The Role of Oxidative Stress in the Risk of Cardiovascular Disease and Identification of Risk Factors Using AIP and Castelli Atherogenicity Indicators in Patients with PCOS

Abstract

Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies in females of reproductive age and may affect 5–14% of women. In women with PCO syndrome, metabolic disorders such as insulin resistance, hyperinsulinemia, obesity, diabetes mellitus, and other elements of metabolic syndrome may occur. Patients with PCOS often have overweight and obesity, especially abdominal obesity, which is one of the risk factors for developing atherosclerosis. The atherogenicity indicators of AIP (atherogenic index of plasma) and Castelli’s index are used to assess the risk of developing atherosclerosis. Studies have shown an increase in the concentration and activity of oxidative stress markers in patients with PCOS compared to women without the disease. The aim of the present study was to evaluate oxidative stress parameters in patients with PCOS in relation to insulin resistance, BMI, and hyperandrogenemia and to correlate them with cardiovascular risk parameters. Conclusions: The severity of oxidative stress in women with PCOS correlates with exposure to cardiovascular diseases. The assessment of additional cardiovascular disease (CVD) parameters is useful in identifying the risk groups for cardiometabolic disease among PCOS patients. When additional risk factors such as hyperandrogenism and insulin resistance (IR) are present in patients with PCOS, it is reasonable to include preventive examinations early. It is also important to evaluate lipidograms, which will make it possible to determine indicators of atherogenicity. Patients with PCOS and IR are at particular risk for cardiovascular complications. PCOS should be considered an important risk factor for CVD, which occurs independently of the occurrence of obesity. This factor is related to the important role of insulin resistance, which occurs independently of obesity. Atherogenic factors (AIP and Castelli index) are useful additional parameters to assess the risk of cardiometabolic disease in PCOS patients, especially among groups with insulin resistance. The early detection of risk factors should be an integral part of the care of PCOS patients. In laboratory studies of women with PCOS, TG, TChol, HDL-c and LDL-c levels, and glutathione peroxidase (GPx) activity were most clearly correlated with exposure to cardiovascular disease.

Molecular Research on Polycystic Ovary Syndrome (PCOS)

“…Furthermore, epidemiological studies linked low serum potassium to a significant CVDs risk. Concerning this, Nawrocka-Rutkowska et al [14] confirmed through a clinical study the positive correlation between oxidative stress markers and the occurrence of CV complications in PCOS women. They proposed AIP and Castelli Index as atherogenicity additional indicators to assess the risk of cardiometabolic diseases in PCOS in order to rapidly identify risk groups among this population.…”

Metabolic Deregulations in Patients with Polycystic Ovary Syndrome

“…PCOS is a condition where metabolic disorders are estimated to coexist in 75% of women with PCOS of a proper weight, and in 90% of obese women with PCOS. Fifty percent of them progress to metabolic syndrome, which refers to impaired glucose tolerance, hypertension, dyslipidemia, central adiposity, and CVD [ 25 ]. Insulin resistance contributes to CVD among other metabolic disorders.…”

“…PCOS should be considered an important CVD risk factor that is associated with insulin resistance, which occurs independently of obesity. [ 25 ]. Hiperinsulinemia exacerbates the hyperandrogenism.…”

“…Nawrocka et al found that 27.6% women with PCOS had insulin resistance, and that hyperandrogenism was found in 48.3% of the studied women [ 25 ]. Nagshband et al reported the prevalence of metabolic syndrome in 59.3% of Indian women with PCOS [ 16 ] Abruzzese et al reported a diagnostic accuracy of LAP in Argentinian young women with PCOS and insulin resistance [ 26 ].…”

Fetuin-A and Its Association with Anthropometric, Atherogenic, and Biochemical Parameters and Indices among Women with Polycystic Ovary Syndrome

“…Moreover, to date only a few studies have used AIP indicators in woman with PCOS to analyze the risk of cardiometabolic disease. We found one study that examined the values of the HOMA-IR, Castelli Index, and AIP in PCOS [ 42 ]. Nawrocka-Rutkowska et al highlights that the Castelli index and AIP are useful additional parameters to determine the risk of cardiometabolic disease in PCOS patients, especially with insulin resistance.…”