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Polycystic ovary syndrome and cardiovascular disease risk

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Abstract

Women with polycystic ovary syndrome (PCOS), an endocrinopathy consisting of oligo-ovulation, excess androgen, and polycystic ovaries, commonly have an adverse cardiovascular risk profile. This profile is exacerbated by obesity, which is common among women with the syndrome, especially in the United States. Recent articles from cohort and case-control studies support an increased risk of cardiovascular disease events in postmenopausal women with PCOS, though the diagnosis of PCOS in menopause is problematic. Treatment of cardiovascular risk factors, including insulin resistance, lipids, and serum markers of atherosclerosis (most commonly C-reactive protein) is receiving increasing clinical focus. While weight loss with lifestyle therapy is a universal goal in obese women, the role of additional pharmaceutical treatment of metabolic risk factors such as hyperinsulinemia and dyslipidemia is uncertain.

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References and Recommended Reading

  1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004, 81:19–25.

    Google Scholar 

  2. Azziz R, Woods KS, Reyna R, et al.: The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004, 89:2745–2749.

    Article  PubMed  CAS  Google Scholar 

  3. 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 

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

    Article  PubMed  Google Scholar 

  5. Shaw LJ, Bairey Merz CN, Azziz R, et al.: Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health—National Heart, Lung, and Blood Institute sponsored Women’s Ischemia Syndrome Evaluation. J Clin Endocrinol Metab 2008, 93:1276–1284.

    Article  PubMed  CAS  Google Scholar 

  6. Krentz AJ, von Muhlen D, Barrett-Connor E: Searching for polycystic ovary syndrome in postmenopausal women: evidence of a dose-effect association with prevalent cardiovascular disease. Menopause 2007, 14:284–292.

    Article  PubMed  Google Scholar 

  7. Talbott EO, Zborowski J, Rager J, Stragand JR: Is there an independent effect of polycystic ovary syndrome (PCOS) and menopause on the prevalence of subclinical atherosclerosis in middle aged women? Vasc Health Risk Manag 2008, 4:453–462.

    PubMed  CAS  Google Scholar 

  8. Ibanez L, de Zegher F, Potau N: Anovulation after precocious pubarche: early markers and time course in adolescence. J Clin Endocrinol Metab 1999, 84:2691–2695.

    Article  PubMed  CAS  Google Scholar 

  9. Recabarren SE, Smith R, Rios R, et al.: Metabolic profile in sons of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2008, 93:1820–1826.

    Article  PubMed  CAS  Google Scholar 

  10. Battaglia C, Mancini F, Cianciosi A, et al.: Cardiovascular risk in normal weight, eumenorrheic, nonhirsute daughters of patients with polycystic ovary syndrome: a pilot study. Fertil Steril 2008 Aug 8 (Epub ahead of print).

  11. Kent SC, Gnatuk CL, Kunselman AR, et al.: Hyperan-drogenism and hyperinsulinism in children of women with polycystic ovary syndrome: a controlled study. J Clin Endocrinol Metab 2008, 93:1662–1669.

    Article  PubMed  CAS  Google Scholar 

  12. Lunde O, Tanbo T: Polycystic ovary syndrome: a follow-up study on diabetes mellitus, cardiovascular disease and malignancy 15–25 years after ovarian wedge resection. Gynecol Endocrinol 2007, 23:704–709.

    Article  PubMed  Google Scholar 

  13. 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 

  14. Luque-Ramirez M, Alvarez-Blasco F, Mendieta-Azcona C, et al.: Obesity is the major determinant of the abnormalities in blood pressure found in young women with the polycystic ovary syndrome. J Clin Endocrinol Metab 2007, 92:2141–2148.

    Article  PubMed  CAS  Google Scholar 

  15. Valkenburg O, Steegers-Theunissen RP, Smedts HP, et al.: A more atherogenic serum lipoprotein profile is present in women with polycystic ovary syndrome: a case-control study. J Clin Endocrinol Metab 2008, 93:470–476.

