SAT372 Obstructive Sleep Apnea (OSA) Risk Among Patients With Polycystic Ovary Syndrome (PCOS)

Abstract Disclosure: J.P. Christ: None. K. Shinkai: None. J. Corley: None. L. Pasch: None. M.I. Cedars: None. H. Huddleston: None. Background: Risk of OSA is increased up to seven-fold among patients with PCOS independent of body mass index (BMI). The cause of this increased risk is poorly understood. Likely a bi-directional relationship exists whereby OSA may worsen insulin resistance and hyperandrogenism which in turn may alter airway physiology. Improved understanding of the link between OSA risk and reproductive and metabolic features of PCOS could reveal new strategies to improve a variety of health outcomes for this population. Objective: To assess associations between OSA risk and reproductive and metabolic features among patients with PCOS. Methods: A cross-sectional analysis of patients that underwent a standardized evaluation for PCOS at a single tertiary center from 2017 to 2022 was completed. Patients were eligible for inclusion if they were aged 18-44, met modified Rotterdam criteria for PCOS and had completed a Berlin Questionnaire (BQ) for OSA risk assessment. The BQ contains 10 questions in 3 categories and a high-risk response was recorded if 2 out of 3 categories were positive. All patients underwent standardized anthropometric, ultrasound, endocrine, and metabolic phenotyping. PCOS features were compared between those with and without a high risk BQ. Results: Of the 572 patients screened, 309 patients with PCOS met inclusion criteria. Of these, 104 (33.7%) patients had a high risk BQ. Compared to those without a high risk BQ, those with high-risk BQ had significantly higher waist to hip ratio (WHR) (mean ± standard deviation, 0.9±0.1 vs 0.8±0.1), LDL (113±31.1 vs 103.3±26.5 mg/dL), triglycerides (132±75 vs 89±55 mg/dL), fasting insulin (22±21.2 vs 13.9±16.9 mIU/mL), 2-hour insulin (125±141.2 vs 68.4±108.9 mIU/mL), fasting glucose (100±39 vs 88±20 mg/dL), 2-hour glucose (125.7±56.4 vs 101.7±40 mg/dL), hemoglobin A1c (5.7±1.1 vs 5.2±0.6%), C-reactive protein (6.2±5.7 vs 2.8±3.8 mg/L), ALT (37±50 vs 27±27 U/L), free testosterone (6.5±3.9 vs 5.1±3.5 pg/mL), and lower HDL (49.7±12.4 vs 61.1±16.5 mg/dL) and sex hormone binding globulin (SHBG) (32.3±20.2 vs 53.7±37 nmol/L); p<0.05 for all comparisons. In multivariable regression, controlling for WHR and age, C-reactive protein (β=0.095, p=0.005), SHBG (β=-0.014, p=0.037), HDL (β=-0.025, p=0.032) and Hemoglobin A1c (β=0.421, p=0.073) were found to independently predict presence of high risk BQ. Conclusions: High risk for OSA is a frequent finding among patients with PCOS. Risk for sleep apnea appears to be associated with markers of dysglycemia, dyslipidemia, inflammation, and hyperandrogenism independent of adiposity. Future research is needed to determine if treatment of OSA has metabolic and/or reproductive benefits. Presentation Date: Saturday, June 17, 2023