthy-weight controls. The aim of this study was to determine the natural history of cardiometabolic risk factors, carotid intimal medial thickness (cIMT) and cardiac function in young adolescents and women with and without PCOS. Methods: Datasets from the PCOS-Together (n=80, Canadian) and Androgens and Insulin Resistance Study (n=88, AIRS Children's Hospital Colorado, USA) were combined and harmonized for age-BMI matched (BMI >25 kg/m2) females aged 12-45 years with (PCOS) and without PCOS (non-PCOS control), and non-PCOS healthy-weight controls (BMI <25 kg/m2). Data included biochemical assessments (blood lipids, apoB, remnant-cholesterol, hormones, insulin, glucose). 2D/3D-echocardiography was performed and carotid intimal medial thickness (cIMT) and cardiac function indices collected. Data from PCOS and non-PCOS controls were compared to non-PCOS healthy-weight controls in age groups: 12-19, 20-29 and 30-45 yrs.Results: Free Testosterone, fasting triglycerides, remnant-cholesterol, apoB, non-HDL-C, LDL-C, insulin and HOMA-IR were increased in PCOS and non-PCOS controls, compared to healthy-weight controls at all age groups. FAI was highest and SHBG lowest in those with PCOS aged 12-19 yrs, compared to other age groups. cIMT, cardiac left ventricular (LV) mass and LV posterior wall thickness tended to be higher in PCOS and non-PCOS controls across all age groups, and increased by 10-20% at 30-45 yrs compared to healthy-weight controls. Cardiac E/A ratio was lower in PCOS and non-PCOS controls across all age groups, and declined in those with PCOS at 30-45 yrs. LV ejection fraction was lower in those with PCOS at 20-29 and 30-45 yrs, and LV global longitudinal strain was impaired in PCOS and non-PCOS controls at 30-45 yrs compared to healthy-weight controls. Conclusion: Our data shows the natural history of ACVD and impaired cardiac morphology and function in young women with and without PCOS, and these outcomes tend to be exacerbated in those with PCOS. Recommendations for early screening and detection, and studies to develop targeted interventions to mitigate CVD development in high-risk young women with and without PCOS are warranted. Presentation: Sunday, July 13, 2025

Purpose:Polycystic Ovary Syndrome (PCOS) is a complex endocrine-metabolic disorder and is associated with a variety of health disorders. The management of PCOS requires a multidisciplinary health care approach. The COVID-19 pandemic affected access and delivery of health care. The aim of this study was to assess the impact of the pandemic on the health and health care experience of those affected by PCOS. Patients and Methods:An online survey was conducted January 2021 to July 2022 in Canada, open to anyone who identified as having PCOS. Data collected in REDCap included questions on demographics, symptoms, and experience of PCOS management during the pandemic. Results:The majority (59%) of respondents (n=194, mean age 34±8 years) experienced pandemic-related employment changes and self-reported a high stress level (73±21/100). Of those who reported changes in body weight, 58% gained weight, which they attributed to unhealthy eating habits and a lack of exercise during the pandemic, and 16% lost weight, which they credited to increased physical activity and a shift towards healthier eating habits. The respondents ascribed the impact of COVID-related changes to clinic cancellations, delayed appointments, long wait times for referrals and lab work, lack of access to exercise facilities and insufficient social support. Some respondents voluntarily reduced access to health care services to limit COVID exposure. COVID-19-related health status was perceived as more important than their own PCOS-related symptoms. Virtual appointments via telehealth were regarded as beneficial for 20% of users. Conclusion:Individuals with PCOS reported an overall reduction in COVID-related access to health care and supports. Some adapted to the use of telemedicine, while others experienced increased stress due to a lack of access to health care and an inability to manage their PCOS symptoms. The pandemic further highlighted that those with PCOS often experience a lack of accessibility to multidisciplinary health care and supports needed to manage their condition.

