Skip to main content
SpringerLink
Log in

Metabolic syndrome and cardiometabolic risk in PCOS

  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

The cardiovascular risk associated with the polycystic ovary syndrome (PCOS) has recently attracted much interest. Women with PCOS are more likely to fulfill the diagnosis of the metabolic syndrome, a cluster of related cardiometabolic factors known to predict long-term risk of cardiovascular disease and type 2 diabetes. We review the literature pertaining to the link between the metabolic syndrome, cardiovascular disease, and PCOS. We focus on the influence of obesity and hyperandrogenemia, and on strategies for identifying cardiovascular risk in PCOS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Alberti K, Zimmet P: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998, 15:539–553.

    Article  PubMed  CAS  Google Scholar 

  2. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) [no authors listed]. JAMA 2001, 285:2486–2497.

  3. Alberti KG, Zimmet P, Shaw J: Metabolic syndrome-a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006, 23:469–480.

    Article  PubMed  CAS  Google Scholar 

  4. Dokras A, Bochner M, Hollinrake E, et al.: Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005, 106:131–137.

    PubMed  Google Scholar 

  5. Faloia E, Canibus P, Gatti C, et al.: Body composition, fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome. J Endocrinol Invest 2004, 27:424–429.

    PubMed  CAS  Google Scholar 

  6. Vrbikova J, Vondra K, Cibula D, et al.: Metabolic syndrome in young Czech women with polycystic ovary syndrome. Hum Reprod 2005, 20:3328–3332.

    Article  PubMed  CAS  Google Scholar 

  7. Vural B, Caliskan E, Turkoz E, et al.: Evaluation of metabolic syndrome frequency and premature carotid atherosclerosis in young women with polycystic ovary syndrome. Hum Reprod 2005, 20:2409–2413.

    Article  PubMed  Google Scholar 

  8. Talbott EO, Zborowski JV, Rager JR, et al.: Evidence for an association between metabolic cardiovascular syndrome and coronary and aortic calcification among women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89:5454–5461.

    Article  PubMed  CAS  Google Scholar 

  9. Apridonidze T, Essah PA, Iuorno MJ, et al.: Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005, 90:1929–1935.

    Article  PubMed  CAS  Google Scholar 

  10. Azziz R: How prevalent is metabolic syndrome in women with polycystic ovary syndrome? Nat Clin Pract Endocrinol Metab 2006, 3:132–133.

    Article  Google Scholar 

  11. Ehrmann DA, Liljenquist DR, Kasza K, et al.: Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006, 91:48–53.

    Article  PubMed  CAS  Google Scholar 

  12. Dunaif A: Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997, 18:774–800.

    Article  PubMed  CAS  Google Scholar 

  13. Talbott E, Guzick D, Clerici A, et al.: Coronary heart disease risk factors in women with polycystic ovary syndrome. Arterioscler Thromb Vasc Biol 1995, 15:821–826.

    PubMed  CAS  Google Scholar 

  14. Norman RJ, Masters L, Milner CR, et al.: Relative risk of conversion from normoglycaemia to impaired glucose tolerance or non-insulin dependent diabetes mellitus in polycystic ovarian syndrome. Hum Reprod 2001, 16:1995–1998.

    Article  PubMed  CAS  Google Scholar 

  15. Barber TM, McCarthy MI, Wass JA, et al.: Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2006, 65:137–145.

    Article  CAS  Google Scholar 

  16. Legro RS: Polycystic ovary syndrome and cardiovascular disease: a premature association? Endocr Rev 2003, 24:302–312.

    Article  PubMed  Google Scholar 

  17. Velazquez ME, Bellabarba GA, Mendoza S, et al.: Postprandial triglyceride response in patients with polycystic ovary syndrome: relationship with waist-to-hip ratio and insulin. Fertil Steril 2000, 74:1159–1163.

    Article  CAS  Google Scholar 

  18. Okamoto Y, Kihara S, Funahashi T, et al.: Adiponectin: a key adipocytokine in metabolic syndrome. Clin Sci (Lond) 2006, 110:267–278.

