{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:19:54Z","timestamp":1791951594184,"version":"4.3.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100024075","name":"Region of Southern Denmark","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Overl\u00e6ger\u00e5det"},{"DOI":"10.13039\/501100004196","name":"Odense University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Danish Research Council"},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Finnish Research Council"},{"DOI":"10.13039\/501100006306","name":"Sigrid Juselius Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the National Regional Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular disease (CVD) risk factors are prevalent in women with polycystic ovary syndrome (PCOS), but prospective data regarding CVD in population-based cohorts are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to investigate prospective risk of CVD in Nordic women with PCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a national register-based study in women with PCOS and age-matched controls originating from Denmark (PCOS Denmark, N = 27 298, controls, N = 135 019), Finland (PCOS Finland, N = 20 765, controls, N = 59 122), and Sweden (PCOS Sweden, N = 79 454, controls, N = 393 669). The main study outcome was CVD. Cardiovascular disease was defined according to ICD-10 diagnostic codes for major adverse cardiac events, pulmonary embolism, and\/or deep venous thrombosis. Cox regression analyses estimated hazard ratio (HR) with 95% CI and adjusted analyses included body mass index (BMI) and education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age at cohort entry was 28 years (Denmark) and 29 years (Finland and Sweden) and the median follow-up time was 8.0-10.0 years. The unadjusted HR (95% CI) for CVD in women with PCOS was 1.30 (1.20; 1.41) in Denmark, 1.45 (1.31; 1.60) in Finland, and 1.52 (1.44; 1.60) in Sweden. Models remained significant after adjusting for obesity and level of education. In a combined meta-analysis including all countries (PCOS, N = 127 517, controls, N = 587 810), the adjusted HR for CVD in women with PCOS was 1.32 (1.25; 1.39). In women with BMI &amp;lt; 25\u2005kg\/m2 and no type 2 diabetes, the adjusted HR for CVD risk was 1.40 (1.26; 1.55).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The risk of CVD was increased in women with PCOS across the 3 Nordic countries, also among women with BMI &amp;lt; 25\u2005kg\/m2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf266","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T12:31:22Z","timestamp":1766406682000},"page":"58-68","source":"Crossref","is-referenced-by-count":9,"title":["Increased prospective cardiovascular disease risk in 127 517 Nordic women with polycystic ovary syndrome: a national cohort study"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8338-8025","authenticated-orcid":false,"given":"Dorte","family":"Glintborg","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital , Odense 5000 ,","place":["Denmark"]},{"name":"Institute of Clinical Research, University of Southern Denmark , Odense 5000 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6794-0369","authenticated-orcid":false,"given":"Meri-Maija","family":"Ollila","sequence":"additional","affiliation":[{"name":"Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu , Oulu 90220 ,","place":["Finland"]},{"name":"Department of Internal Medicine, Oulu University Hospital , Oulu 90220 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noona","family":"Koskenkari","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital , Oulu 90220 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens-Jakob Kjer","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"OPEN\u2014Odense Patient Data Explorative Network, Odense University Hospital , Odense 5000 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"Calla","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University , Uppsala 751 85 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frida","family":"Gyllenberg","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University , Uppsala 751 85 ,","place":["Sweden"]},{"name":"Department of General Practice and Primary Health Care, University of Helsinki, Helsinki 00290 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrine Hass","family":"Rubin","sequence":"additional","affiliation":[{"name":"OPEN\u2014Odense Patient Data Explorative Network, Odense University Hospital , Odense 5000 ,","place":["Denmark"]},{"name":"Research Unit OPEN, Department of Clinical Research, University