Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis

Abstract

Some studies reported a significant association between polycystic ovary syndrome (PCOS) and risk of cardiovascular disease (CVD). However, the results are controversial. A systematic search was conducted in the PubMed, Science Direct, EMBASE, and Cochrane Library databases. Five case-control studies and 5 cohort studies were selected, involving a total of 104392 subjects in this meta-analysis. PCOS was significantly associated with the increased risk of CVD (OR = 1.30; 95% CI 1.09 – 1.56; P = 0.004). In the subgroup analysis of study design, both case-control studies and prospective cohort studies showed significant results (OR = 1.79; 95% CI 1.16 – 2.77; P = 0.009; OR = 1.20; 95% CI 1.06 – 1.37; P = 0.005), while retrospective cohort studies did not show positive result (OR = 0.91; 95% CI 0.60 – 1.40; P = 0.68). In a further stratified analysis by type of CVD, a significant association was found between PCOS and coronary heart disease (CHD) (OR = 1.44; 95% CI 1.13 – 1.84; P = 0.004). However, no significant association was observed between PCOS and myocardial infarction (MI) (OR = 1.01; 95% CI 0.68 – 1.51; P = 0.95). In conclusion, this meta-analysis suggested that PCOS is significantly associated with increased CHD risk.

Comorbidities and complications of polycystic ovary syndrome: An overview of systematic reviews

“…The number of studies included in each systematic review ranged from 5 to 106 and the total participants ranged from 213 to 767 988. N = 8 of the systematic reviews had 10 studies or fewer in total …”

“…CVD and associated risk factors of PCOS were assessed by n = 10 reviews . N = 9 reviews were rated moderate quality and n = 1 was rated low quality.…”

“…N = 2 reviews examined the risk of early markers of CVD and reported women with PCOS were at a significantly increased risk for higher carotid intima‐media thickness (CIMT) and compromised flow‐mediated dilatation (FMD) . N = 2 reviews assessed the prevalence of CVD and reported women with PCOS were at a significantly increased risk for coronary heart disease (CHD) and stroke …”

“…Moreover, women with PCOS also show a propensity for excess weight gain which exacerbates these symptoms . Cardiovascular risk factors such as chronic inflammation, oxidative stress and impaired fibrinolysis are increased with some evidence of a higher prevalence of cardiovascular disease (CVD) . Furthermore, affected women are more likely to experience moderate‐to‐severe depression and anxiety symptoms, low self‐esteem, negative body image and psychosexual function compared to healthy women .…”

“…24 Cardiovascular risk factors such as chronic inflammation, oxidative stress 25 and impaired fibrinolysis are increased 24 with some evidence of a higher prevalence of cardiovascular disease (CVD). 11,26 Furthermore, affected women are more likely to experience moderate-to-severe depression and anxiety symptoms, 27 low self-esteem, negative body image and psychosexual function compared to healthy women. 28 PCOS also negatively impacts health-related quality of life (HRQoL) 29,30 and may limit a woman's ability to optimize healthy lifestyle.…”