title: Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome.
abstract: BACKGROUND
  The relation between polycystic ovary syndrome (PCOS) and cardiovascular disease (CVD) remains unclear. In an attempt to provide high-quality evidence on the relation between PCOS and CVD, relevant literature for CVD risk markers [C-reactive protein (CRP), homocysteine (Hcy), tumor necrosis factor-alpha (TNF-α), plasminogen activator inhibitor-1 (PAI-1), lipoprotein (a) [Lp(a)], advanced glycation end-products (AGEs), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), asymmetric dimethylarginine (ADMA), endothelin-1 (ET-1) and fibrinogen] in women with PCOS was reviewed and analyzed.
  
  
  METHODS
  A systematic search was conducted electronically using specific eligibility criteria. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated and combined appropriately. To ensure synthesis of the best available evidence, sensitivity analyses were performed. RESULTS A total of 130 data sets were included in 11 different outcomes, involving 7174 and 5076 CVD markers in women with PCOS and controls, respectively. Women with PCOS demonstrated significantly elevated CRP [WMD (95% CI) 0.99 (0.77-1.21)], Hcy [2.25 (1.46-3.03)], PAI-1 antigen [16.96 (7.25-26.28)], PAI-1 activity [0.71 (0.18-1.23)], VEGF [1.72 (0.96-2.48)], ADMA [0.19 (0.08-0.3)], AGEs [3.91 (2.36-5.45)] and Lp(a) [0.81 (0.58-1.04)] concentrations compared with controls, yet with significant between-study heterogeneity. Borderline significance (not robust in the sensitivity analyses) was detected for TNF-α [0.75 (0.07-1.44)], ET-1 [1.06 (0.52-1.59)] and fibrinogen [0.20 (0.01-0.39)], whereas no difference was detected for IL-6 [0.71 (-0.16 to 1.59)]. CONCLUSIONS Women with PCOS have increased serum concentrations of CVD risk markers compared with controls. Whether this apparent risk is translated into increased incidence of CVD in later life remains to be elucidated.
authors.affiliation: Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Ring Road, 56403 Nea Efkapria, Thessaloniki, Greece.
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Toulis
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Goulis
authors.forename: Gesthimani
authors.initials: G
authors.lastname: Mintziori
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kintiraki
authors.forename: Evangelos
authors.initials: E
authors.lastname: Eukarpidis
authors.forename: Sophia-Anastasia
authors.initials: SA
authors.lastname: Mouratoglou
authors.forename: Antigoni
authors.initials: A
authors.lastname: Pavlaki
authors.forename: Stavros
authors.initials: S
authors.lastname: Stergianos
authors.forename: Maria
authors.initials: M
authors.lastname: Poulasouchidou
authors.forename: Thrasivoulos G
authors.initials: TG
authors.lastname: Tzellos
authors.forename: Anastasios
authors.initials: A
authors.lastname: Makedos
authors.forename: Michael
authors.initials: M
authors.lastname: Chourdakis
authors.forename: Basil C
authors.initials: BC
authors.lastname: Tarlatzis
mesh_terms: D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D015415:Biomarkers; D019332:Endothelin-1; D017127:Glycation End Products, Advanced; C508600:IL6 protein, human; D015850:Interleukin-6; D017270:Lipoprotein(a); D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D014409:Tumor Necrosis Factor-alpha; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D006710:Homocysteine; C018524:N,N-dimethylarginine; D005340:Fibrinogen; D002097:C-Reactive Protein; D001120:Arginine