of Southern Denmark , Odense 5000 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-3430","authenticated-orcid":false,"given":"Paula","family":"Pesonen","sequence":"additional","affiliation":[{"name":"Infrastructure for Population Studies, Faculty of Medicine, University of Oulu , Oulu 90220 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne Skovsager","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital , Odense 5000 ,","place":["Denmark"]},{"name":"Institute of Clinical Research, University of Southern Denmark , Odense 5000 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Sundstr\u00f6m-Poromaa","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University , Uppsala 751 85 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9921-7300","authenticated-orcid":false,"given":"Terhi","family":"Piltonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital , Oulu 90220 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"issue":"1","key":"2026011311515870400_lvaf266-B1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/s41572-024-00511-3","article-title":"Polycystic ovary syndrome","volume":"10","author":"Stener-Victorin","year":"2024","journal-title":"Nat Rev Dis Primers"},{"issue":"2","key":"2026011311515870400_lvaf266-B2","doi-asserted-by":"publisher","first-page":"G43","DOI":"10.1093\/ejendo\/lvad096","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"189","author":"Teede","year":"2023","journal-title":"Eur J Endocrinol."},{"issue":"2","key":"2026011311515870400_lvaf266-B3","doi-asserted-by":"publisher","first-page":"R53","DOI":"10.1530\/EJE-16-0373","article-title":"MANAGEMENT OF ENDOCRINE DISEASE: morbidity in polycystic ovary syndrome","volume":"176","author":"Glintborg","year":"2017","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2026011311515870400_lvaf266-B4","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/S2213-8587(22)00163-2","article-title":"Polycystic ovary syndrome","volume":"10","author":"Joham","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"7","key":"2026011311515870400_lvaf266-B5","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1111\/aogs.14382","article-title":"Women with polycystic ovary syndrome are burdened with multimorbidity and medication use independent of body mass index at late fertile age: a population-based cohort study","volume":"101","author":"Kujanp\u00e4\u00e4","year":"2022","journal-title":"Acta Obstet Gynecol Scand."},{"issue":"5","key":"2026011311515870400_lvaf266-B6","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1530\/EJE-14-1108","article-title":"Morbidity and medicine prescriptions in a nationwide Danish population of patients diagnosed with polycystic ovary syndrome","volume":"172","author":"Glintborg","year":"2015","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2026011311515870400_lvaf266-B7","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s12020-021-02801-2","article-title":"Risk of type 2 diabetes mellitus in polycystic ovary syndrome is associated with obesity: a meta-analysis of observational studies","volume":"74","author":"Anagnostis","year":"2021","journal-title":"Endocrine"},{"issue":"8","key":"2026011311515870400_lvaf266-B8","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1093\/humrep\/deae124","article-title":"Prospective risk of type 2 diabetes in 99 892 Nordic women with polycystic ovary syndrome and 446 055 controls: national cohort study from Denmark, Finland, and Sweden","volume":"39","author":"Glintborg","year":"2024","journal-title":"Hum Reprod"},{"key":"2026011311515870400_lvaf266-B9","author":"World Health Organization"},{"issue":"7","key":"2026011311515870400_lvaf266-B10","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1038\/s41366-019-0318-z","article-title":"Age at adiposity rebound in childhood is associated with PCOS diagnosis and obesity in adulthood-longitudinal analysis of BMI data from birth to age 46 in cases of PCOS","volume":"43","author":"Koivuaho","year":"2019","journal-title":"Int J Obes (Lond)"},{"issue":"1","key":"2026011311515870400_lvaf266-B11","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1093\/ejendo\/lvad077","article-title":"Women with PCOS have an increased risk for cardiovascular disease regardless of diagnostic criteria-a prospective population-based cohort study","volume":"189","author":"Ollila","year":"2023","journal-title":"Eur J Endocrinol."