ObjectivesPolycystic ovary syndrome (PCOS), characterized by polycystic ovaries, anovulation, and hyperandrogenism, is believed to be an evolutionary mismatch disease. Past research has examined PCOS as a uniform disease, despite variation in phenotypes across diagnostic categories, but establishing an evolutionary mismatch requires a focus on individual traits. We suggest PCOS hyperandrogenism may have been beneficial in ancestral environments because it reduced fracture risk and associated morbidity and mortality due to increased bone mineral density (BMD). We test this hypothesis by assessing fracture frequency, a proxy for BMD, in highly active females with and without PCOS hyperandrogenism.MethodsSixty‐seven reproductive‐aged women were surveyed and grouped as: high intensity interval training (HIIT; a proxy for metabolic and physical stress) athletes with hyperandrogenic PCOS (31.24%), HIIT athletes without PCOS (29.85%), and nonathletes with hyperandrogenic PCOS (38.81%). Fracture occurrence was compared between the groups using independent samples Kruskal–Wallis tests for non‐normally distributed data, and multiple regression analysis was used to examine anthropometrics, lifestyle and reproductive factors, PCOS status, and exercise frequency on fracture occurrence.ResultsFracture occurrence was higher in non‐PCOS athletes (3.8 ± 4.3) than PCOS‐athletes (1.2 ± 1.4, p = .11) and PCOS‐non‐athletes (1.0 ± 1.4, p < .01). PCOS‐athletes and nonathletes did not differ significantly in fracture occurrence (p = .33). These results were independent of factors associated with bone health.ConclusionsThese preliminary findings suggest females with PCOS‐related hyperandrogenism may be less likely to experience bone fractures and provide an initial step to explaining why PCOS has persisted despite marked negative reproductive consequences in modern populations.

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与多囊卵巢综合征相关的高雄激素血症可能对女运动员骨折风险具有保护作用：一项试点研究

目的多囊卵巢综合征（PCOS）以多囊卵巢、无排卵和雄激素过多症为特征，被认为是一种进化错配疾病。过去的研究将多囊卵巢综合症视为一种统一的疾病，尽管不同诊断类别的表型存在差异，但建立进化不匹配需要关注个体特征。我们认为，PCOS 高雄激素血症可能在祖先环境中有益，因为它降低了骨折风险以及由于骨矿物质密度 (BMD) 增加而导致的相关发病率和死亡率。我们通过评估患有或不患有 PCOS 高雄激素血症的高度活跃女性的骨折频率（BMD 的代表）来检验这一假设。 方法 对 67 名育龄女性进行了调查并分组为：高强度间歇训练（HIIT；代谢和体力的代表）患有高雄激素性 PCOS 的运动员（31.24%）、无 PCOS 的 HIIT 运动员（29.85%）和患有高雄激素性 PCOS 的非运动员（38.81%）。采用非正态分布数据的独立样本Kruskal-Wallis检验比较各组间骨折发生率，并采用多元回归分析考察人体测量学、生活方式和生殖因素、PCOS状态以及运动频率对骨折发生率的影响。结果骨折发生率较高非 PCOS 运动员（3.8 ± 4.3）高于 PCOS 运动员（1.2 ± 1.4，p= .11) 和 PCOS 非运动员 (1.0 ± 1.4,p< .01)。 PCOS 运动员和非运动员在骨折发生率上没有显着差异（p= .33）。这些结果独立于与骨骼健康相关的因素。结论这些初步研究结果表明，患有 PCOS 相关高雄激素血症的女性发生骨折的可能性较小，并为解释为什么 PCOS 在现代人群中存在明显的负面生殖后果而持续存在提供了第一步。