ECE2011 Poster Presentations Female reproduction (39 abstracts)
Cardiovascular disease risk markers in women with polycystic ovary syndrome: systematic review and meta-analysis
K A Toulis , G Mintziori , D G Goulis , E Kintiraki , E Eukarpidis , S A Mouratoglou , A Pavlaki , S Stergianos , M Poulasouhidou , T G Tzellos & B C Tarlatzis
Aristotle University of Thessaloniki, Thessaloniki, Greece.
Introduction: The relation between polycystic ovary syndrome (PCOS) and cardiovascular disease (CVD) remains unclear. The aim of the study was to systematically review the relevant trials that have studied CVD risk factors in woman with PCOS (CRP, Hcy, TNF-α, PAI-1, Lp(a), AGEs, VEGF, IL6, ADMA and fibrinogen) and to meta-analyze the best evidence available.
Patients and methods: Search was conducted in the MEDLINE, EMBASE and CENTRAL d (last update June 2010). Eligible for the systematic reviews were studies, which reported on CVD risk markers levels in women with PCOS compared to controls. Weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated in each of the CVD risk markers for all eligible studies and combined using random effects model. To ensure synthesis of the best available evidence, sensitivity analyses were performed.
Results: One hundred and thirty studies were including in 11 different meta-analyses, involving in total 6260 women with PCOS and 4546 controls. Women with PCOS demonstrated significantly elevated CRP (WMD (95% CI)=0.96 (0.74 to 1.19)), Hcy (2.25 (1.46 to 3.03)), PAI-1 antigen (16.96 (7.65 to 26.28)), PAI-1 activity (0.70 (0.17 to 1.23)), VEGF (1.72 (0.96 to 2.48)), ADMA (0.19 (0.08 to 0.3)) and AGEs (3.91 (2.36 to 5.45)) levels as compared – controls, yet with significant between-study heterogeneity. Borderline significance was detected for TNF-α (0.75 (0.07 to 1.44)) and fibrinogen (0.20 (0.01 to 0.39)) whereas no significance was detected for IL6 (0.71 (−0.16 to 1.59)).
Conclusions: Women with PCOS have increased serum concentrations of CVD risk factors as compared to controls. If this apparent risk is translated into increased incidence of CVD in later life remains to be elucidated.
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