    Article  PubMed  CAS  Google Scholar 

  16. Brinkworth GD, Noakes M, Moran LJ, et al.: Flow-mediated dilatation in overweight and obese women with polycystic ovary syndrome. BJOG 2006, 113:1308–1314.

    Article  PubMed  CAS  Google Scholar 

  17. Sorensen MB, Franks S, Robertson C, et al.: Severe endothelial dysfunction in young women with polycystic ovary syndrome is only partially explained by known cardiovascular risk factors. Clin Endocrinol (Oxf) 2006, 65:655–659.

    Article  Google Scholar 

  18. Carmina E, Orio F, Palomba S, et al.: Endothelial dysfunction in PCOS: role of obesity and adipose hormones. Am J Med 2006, 119:356:e351–e356.

    Google Scholar 

  19. Shroff R, Kerchner A, Maifeld M, et al.: Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis. J Clin Endocrinol Metab 2007, 92:4609–4614.

    Article  PubMed  CAS  Google Scholar 

  20. Legro RS, Myers ER, Barnhart HX, et al.: The pregnancy in polycystic ovary syndrome study: baseline characteristics of the randomized cohort including racial effects. Fertil Steril 2006, 86:914–933.

    Article  PubMed  CAS  Google Scholar 

  21. 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 

  22. Thomson RL, Buckley JD, Noakes M, et al.: The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2008, 93:3373–3380.

    Article  PubMed  CAS  Google Scholar 

  23. Vigorito C, Giallauria F, Palomba S, et al.: Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2007, 92:1379–1384.

    Article  PubMed  CAS  Google Scholar 

  24. Lindholm A, Bixo M, Bjorn I, et al.: Effect of sibutramine on weight reduction in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Fertil Steril 2008, 89:1221–1228.

    Article  PubMed  CAS  Google Scholar 

  25. Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F, et al.: The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab 2005, 90:6364–6369.

    Article  PubMed  CAS  Google Scholar 

  26. Sjostrom L, Narbro K, Sjostrom CD, et al.: Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007, 357:741–752.

    Article  PubMed  Google Scholar 

  27. Legro RS, Barnhart HX, Schlaff WD, et al.: Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med 2007, 356:551–566.

    Article  PubMed  CAS  Google Scholar 

  28. Meyer C, McGrath BP, Teede HJ: Effects of medical therapy on insulin resistance and the cardiovascular system in polycystic ovary syndrome. Diabetes Care 2007, 30:471–478.

    Article  PubMed  CAS  Google Scholar 

  29. Glintborg D, Hojlund K, Andersen M, et al.: Soluble CD36 and risk markers of insulin resistance and atherosclerosis are elevated in polycystic ovary syndrome and significantly reduced during pioglitazone treatment. Diabetes Care 2008, 31:328–334.

    Article  PubMed  CAS  Google Scholar 

  30. Elkind-Hirsch K, Marrioneaux O, Bhushan M, et al.: Comparison of single and combined treatment with exenatide and metformin on menstrual cyclicity in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2008, 93:2670–2678.

    Article  PubMed  CAS  Google Scholar 

  31. Banaszewska B, Pawelczyk L, Spaczynski RZ, et al.: Effects of simvastatin and oral contraceptive agent on polycystic ovary syndrome: prospective, randomized, crossover trial. J Clin Endocrinol Metab 2007, 92:456–461.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics/Gynecology, Milton S. Hershey Medical Center, PO Box 850, 500 University Drive, Hershey, PA, 17033, USA

    Richard S. Legro

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  1. Richard S. Legro
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Correspondence to Richard S. Legro.

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Legro, R.S. Polycystic ovary syndrome and cardiovascular disease risk. Curr Cardio Risk Rep 3, 65–70 (2009). https://doi.org/10.1007/s12170-009-0011-1

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  • DOI: https://doi.org/10.1007/s12170-009-0011-1

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