Androgen-Induced Cardiovascular Risk in Polycystic Ovary Syndrome: The Role of T Lymphocytes

Abstract

An estimated 15–20% of reproductive-age women are affected by polycystic ovary syndrome (PCOS). PCOS is associated with substantial metabolic and cardiovascular long-term consequences. In young women with PCOS, several cardiovascular risk factors may be found, including chronic inflammation, high blood pressure, and elevated leukocytes. These women are at an increased risk of cardiovascular diseases (CVD), not only during the reproductive years, but also with aging and menopause; therefore, the early prevention and treatment of future cardiovascular adverse effects are necessary. The fundamental characteristic of PCOS is hyperandrogenemia, which is associated with increased pro-inflammatory cytokines and T lymphocytes. Whether these factors play a role in the pathophysiology of hypertension, a risk factor of CVD, due to PCOS is not well established. This review will briefly discuss how a modest increase in androgens in females is linked to the development of hypertension through pro-inflammatory cytokines and T lymphocyte subsets and the promotion of renal injury. Moreover, it reveals a few existing research gaps in this area, including the lack of specific therapy directed at androgen-induced inflammation and immune activation, thus emphasizing the necessity to explore the systemic inflammation in women with PCOS to halt the inevitable inflammatory process targeting the underlying abnormalities of CVD.

Androgen excess: a hallmark of polycystic ovary syndrome

“…Hence, promoting the conversion from DHEA into A4 and thus downstream 11-oxygenated androgens through the action of HSD3B2 ( 80 ). This may partly explain why women with PCOS still have a higher cardiovascular risk even after menopause ( 81 – 83 ). As for adolescents, there is no evident increase in 11-KT in patients with PCOS, and metformin administration has no effect on 11-KT levels ( 84 ).…”

Acupuncture improves the emotion domain and lipid profiles in women with polycystic ovarian syndrome: a secondary analysis of a randomized clinical trial

“…Polycystic ovarian syndrome (PCOS) is the most common endocrine disease in women of reproductive age, affecting more than 15%–20% of the population ( 1 ). Women with PCOS are frequently associated with metabolic abnormalities, including hyperinsulinemia, chronic low-grade inflammation, insulin resistance (IR), dyslipidemia, and obesity, and even anovulatory infertility and type 2 diabetes, as well as the risk of cardiovascular disease (CVD) ( 2 ).…”