    Article  CAS  Google Scholar 

  19. Orio F Jr, Palomba S, Cascella T, et al.: Adiponectin levels in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003, 88:2619–2623.

    Article  PubMed  CAS  Google Scholar 

  20. Boulman N, Levy Y, Leiba R, et al.: Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab 2004, 89:2160–2165.

    Article  PubMed  CAS  Google Scholar 

  21. Orio F Jr, Palomba S, Cascella T, et al.: The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol Metab 2005, 90:2–5.

    Article  PubMed  CAS  Google Scholar 

  22. Sampson M, Kong C, Patel A, et al.: Ambulatory blood pressure profiles and plasminogen activator inhibitor (PAI-1) activity in lean women with and without the polycystic ovary syndrome. Clin Endocrinol (Oxf) 1996, 45:623–629.

    Article  CAS  Google Scholar 

  23. Dahlgren E, Janson PO, Johansson S, et al.: Hemostatic and metabolic variables in women with polycystic ovary syndrome. Fertil Steril 1994, 61:455–460.

    PubMed  CAS  Google Scholar 

  24. Diamanti-Kandarakis E, Spina G, Kouli C, et al.: Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J Clin Endocrinol Metab 2001, 86:4666–4673.

    Article  PubMed  CAS  Google Scholar 

  25. Sabuncu T, Vural H, Harma M, et al.: Oxidative stress in polycystic ovary syndrome and its contribution to the risk of cardiovascular disease. Clin Biochem 2001, 34:407–413.

    Article  PubMed  CAS  Google Scholar 

  26. Orio F Jr, Giallauria F, Palomba S, et al.: Cardiopulmonary impairment in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006, 91:2967–2971.

    Article  PubMed  CAS  Google Scholar 

  27. Vgontzas AN, Legro RS, Bixler EO, et al.: Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 2001, 86:517–520.

    Article  PubMed  CAS  Google Scholar 

  28. Kelly CJ, Speirs A, Gould GW, et al.: Altered vascular function in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002, 87:742–746.

    Article  PubMed  CAS  Google Scholar 

  29. Cussons AJ, Stuckey BG, Watts GF: Cardiovascular disease in the polycystic ovary syndrome: new insights and perspectives. Atherosclerosis 2006, 185:227–239.

    Article  PubMed  CAS  Google Scholar 

  30. Orio FJ, Palomba S, Spinelli L, et al.: The cardiovascular risk of young women with polycystic ovary syndrome: an observational, analytical, prospective case-control study. J Clin Endocrinol Metab 2004, 89:3694–3695.

    Article  CAS  Google Scholar 

  31. Burghen GA, Givens JR, Kitabchi AE: Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab 1980, 50:113–116.

    Article  PubMed  CAS  Google Scholar 

  32. Wu FC, von Eckardstein A: Androgens and coronary artery disease. Endocr Rev 2003, 24:183–217.

    Article  PubMed  CAS  Google Scholar 

  33. Dahlgren E, Janson PO, Johansson S, et al.: Polycystic ovary syndrome and risk for myocardial infarction. Evaluated from a risk factor model based on a prospective population study of women. Acta Obstet Gynecol Scand 1992, 71:599–604.

    PubMed  CAS  Google Scholar 

  34. Wild S, Pierpoint T, McKeigue P, et al.: Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000, 52:595–600.

    Article  CAS  Google Scholar 

  35. Solomon CG, Hu FB, Dunaif A, et al.: Menstrual cycle irregularity and risk for future cardiovascular disease. J Clin Endocrinol Metab 2002, 87:2013–2017.

    Article  PubMed  CAS  Google Scholar 

  36. Talbott EO, Guzick DS, Sutton-Tyrrell K, et al.: Evidence for association between polycystic ovary syndrome and premature carotid atherosclerosis in middle-aged women. Arterioscler Thromb Vasc Biol 2000, 20:2414–2421.

