Predictors of Subclinical Cardiovascular Disease in Women with Polycystic Ovary Syndrome: Interrelationship of Dyslipidemia and Arterial Blood Pressure

Abstract

Background. Women with polycystic ovary syndrome (PCOS) could develop subclinical atherosclerosis during life. Purpose. To analyze cardiovascular risk (CVR) factors and their relation to clinical markers of cardiovascular disease (CVD) in respect to their age. Material and Methods. One hundred women with PCOS (26.32 ± 5.26 years, BMI: 24.98 ± 6.38 kg/m2) were compared to 50 respective controls. In all subjects, total cholesterol (TC), HDL-C, LDL-C, triglycerides, TC/HDL-C and TG/HDL-C ratios, glucose, insulin and HOMA index, waist-to-hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP, resp.), and carotid intima-media thickness (CIMT) were analyzed in respect to their age and level of androgens. Results. PCOS over 30 years had higher WHR (P = 0.008), SBP (P < 0.001), DBP (P < 0.001), TC (P = 0.028), HDL-C (P = 0.028), LDL-C (P = 0.045), triglycerides (P < 0.001), TC/HDL-C (P < 0.001), and triglycerides/HDL-C (P < 0.001) and had more prevalent hypertension and pronounced CIMT on common carotid arteries even after adjustment for BMI (P = 0.005 and 0.036, resp.). TC/HDL-C and TG/HDL-C were higher in PCOS with the highest quintile of FAI in comparison to those with lower FAI (P = 0.045 and 0.034, resp.). Conclusions. PCOS women older than 30 years irrespective of BMI have the potential for early atherosclerosis mirrored through the elevated lipids/lipid ratios and through changes in blood pressure.

Carotid Intima-Media Thickness Is Associated with Increased Androgens in Adolescents and Young Adults with Classical Congenital Adrenal Hyperplasia

“…It is well-established that men have earlier CVD manifestations than women in middle to late adulthood [22], but studies in men have failed to find a definitive link between higher androgen levels and CVD risk [23], with the exception of illicit androgen use for appearance/performance enhancement [24]. However, multiple associations exist between androgen excess and the development of an atherogenic lipid profile in hyperandrogenic women [25,26,27], as well as insulin resistance in adolescent girls and women [28,29]. In post-menopausal women, the risk of hypertension correlates positively with free testosterone and DHEAS, and inversely with SHBG [30].…”

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

“…51,52 Interestingly, publications regarding elevated levels of inflammatory markers 53,54 and high frequency of subclinical vascular disease in PCOS have increasingly been published in the last years. [55][56][57][58][59][60] In spite of the fact that already in the 90s, it was hypothesized that PCOS patients would have increased prevalence of CV morbidity and mortality 61 ; an increased risk of CVD is still debated. In the 21st century, authors still emphasized that long-lasting metabolic dysfunction in women with PCOS could exaggerate CVD risk and probably lead to an increase in CV events with age, especially after menopause.…”

The effect of metformin on clinical features of women with polycystic ovary syndrome

“…Prevalencija IR u PCOS iznosi oko 85% (75% kod normalno uhranjenih i 95% kod gojaznih) (5). Insulinska rezistencija povećava rizik za nastanak metaboličkih komplikacija kao što su T2DM, hiperlipidemija, hipertenzija i masna jetra (6,7,8). Ovaj poremećaj potencira i hiperandrogenemiju u PCOS indukcijom proizvodnje androgenih hormona u teka ćelijama jajnika (9) i smanjuje sintezu globulina koji vezuje polne hormone (engl.…”