BACKGROUND Atherosclerosis is triggered by the retention of apolipoprotein B‐containing lipoproteins by proteoglycans. In addition to low‐density lipoprotein, remnant lipoproteins have emerged as pivotal contributors to this pathology, particularly in the context of insulin resistance and diabetes. We have previously reported antiatherogenic properties of a monoclonal antibody (chP3R99) that recognizes sulfated glycosaminoglycans on arterial proteoglycans. METHODS AND RESULTS Solid‐phase assays demonstrated that chP3R99 effectively blocked >50% lipoprotein binding to chondroitin sulfate and vascular extracellular matrix in vitro. The preperfusion of chP3R99 (competitive effect) resulted in specific antibody‐arterial accumulation and reduced fluorescent lipoprotein retention by ~60% in insulin resistant JCR:LA‐ cp rats. This competitive reduction was dose dependent (25–250 μg/mL), effectively decreasing deposition of cholesterol associated with lipoproteins. In a 5‐week vaccination study in insulin resistant rats with (200 μg subcutaneously, once a week), chP3R99 reduced arterial lipoprotein retention, and was associated with the production of antichondroitin sulfate antibodies (Ab3) able to accumulate in the arteries (dot‐blot). Neither the intravenous inoculation of chP3R99 (4.5 mg/kg), nor the immunization with this antibody displayed adverse effects on lipid or glucose metabolism, insulin resistance, liver function, blood cell indices, or inflammation pathways in JCR:LA ‐cp rats. CONCLUSIONS Both acute (passive) and long‐term administration (idiotypic cascade) of chP3R99 antibody reduced low‐density lipoprotein and remnant lipoprotein interaction with proteoglycans in an insulin‐resistant setting. These findings support the innovative approach of targeting proatherogenic lipoprotein retention by chP3R99 as a passive therapy or as an idiotypic vaccine for atherosclerosis.

Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder affecting females across the lifespan. Eating disorders (EDs) are psychiatric conditions that may impact the development of PCOS and comorbidities including obesity, metabolic syndrome, and type 2 diabetes. The aim of this scoping review was to determine the prevalence of EDs and disordered eating, and to review the etiology of EDs in PCOS. The review was conducted using search terms addressing PCOS, EDs, and disordered eating in databases, including PubMed, Scopus, PsycINFO, and CINAHL. Structured interviews, self-administered questionnaires, chart review, or self-reported diagnosis were used to identify EDs in 38 studies included in the review. The prevalence of any ED in those with PCOS ranged from 0% to 62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios (ORs) of an elevated ED score compared with controls. In those with PCOS, 30% had a higher OR of bulimia nervosa and binge ED was 3-fold higher compared with controls. Studies were limited on anorexia nervosa and other specified feeding or ED (such as night eating syndrome) and these were not reported to be higher in PCOS. To our knowledge, no studies reported on avoidant/restrictive food intake disorder, rumination disorder, or pica in PCOS. Studies showed strong associations between overweight, body dissatisfaction, and disordered eating in PCOS. The etiologic development of EDs in PCOS remains unclear; however, psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied because of the use of different diagnostic and screening tools. Screening of all individuals with PCOS for EDs is recommended and high-quality studies on the prevalence, pathogenesis of specific EDs, relationship to comorbidities, and effective interventions to treat ED in those with PCOS are needed.

PURPOSE OF REVIEW:Remnant cholesterol (RC) is the cholesterol carried in lipoproteins derived from the catabolism of chylomicrons and very low-density lipoproteins. Evidence supporting the causal relationship of RC with atherosclerotic cardiovascular disease (ASVD) is accumulating rapidly. The number of impactful contributions to this field are increasing and provide a pathophysiological insight into the current residual cardiovascular risk beyond low-density cholesterol (LDL)-cholesterol (LDL-C). They also raise the question of whether RC should be used in prediction models and become the target of new therapeutic interventions. The intent of this review is to highlight the recent advances on the role of RC in atherogenesis and the validation of RC as a predictor of ASVD.RECENT FINDINGS:Numerous prospective and retrospective cohorts helped validate a significant causal relationship of RC with various forms of ASVD, independent of LDL-C. A recent large Mendelian randomization study reinforced the existence of this relationship and showed that the risk of atherosclerotic events was driven nearly entirely by a direct effect of RC.SUMMARY:Both available and accumulating evidence suggest that a lifelong reduction in RC could translate into a substantial reduction in ASVD risk. The data support a revision of current guidelines to incorporate RC as an independent risk factor for ASVD. We propose that early screening of RC should be implemented and that RC lowering should become the target of future drug developments.