    PubMed  CAS  Google Scholar 

  37. Orio F Jr, Palomba S, Cascella T, et al.: Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89:4588–4593.

    Article  PubMed  CAS  Google Scholar 

  38. Meyer C, McGrath BP, Cameron J, et al.: Vascular dysfunction and metabolic parameters in polycystic ovary syndrome. J Clin Endocrinol Metab 2005, 90:4630–4635.

    Article  PubMed  CAS  Google Scholar 

  39. Grundy SM: Drug therapy of the metabolic syndrome: minimizing the emerging crisis in polypharmacy. Nat Rev Drug Discov 2006, 5:295–309.

    Article  PubMed  CAS  Google Scholar 

  40. Huber-Buchholz MM, Carey DG, Norman RJ: Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab 1999, 84:1470–1474.

    Article  PubMed  CAS  Google Scholar 

  41. Knowler WC, Barrett-Connor E, Fowler SE, et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403.

    Article  PubMed  CAS  Google Scholar 

  42. Glueck CJ, Papanna R, Wang P, et al.: Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome. Metabolism 2003, 52:908–915.

    Article  PubMed  CAS  Google Scholar 

  43. Orio F Jr, Palomba S, Cascella T, et al.: Improvement in endothelial structure and function after metformin treatment in young normal-weight women with polycystic ovary syndrome: results of a 6-month study. J Clin Endocrinol Metab 2005, 90:6072–6076.

    Article  PubMed  CAS  Google Scholar 

  44. Topcu S, Tok D, Caliskan M, et al.: Metformin therapy improves coronary microvascular function in patients with polycystic ovary syndrome and insulin resistance. Clin Endocrinol (Oxf) 2006, 65:75–80.

    Article  CAS  Google Scholar 

  45. Brettenthaler N, De Geyter C, Huber PR, et al.: Effect of the insulin sensitizer pioglitazone on insulin resistance, hyperandrogenism, and ovulatory dysfunction in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89:3835–3840.

    Article  PubMed  CAS  Google Scholar 

  46. Paradisi G, Steinberg HO, Shepard MK, et al.: Troglitazone therapy improves endothelial function to near normal levels in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003, 88:576–580.

    Article  PubMed  CAS  Google Scholar 

  47. Xiang AH, Peters RK, Kjos SL, et al.: Effect of pioglitazone on pancreatic beta-cell function and diabetes risk in Hispanic women with prior gestational diabetes. Diabetes 2006, 55:517–522.

    Article  PubMed  CAS  Google Scholar 

  48. Graff-Iversen S, Hammar N, Thelle DS, et al.: Use of oral contraceptives and mortality during 14 years’ follow-up of Norwegian women. Scand J Public Health 2006, 34:11–16.

    Article  PubMed  Google Scholar 

  49. Diamanti-Kandarakis E, Baillageon JP, Iuorno MJ, et al.: A modern medical quandary: polycystic ovary syndrome, insulin resistance, and oral contraceptive pills. J Clin Endocrinol Metab 2003, 88:1927–1932.

    Article  PubMed  CAS  Google Scholar 

  50. Macdonald JE, Kennedy N, Struthers AD: Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment. Heart 2004, 90:765–770.

    Article  PubMed  CAS  Google Scholar 

  51. Daviglus ML, Stamler J, Pirzada A, et al.: Favorable cardiovascular risk profile in young women and long-term risk of cardiovascular and all-cause mortality. JAMA 2004, 292:1588–1592.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine and Pharmacology, University of Western Australia, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia, Australia, 6847

    Gerald F. Watts DSc, MD, PhD, FRACP

Authors
  1. Andrea J. Cussons MB, FRACP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bronwyn G. A. Stuckey MB, FRACP
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gerald F. Watts DSc, MD, PhD, FRACP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gerald F. Watts DSc, MD, PhD, FRACP.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cussons, A.J., Stuckey, B.G.A. & Watts, G.F. Metabolic syndrome and cardiometabolic risk in PCOS. Curr Diab Rep 7, 66–73 (2007). https://doi.org/10.1007/s11892-007-0012-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11892-007-0012-8

Keywords

Search

Navigation