The Cardiovascular Risk of Young Women with Polycystic Ovary Syndrome: An Observational, Analytical, Prospective Case-Control Study

Abstract

To evaluate the cardiovascular risk of polycystic ovary syndrome (PCOS), we investigated lipid profile, metabolic pattern, and echocardiography in 30 young women with PCOS and 30 healthy age- and body mass index (BMI)-matched women. PCOS women had higher fasting glucose and insulin levels, homeostasis model assessment score of insulin sensitivity, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels, and TC/high density lipoprotein cholesterol (HDL-C) ratio and lower HDL-C levels than controls. Additionally, PCOS women had higher left atrium size (32.0 +/- 4.9 vs. 27.4 +/- 2.1 mm; P < 0.0001) and left ventricular mass index (80.5 +/- 18.1 vs. 56.1 +/- 5.4 g/m(2); P < 0.0001) and lower left ventricular ejection fraction (64.4 +/- 4.1 vs. 67.1 +/- 2.6%; P = 0.003) and early to late mitral flow velocity ratio (1.6 +/- 0.4 vs. 2.1 +/- 0.2; P < 0.0001) than controls. When patients and controls were grouped according to BMI [normal weight (BMI, >18 and <25 kg/m(2)), overweight (BMI, 25.1-30 kg/m(2)), and obese (BMI, >30 kg/m(2))], the differences between PCOS women and controls were maintained in overweight and obese women. In normal weight PCOS women, a significant increase in left ventricular mass index and a decrease in diastolic filling were observed, notwithstanding no change in TC, LDL-C, HDL-C, TC/HDL-C ratio, and TG compared with controls. In conclusion, our data show the detrimental effect of PCOS on the cardiovascular system even in young women asymptomatic for cardiac disease.

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

“…While several studies have shown that women with PCOS are more prone to atherosclerotic issues, [16][17][18][19][20]37 we show here, as Mak and Dokras 22 suggested, that women with PCOS have a higher probability of having VTE compared with women without PCOS. 22 We acknowledge that our findings should be interpreted with caution and the relationship between PCOS and VTE should be evaluated further in prospective studies because our data were obtained from administrative data.…”

“…These findings also demonstrate the complex nature of PCOS and its related clinical consequences. For instance, increased cardiovascular risks has been found among women with phenotype A (hyperandrogenism and ovulatory dysfunction) or classic PCOS [15][16][17][18][19][20] ; on the other hand, Wiltgen and Spritzer 30 showed that hirsute ovulatory patients with polycystic ovaries (phenotype B) had a lower prevalence of cardiovascular risk factors than those with the classic PCOS phenotype. One would then expect that the highest probability of VTE also would be found among women with phenotype A and the lowest probability among women with phenotype B.…”

“…13 PCOS is also associated with insulin-induced elevations of plasminogen activator inhibitor (PAI)-1, which is a potent inhibitor of fibrinolysis. 14 While some studies have found PCOS to be associated with coronary heart disease risk factors, [15][16][17][18][19][20] other studies have shown that women with PCOS were 3 times more likely to have a family history of venous thrombosis. 21 Mak and Dokras 22 hypothesized that women with PCOS likely have an increased baseline risk for developing thrombosis compared with other women in the general population.…”

The polycystic ovary syndrome: an example of obesity-related cardiovascular complication affecting young women

“…Infatti, diverse evidenze mostrano una relazione tra malattia cardiaca e PCOS e rischio CV, cioè dislipidemia [49], insulino-resistenza (50), LVM (massa ventricolare sinistra) aumentata [51] e disfunzione diastolica del ventricolo sinistro [51,19].…”

Polycystic Ovary Syndrome in Adolescence

“…Thus, insulin resistance may develop in parallel with androgen excess, rather than independently of it. The known association of PCOS with insulin resistance [57] and obesity accounts for the predisposition of these women to metabolic syndrome [58,59] and type 2 diabetes mellitus (T2DM) [60,61]. The authors' preliminary studies show a stronger relationship of adolescent PCOS to parental metabolic syndrome than to any other parental feature [62].…”