Background: Observational studies suggested that residual risk of cardiovascular events after LDL (low-density lipoprotein) cholesterol lowering may be linked to remnant cholesterol (RC). We conducted a large-scale Mendelian randomization study to investigate the causal role of RC to predict coronary artery disease (CAD), myocardial infarction (MI), and stroke risk. Methods: We extracted single-nucleotide polymorphisms for RC and LDL from large-scale genome-wide association databases. We estimated the genetic association with outcomes from the CARDIoGRAMplusC4D consortium (Coronary Artery Disease Genome-Wide Replication and Meta-Analysis Plus the Coronary Artery Disease Genetics), the Metastroke consortium, as well as the GLGC (Global Lipids Genetics Consortium). Genetic variants were used as instruments, thereby minimizing residual confounding and reverse causation biases of observational studies. Results: By leveraging data from a combined sample of 958 434 participants, we found evidence for a significant causal effect of RC on the risk of CAD (odds ratio [OR], 1.51 per SD unit increase in RC [95% CI, 1.42–1.60]; P =5.3×10 -5 ), MI (OR, 1.57 [95% CI, 1.21–2.05]; P =9.5×10 -4 ), and stroke (OR, 1.23 [95% CI, 1.12–1.35]; P =3.72×10 -6 ). There was no evidence of pleiotropy. The effect of RC on CAD and MI remained consistent after accounting for the effects of RC-associated genetic variants on LDL cholesterol: OR, 1.49 (95% CI, 1.37–1.61) for CAD and OR, 1.80 (95% CI, 1.70–19.1) for MI without a meaningful indirect effect exerted on these outcomes via the LDL cholesterol mediator. Conclusions: This large-scale Mendelian randomization study showed a robust genetic causal association between RC and cardiovascular outcomes. The effect on CAD and MI is independent of LDL cholesterol. Early screening for RC along with long-term inhibition of RC should be the focus of future therapeutic interventions.

Polycystic ovary syndrome (PCOS) is the most common reproductive-endocrine disorder affecting 10% of women. PCOS increases risk of developing diabetes and cardiovascular disease (CVD). We have previously shown high-risk young women with and without PCOS have an atherogenic lipoprotein profile, and this is exacerbated in PCOS, with elevated triglycerides (TG), remnant cholesterol and apoB-lipoproteins. The aim of this study was to determine the association of this atherogenic lipoprotein profile with atherosclerotic CVD (ACVD) and cardiac function in control and high-risk women with and without PCOS.

Polycystic Ovary Syndrome (PCOS) affects 1 in 10 women yet remains understudied despite being the most common endocrine-metabolic disorder in women affecting health and quality of life across the lifespan. To date we do not have a good understanding of the scale of the problem, in terms of its clinical diagnosis, symptom severity, societal impact, health across the lifespan and health care management. The aim of this study was to assess the perceptions of health status, health care experience and lifestyle management support of women with PCOS in Canada.

Background:Polycystic ovary syndrome (PCOS) is the most common metabolic-endocrine disorder impacting the health and quality of life of women over the lifespan. Evidence-based data on the scope of adverse health outcomes in those affected by PCOS is critical to improve healthcare and quality of life in this population. The aim of this study was to determine the prevalence of adverse health outcomes in those with PCOS compared to age-matched controls. Methods:We conducted a retrospective observational case-control study in those diagnosed with PCOS and age-matched controls using the Alberta Health Services Health Analytics database and the International Classification of Diseases, for the period from 2002-2018 in Alberta, Canada. Results:The cohort consisted of n = 16,531 exposed PCOS cases and n = 49,335 age-matched un-exposed controls. The prevalences of hypertension, renal disease, gastrointestinal disease, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections, and all malignancies were 20%-40% (P < 0.0001) higher in those with PCOS, compared to controls. The prevalence of obesity, dyslipidemia, nonalcoholic fatty liver disease, and type 2 diabetes was 2-3 fold higher in those with PCOS (P < 0.001). Cardiovascular, cerebrovascular, and peripheral vascular disease were 30%-50% higher, and they occurred 3-4 years earlier in those with PCOS (P < 0.0001); a 2-fold higher prevalence of dementia occurred in those with PCOS, compared to controls. Conclusion:These findings provide evidence that PCOS is associated with a higher prevalence of morbidities over the lifespan, and the potential scope of the healthcare burden in women affected by PCOS.

