Polycystic ovary syndrome: a “risk-enhancing” factor for cardiovascular disease

Guan, Carolyn; Zahid, Salman; Minhas, Anum; Ouyang, Pamela; Vaught, Arthur J.; Baker, Valerie L.; Michos, Erin D.

doi:10.1016/j.fertnstert.2022.03.009

Cited by 63 publications

(43 citation statements)

References 86 publications

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“…Our findings suggest that a more androgenic sex hormone state after menopause is related to this unfavorable adipokine pattern. Reproductive age women with polycystic ovary syndrome also have hyperandrogenic sex hormone profiles that were associated with higher levels of leptin and lower levels of adiponectin (47,48,51). Although we studied post-menopausal women in our analysis, our findings are generally consistent with this findings by demonstrating higher free T and lower SHBG being associated with lower adiponectin.…”

Section: Putting Findings Into Clinical Contextsupporting

confidence: 82%

Associations between endogenous sex hormone levels and adipokine levels in the Multi-Ethnic Study of Atherosclerosis

Varma¹,

Ogunmoroti²,

Ndumele³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundDifferences in sex hormone levels contribute to differences in cardiovascular disease (CVD) risk. Adipokines play a role in cardiometabolic pathways and have differing associations with CVD. Adipokine levels differ by sex; however, the association between sex hormone profiles and adipokines is not well established. We hypothesized that a more androgenic sex hormone profile would be associated with higher leptin and resistin and lower adiponectin levels among postmenopausal women, with the opposite associations in men.MethodsWe performed an analysis of 1,811 adults in the Multi-Ethnic Study of Atherosclerosis who had both sex hormones and adipokines measured an average of 2.6 years apart. Sex hormones [Testosterone (T), estradiol (E2), sex hormone binding globulin (SHBG), and dehydroepiandrosterone (DHEA)] were measured at exam 1; free T was estimated. Serum adipokines (leptin, resistin, adiponectin) were measured at exams 2 or 3. We used multivariable linear regression to examine the cross-sectional associations between sex hormones and adipokines.ResultsThe mean (SD) age was 63 (10) years, 48% were women; 59% non-White participants. For leptin, after adjusting for demographics only, higher free T and lower SHBG, were associated with higher leptin in women; this association was attenuated after further covariate adjustment. However in men, higher free T and lower SHBG were associated with greater leptin levels in fully adjusted models. For adiponectin, lower free T and higher SHBG were associated with greater adiponectin in both women and men after adjustment for CVD risk factors. For resistin, no significant association was found women, but an inverse association with total T and bioT was seen in men.ConclusionOverall, these results further suggest a more androgenic sex profile (higher free T and lower SHBG) is associated with a less favorable adipokine pattern. These findings may provide mechanistic insight into the interplay between sex hormones, adipokines, and CVD risk.

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Section: Putting Findings Into Clinical Contextsupporting

confidence: 82%

Associations between endogenous sex hormone levels and adipokine levels in the Multi-Ethnic Study of Atherosclerosis

Varma¹,

Ogunmoroti²,

Ndumele³

et al. 2023

Front. Cardiovasc. Med.

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“…PCOS is a heterogeneous disease characterized by the presence of at least two of the following conditions: hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology, often resulting in infertility [ 87 , 88 ]. This syndrome is associated with hyperinsulinemia, insulin resistance, hyperlipidemia and chronic low-grade inflammation, often leading to the development of metabolic syndrome and cardiovascular diseases [ 89 , 90 , 91 , 92 ]. Its pathogenesis, including heredity, epigenetic mechanisms, environment, living habits and diet, is complex.…”

