Endocrine Abstracts

The polycystic ovary syndrome (PCOS) is actually considered not only a reproductive disease but also a multifaceted disease with metabolic, cardiovascular and long-term health implications, including diabetes mellitus and coronary artery disease. In particular, insulin resistance, hyperandrogenemia and dyslipidemia are likely the major risk factors for the occurrence of cardiovascular disease (CVD) in PCOS. These cardiovascular risk (CVR) factors are often evident at an early age, suggesting that women with PCOS represent a large group of women at increased risk for developing early onset CVD.

Multiple lines suggest an increased CVR and CVD characterized by an impairment of cardiac structure and function, early coronary artery disease, endothelial dysfunction, lipid abnormalities and low grade chronic inflammation.

Actually exists evidence for association between PCOS and CVD and it includes: 1) known CVR factor, like atherosclerosis, coronary artery disease, myocardial infarction, atherogenic lipid profile (increased total cholesterol, LDL-cholesterol and triglycerides and reduced HDL-cholesterol); 2) emerging new CVR factors, like increased C-reactive protein, increased white blood cell count (lymphocytes and monocytes), increased tumor necrosis factor-α and Interleukines (6 and 18); 3) subclinical CVD, like increased intima media thickness, endothelial dysfunction (reduced flow mediated dilation and higher endothelin-1 levels) and impaired fibrinolysis (increased plasminogen activator inhibitor-1); 4) clinical CVD demonstrating no increased mortality for CVD in PCOS.

However no long-term data for well-characterized PCOS women are present in literature, and large-scale clinical trials evaluating the morbidity and mortality for CVD in PCOS subjects are lacking.