Polycystic Ovary Syndrome (PCOS) is the most common metabolic-endocrine reproductive disorder impacting 10-15% of women across their lifespan. Large epidemiological studies across the globe have found PCOS is associated with increased cardiometabolic risk factors, Type 2 Diabetes (T2D) and Cardiovascular Disease (CVD). In Canada we currently have limited data on the incidence of cardiometabolic risk factors, T2D and CVD in those afflicted with PCOS. The aim of this study was to determine the incidence of cardiometabolic risk factors and CVD in PCOS compared to age matched controls in a Canadian population. A retrospective observational case-control study in those diagnosed with PCOS and age-matched controls was undertaken using the Alberta Health Services Health Analytics database from 2002-2019 in Alberta, Canada. The incidence of overweight-obesity, hypertension, dyslipidemia, non-alcoholic liver fatty disease, T1D and T2D were increased 2-3 fold in PCOS, (n=16531) compared to the control population (n=49335, p<0.0001). CVD and Cerebrovascular Disease (CEVD) had a 1.6 fold higher incidence in those with PCOS (p<0.001). The median age of a myocardial infarction (43 vs 47 yrs), pulmonary vascular disease (38 vs 40 yrs) and CEVD (35 vs 38 yrs) was 2-4 years younger in PCOS compared to the control population. These findings in a Canadian population are consistent with recent global studies on increased premature CVD risk in PCOS. This evidence-based data provides impetus for the need to improve education of patients and clinicians on CVD risk and preventative health care in this high-risk population.

The incidence of cardiovascular disease (CVD) is increased in the endocrine-metabolic condition of polycystic ovary syndrome (PCOS) which impacts 10-15% of females across the lifespan. The mechanisms of cardiac dysfunction in PCOS related to hyperandrogenemia, and androgen receptor (AR) and estrogen receptor (ER) activation and energy substrate utilization remain unclear. The aim of this study was to investigate the effect of androgen treatment on cardiac AR and ER activation, fatty acid metabolism and cardiac function in a PCOS-prone rodent model.

Understanding sex differences in immunological responses in the context of obesity is important to improve health outcomes. This systematic review aimed to investigate sex differences in systemic inflammation, immune cell phenotype, and function in diet-induced obesity (DIO) animal models. A systematic search in Medline, Embase, and CINAHL from inception to April 2023 was conducted, using a combination of the following concepts: sex, obesity, cytokines, and immune cell phenotypes/function. Forty-one publications reporting on systemic inflammation (61%), cell phenotype (44%), and/or function (7%) were included. Females had lower systemic inflammation compared with males in response to DIO intervention and a higher proportion of macrophage (M)2-like cells compared with males that had a higher proportion of M1-like in adipose tissue. Although there were no clear sex differences in immune function, high-fat DIO intervention remains an important factor in the development of immune dysfunction in both males and females, including disturbances in cytokine production, proliferation, and migration of immune cells. Yet, the mechanistic links between diet and obesity on such immune dysfunction remain unclear. Future studies should investigate the role of diet and obesity in the functionality of immune cells and employ adequate methods for a high-quality investigation of sex differences in this context.

The incidence of cardiovascular disease (CVD) is increased in the endocrine-metabolic condition of polycystic ovary syndrome (PCOS) which impacts 10-15% of females. The mechanisms of cardiac dysfunction in PCOS related to hyperandrogenemia, and androgen receptor (AR) and estrogen receptor (ER) activation remain unclear. The aim of this study was to investigate the effect of androgen treatment on cardiac AR and ER activation, fatty acid metabolism and cardiac function in a PCOS-prone rodent model. An established rodent model pf PCOS and the metabolic syndrome, and controls were treated with testosterone (T) for 12 weeks. Cardiac function was assessed using transthoracic doppler echocardiography, lipogenic, AR, ER and other metabolic gene and protein expression was using RTPCR and SDS-PAGE western blot. PCOS-prone animals exhibited left ventricular (LV) hypertrophy, with increased LV mass to body weight ratio (551.6 ± 38.85 mg vs 999 ± 96.17 mg, p<0.05) and beta-myosin heavy chain (-MHC) protein compared to controls. Systolic dysfunction was evidenced by increased isovolumetric contraction time (IVCT; 22.5 ± 1.348 msec vs 28.96 ± 1.248 msec, p<0.05) and elevated B-type natriuretic peptide (BNP) in PCOS-prone compared to controls. T treatment increased LV mass, IVCT and IVRT in controls but did not exacerbate cardiac function in PCOS-prone animals. T treatment increased cardiac protein expression of PPAR-⍺, and ER-⍺ was reduced in both T treated control and PCOS-prone animals. Testosterone alters fatty acid metabolism and ER activation, and is associated with adverse cardiac morphology and function in control and PCOS-prone conditions.

