title: Cardiovascular risk and subclinical cardiovascular disease in polycystic ovary syndrome.
abstract: In addition to its effects on reproductive health, it is now well recognized that polycystic ovary syndrome (PCOS) is a metabolic disorder, characterized by decreased insulin sensitivity which leads to an excess lifetime risk of type 2 diabetes and cardiovascular disease. PCOS patients are often obese, hypertensive, dyslipidemic and insulin resistant; they have obstructive sleep apnea and have been reported to have higher aldosterone levels in comparison to normal healthy controls. These are all components of an adverse cardiovascular risk profile. Many studies exploring subclinical atherosclerosis using different methods (flow-mediated dilatation, intima media thickness, arterial stiffness, coronary artery calcification) as well as assessing circulating cardiovascular risk markers, point toward an increased cardiovascular risk and early atherogenesis in PCOS. The risk and early features of subclinical atherosclerosis can be reversed by non-medical (normalization of weight, healthy lifestyle) and medical (metformin, thiazolidinediones, spironolactone, and statins) interventions. However, the long-term risk for cardiovascular morbidity and mortality as well as the clinical significance of different interventions still need to be properly addressed in a large prospective study.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors.forename: Katica
authors.initials: K
authors.lastname: Bajuk Studen
authors.forename: Mojca
authors.initials: M
authors.lastname: Jensterle Sever
authors.forename: Marija
authors.initials: M
authors.lastname: Pfeifer
mesh_terms: D000293:Adolescent; D000328:Adult; D000736:Androstenes / Q000627:therapeutic use; D050197:Atherosclerosis / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D054795:Incretins / Q000627:therapeutic use; D007333:Insulin Resistance; D008019:Life Style; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D017698:Postmenopause; D012084:Renin-Angiotensin System / Q000502:physiology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000628:therapy; D045162:Thiazolidinediones / Q000627:therapeutic use; D059289:Vascular Stiffness; D061217:Weight Reduction Programs
chemical_list: D000736:Androstenes; D054795:Incretins; D045162:Thiazolidinediones; D008687:Metformin; C035144:drospirenone