Cardiometabolic Risk, Peripheral Arterial Disease and Cardiovascular Events in Polycystic Ovary Syndrome: Time to Implement Systematic Screening and Update the Management.
Andrej JanezRok HermanPavel PoredosDimitri P MikhailidisAles BlincMiso SabovicKatica Bajuk StudenMateja Kaja JezovnikGerit-Holger SchernthanerPanagiotis AnagnostisPier Luigi AntignaniMojca JensterlePublished in: Current vascular pharmacology (2023)
Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder in women of reproductive age. It presents with gynaecologic, metabolic, and psychologic manifestations. The dominant drivers of pathophysiology are hyperandrogenism and insulin resistance. Both conditions are related to cardiometabolic risk factors, such as obesity, hypertension, dyslipidaemia, hyperglycaemia, type 2 and gestational diabetes, nonalcoholic fatty liver disease and obstructive sleep apnoea. Women with PCOS of reproductive age consistently demonstrated an elevated risk of subclinical atherosclerosis, as indicated by different measurement methods, while findings for menopausal age groups exhibited mixed results. Translation of subclinical atherosclerosis into the increased incidence of peripheral arterial disease and major cardiovascular (CV) events is less clear. Although several expert groups have advised screening, the CV risk assessment and prevention of CV events are frequently underdiagnosed and overlooked aspects of the management of PCOS. A combination of lifestyle management and pharmacotherapy, including the promising new era of anti-obesity medicine, can lead to improvements in cardiometabolic health.
Keyphrases
- polycystic ovary syndrome
- insulin resistance
- metabolic syndrome
- cardiovascular events
- adipose tissue
- risk factors
- high fat diet
- skeletal muscle
- high fat diet induced
- cardiovascular disease
- type diabetes
- risk assessment
- weight loss
- coronary artery disease
- healthcare
- blood pressure
- mental health
- pregnant women
- glycemic control
- obstructive sleep apnea
- heavy metals
- pregnancy outcomes
- positive airway pressure