},{"issue":"6","key":"2026011311515870400_lvaf266-B12","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1093\/humupd\/dmaa029","article-title":"Long-term cardiometabolic disease risk in women with PCOS: a systematic review and meta-analysis","volume":"26","author":"Wekker","year":"2020","journal-title":"Hum Reprod Update"},{"issue":"16","key":"2026011311515870400_lvaf266-B13","doi-asserted-by":"publisher","first-page":"e033572","DOI":"10.1161\/JAHA.123.033572","article-title":"2023 international evidence-based polycystic ovary syndrome guideline update: insights from a systematic review and meta-analysis on elevated clinical cardiovascular disease in polycystic ovary syndrome","volume":"13","author":"Tay","year":"2024","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"2026011311515870400_lvaf266-B14","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s40200-018-0371-5","article-title":"Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach","volume":"17","author":"Toosy","year":"2018","journal-title":"J Diabetes Metab Disord"},{"issue":"4","key":"2026011311515870400_lvaf266-B15","doi-asserted-by":"publisher","first-page":"2791","DOI":"10.1093\/humrep\/dew228","article-title":"Should we individualize lipid profiling in women with polycystic ovary syndrome?","volume":"31","author":"Sundstrom","year":"2016","journal-title":"Hum Reprod"},{"issue":"2","key":"2026011311515870400_lvaf266-B16","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1530\/EC-20-0527","article-title":"Higher blood pressure in normal weight women with PCOS compared to controls","volume":"10","author":"Mellembakken","year":"2021","journal-title":"Endocr Connect."},{"issue":"9","key":"2026011311515870400_lvaf266-B17","doi-asserted-by":"publisher","first-page":"e3369","DOI":"10.1210\/clinem\/dgab392","article-title":"Women with polycystic ovary syndrome have an increased risk of Major cardiovascular events: a population study","volume":"106","author":"Berni","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026011311515870400_lvaf266-B18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12933-018-0680-5","article-title":"Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome","volume":"17","author":"Glintborg","year":"2018","journal-title":"Cardiovasc Diabetol"},{"issue":"10","key":"2026011311515870400_lvaf266-B19","doi-asserted-by":"publisher","first-page":"2396","DOI":"10.3390\/biomedicines10102396","article-title":"Diabetes Mellitus mediates risk of depression in Danish women with polycystic ovary syndrome-A national cohort study","volume":"10","author":"Glintborg","year":"2022","journal-title":"Biomedicines"},{"issue":"10","key":"2026011311515870400_lvaf266-B20","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1093\/humrep\/dez159","article-title":"Fecundity among women with polycystic ovary syndrome (PCOS)-a population-based study","volume":"34","author":"Persson","year":"2019","journal-title":"Hum Reprod"},{"key":"2026011311515870400_lvaf266-B21","doi-asserted-by":"publisher","first-page":"533","DOI":"10.2147\/CLEP.S314959","article-title":"Nordic health registry-based research: a review of health care systems and key registries","volume":"13","author":"Laugesen","year":"2021","journal-title":"Clin Epidemiol"},{"issue":"1","key":"2026011311515870400_lvaf266-B22","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.fertnstert.2013.03.013","article-title":"Hyperandrogenism during puberty in the development of polycystic ovary syndrome","volume":"100","author":"Nader","year":"2013","journal-title":"Fertil Steril"},{"key":"2026011311515870400_lvaf266-B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/AHMT.S15946","article-title":"Life-course origins of the ages at menarche and menopause","volume":"4","author":"Forman","year":"2013","journal-title":"Adolesc Health Med Ther"},{"issue":"7_suppl","key":"2026011311515870400_lvaf266-B24","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1177\/1403494810394715","article-title":"Danish education registers","volume":"39","author":"Jensen","year":"2011","journal-title":"Scand J Public Health"},{"issue":"10","key":"2026011311515870400_lvaf266-B25","doi-asserted-by":"publisher","first-page":"Ed000142","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2026011311515870400_lvaf266-B26","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.2147\/IJWH.S475149","article-title":"Association between female androgen levels, metabolic syndrome, and cardiovascular disease: an NHANES analysis (2013-2016)","volume":"16","author":"Luo","year":"2024","journal-title":"Int J Womens Health"},{"issue":"4","key":"2026011311515870400_lvaf266-B27","doi-asserted-by":"publisher","first-page":"oead061","DOI":"10.1093\/ehjopen\/oead061","article-title":"Cardiovascular disease risk in women with hyperandrogenism, oligomenorrhea\/menstrual irregularity or polycystic ovaries (components of polycystic ovary syndrome): a systematic review and meta-analysis","volume":"3","author":"Lo","year":"2023","journal-title":"Eur Heart J Open"},{"issue":"4","key":"2026011311515870400_lvaf266-B28","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1093\/ejendo\/lvae124","article-title":"Association of hyperandrogenaemia with hypertension and cardiovascular events in pre-menopausal women: a prospective population-based cohort study","volume":"191","author":"Tuorila","year":"2024","journal-title":"Eur J Endocrinol."