Polycystic ovary syndrome (PCOS) is the most common reproductive-endocrine disorder affecting 15% of women across the lifespan. PCOS and obesity are associated with increased cardiovascular disease (CVD) risk, yet there remains limited research on early atherogenic dyslipidemia, atherosclerotic CVD (ACVD) and cardiac function in these conditions. We have shown those with PCOS have an exacerbated atherogenic lipid profile compared to BMI-matched individuals. The aim of this study was to examine the relationship between atherogenic dyslipidemia, ACVD and the cardiac function in high-risk young obese women with and without PCOS.

Abstract Background Polycystic Ovary Syndrome (PCOS) is the most common endocrine-metabolic disorder affecting health and quality of life of those affected across the lifespan. We currently have limited evidence-based data on the experience of those living with PCOS in the health care system including diagnosis, health concerns and disease management. The aim of this study was to assess the perceptions of health status, health care experience and disease management support in those affected by PCOS in Alberta, Canada. Methods An online questionnaire was completed via REDCap by individuals self-reporting a diagnosis of PCOS. Question categories included demographics, symptoms of PCOS and time to confirm a diagnosis, follow-up care, health concerns, and information resources. Descriptive statistics were used and thematic analyses was applied to open-response questions. Results Responses from 194 participants living in Canada (93% in Alberta) were included. The average age was 34 ± 8 years and BMI was 35 ± 9. Menstrual irregularity was identified in 84% of respondents as the first symptom noticed and the primary reason for seeking a medical consultation. A PCOS diagnosis occurred on average 4.3 years following awareness of first symptoms and required consultation with more than one primary care provider for 57% of respondents. Half (53%) of respondents reported not receiving a referral to specialists for follow-up care and 70% were not informed about long-term health morbidity such as diabetes or cardiovascular disease. Most respondents (82%) did their own research about PCOS using on-line sources, academic literature and advice from peer support. The participant themes from open questions for improving health care included more resources and support, increased and reliable information, better education and training for clinicians, timely diagnosis, prompt referrals to specialists, and generally more compassion and empathy to the challenges faced by those managing their disease. Conclusion Our findings highlight the health concerns and challenges in health care for those with PCOS. In Alberta, Canada we have identified major gaps in health care including a timely diagnosis, follow up care and supports, and multidisciplinary care. This evidence-based data can be used to inform development of pathways to improve the health care experience in those affected by PCOS.

Abstract Background PCOS is the most common metabolic-endocrine disorder impacting women over their lifespan. It is important to understand the scope of health outcomes that impact the health and quality of life of those with PCOS in order to improve clinical and patient-centered health care in this population. Aim The aim of this study was to determine the incidence of co-morbidities in PCOS compared to age matched controls. We hypothesised that women with PCOS would have increased incidence of co-morbidities. Methods A retrospective observational case-control study in those diagnosed with PCOS and age-matched controls (>12 yrs of age in a ratio of 1: 3) was undertaken using the Alberta Health Services Health Analytics database from 2002-2019 in Alberta, Canada. International classification codes (ICD9 and ICD10) were used to determine PCOS diagnosis including visits to a health care provider, Alberta ambulatory care reporting system and Discharge Abstract Data databases. Results The incidence of several co-morbidities were 20-40% higher in PCOS (n=16531) including hypertension, dyslipidemia, cardiovascular, cerebrovascular, gastrointestinal and renal disease, metabolic syndrome, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections and all cancers compared to controls (n=49335) (p<0. 0001). Overweight-obesity, non-alcoholic liver disease, Type 1 diabetes and Type 2 Diabetes had a 3-fold greater incidence in PCOS compared to controls (p<0. 0001). Conclusion These findings demonstrate PCOS is a major public health concern due to increased risk of co-morbidities and associated health-care costs. These findings provide evidence-based research to support the development of strategies to improve health care; screening, management and prevention of co-morbidities in high-risk PCOS populations. Presentation: No date and time listed