Section: Polycystic Ovary Syndromementioning

confidence: 99%

The Complex Roles of Adipokines in Polycystic Ovary Syndrome and Endometriosis

Schüler-Toprak¹,

Ortmann²,

Buechler³

et al. 2022

Biomedicines

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Polycystic ovary syndrome (PCOS) and endometriosis are frequent diseases of the female reproductive tract causing high morbidity as they can significantly affect fertility and quality of life. Adipokines are pleiotropic signaling molecules secreted by white or brown adipose tissues with a central role in energy metabolism. More recently, their involvement in PCOS and endometriosis has been demonstrated. In this review article, we provide an update on the role of adipokines in both diseases and summarize previous findings. We also address the results of multi-omics approaches in adipokine research to examine the role of single nucleotide polymorphisms (SNPs) in genes coding for adipokines and their receptors, the secretome of adipocytes and to identify epigenetic alterations of adipokine genes that might be conferred from mother to child. Finally, we address novel data on the role of brown adipose tissue (BAT), which seems to have notable effects on PCOS. For this review, original research articles on adipokine actions in PCOS and endometriosis are considered, which are listed in the PubMed database.

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“…There also was a slightly higher prevalence of PCOS among individuals with GD versus those without GD. PCOS is also characterized by insulin resistance 30 and associated with adverse pregnancy outcomes. 31 …”

Section: Discussionmentioning

confidence: 99%

Trends, Predictors, and Outcomes of Cardiovascular Complications at Delivery Associated With Gestational Diabetes: A National Inpatient Sample Analysis (2004–2019)

Zahid

Hashem

Minhas

et al. 2022

JAHA

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Background Gestational diabetes (GD) is associated with increased risk of long‐term cardiovascular complications. However, data on acute peripartum cardiovascular complications are not well established. Hence, we aimed to investigate the association of GD with acute cardiovascular outcomes at the time of delivery admission. Methods and Results We used data from the National Inpatient Sample (2004–2019). International Classification of Diseases, Ninth Revision ( ICD‐9 ) or Tenth Revision ( ICD‐10 ) codes were used to identify delivery hospitalizations and GD diagnosis. A total of 63 115 002 weighted hospitalizations for deliveries were identified, of which 3.9% were among individuals with GD (n=2 435 301). The prevalence of both GD and obesity increased during the study period ( P trends<0.01). Individuals with GD versus those without GD had a higher prevalence of obesity, hypertension, and dyslipidemia. After adjustment for age, race or ethnicity, comorbidities, insurance, and income, GD remained independently associated with cardiovascular complications including preeclampsia (adjusted odds ratio [aOR], 1.97 [95% CI, 1.96–1.98]), peripartum cardiomyopathy (aOR, 1.15 [1.08–1.22]), acute kidney injury (aOR, 1.16 [1.11–1.21]), stroke (aOR, 1.15 [1.09–1.23]), and arrhythmias (aOR, 1.48 [1.46–1.50]), compared with no GD. Moreover, delivery hospitalizations among individuals with GD were associated with increased length (3 versus 2 days, P <0.01) and cost of hospitalization ($4909 versus $3682, P <0.01). Even in the absence of preeclampsia, GD was associated with elevated cardiovascular risk. Conclusions Individuals with GD had a higher risk of preeclampsia, peripartum cardiomyopathy, acute kidney injury, stroke, and arrhythmias during delivery hospitalizations. As rates of GD are increasing globally, efforts to improve preconception cardiometabolic health and prevent GD may represent important strategies to improve peripartum maternal outcomes and mitigate long‐term cardiovascular risk.

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Polycystic ovary syndrome: a “risk-enhancing” factor for cardiovascular disease

Cited by 63 publications

References 86 publications

Associations between endogenous sex hormone levels and adipokine levels in the Multi-Ethnic Study of Atherosclerosis

Associations between endogenous sex hormone levels and adipokine levels in the Multi-Ethnic Study of Atherosclerosis

The Complex Roles of Adipokines in Polycystic Ovary Syndrome and Endometriosis

Trends, Predictors, and Outcomes of Cardiovascular Complications at Delivery Associated With Gestational Diabetes: A National Inpatient Sample Analysis (2004–2019)

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