},{"issue":"3","key":"2026011311515870400_lvaf266-B29","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1530\/EJE-22-0306","article-title":"Cardiovascular risk in Danish transgender persons: a matched historical cohort study","volume":"187","author":"Glintborg","year":"2022","journal-title":"Eur J Endocrinol."},{"issue":"1","key":"2026011311515870400_lvaf266-B30","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s12020-023-03648-5","article-title":"The prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome in treatment-na\u00efve transgender people assigned female at birth","volume":"84","author":"O\u011fuz","year":"2024","journal-title":"Endocrine"},{"issue":"4","key":"2026011311515870400_lvaf266-B31","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1007\/s42000-024-00576-5","article-title":"Female-specific risk factors for cardiovascular disease: an update","volume":"23","author":"Theodorou","year":"2024","journal-title":"Hormones (Athens)"},{"key":"2026011311515870400_lvaf266-B32","doi-asserted-by":"publisher","first-page":"100558","DOI":"10.1016\/j.ahjo.2025.100558","article-title":"Reproductive-associated risk factors and incident coronary heart disease in women: an umbrella review","volume":"55","author":"Alnefaie","year":"2025","journal-title":"Am Heart J Plus"},{"issue":"5","key":"2026011311515870400_lvaf266-B33","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1006\/pmed.1997.0199","article-title":"Determinants of obesity in relation to socioeconomic status among middle-aged Swedish women","volume":"26","author":"Wamala","year":"1997","journal-title":"Prev Med"},{"issue":"4","key":"2026011311515870400_lvaf266-B34","doi-asserted-by":"publisher","first-page":"S178","DOI":"10.1016\/j.amepre.2007.07.008","article-title":"The epidemiology of overweight and related lifestyle behaviors: racial\/ethnic and socioeconomic status differences among American youth","volume":"33","author":"Delva","year":"2007","journal-title":"Am J Prev Med"},{"issue":"5","key":"2026011311515870400_lvaf266-B35","doi-asserted-by":"publisher","first-page":"161","DOI":"10.2188\/jea.17.161","article-title":"Socioeconomic status and overweight\/obesity in an adult Chinese population in Singapore","volume":"17","author":"Sabanayagam","year":"2007","journal-title":"J Epidemiol"},{"issue":"4","key":"2026011311515870400_lvaf266-B36","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1111\/aogs.13514","article-title":"Socioeconomic status in Danish women with polycystic ovary syndrome: a register-based cohort study","volume":"98","author":"Rubin","year":"2019","journal-title":"Acta Obstet Gynecol Scand."},{"issue":"3","key":"2026011311515870400_lvaf266-B37","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1089\/jwh.2010.2303","article-title":"Socioeconomic status and polycystic ovary syndrome","volume":"20","author":"Merkin","year":"2011","journal-title":"J Womens Health (Larchmt)"},{"issue":"1","key":"2026011311515870400_lvaf266-B38","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register","volume":"11","author":"Ludvigsson","year":"2011","journal-title":"BMC Public Health"},{"issue":"5","key":"2026011311515870400_lvaf266-B39","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1210\/er.2015-1018","article-title":"Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome","volume":"36","author":"Dumesic","year":"2015","journal-title":"Endocr Rev"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejendo\/advance-article-pdf\/doi\/10.1093\/ejendo\/lvaf266\/66123441\/lvaf266.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/194\/1\/58\/66123441\/lvaf266.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/194\/1\/58\/66123441\/lvaf266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:52:09Z","timestamp":1768323129000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/194\/1\/58\/8404129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ejendo\/lvaf266","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,12,24]]}}}