Cardiovascular risk factors in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterised by menstrual irregularities and hyperandrogenism, affecting approximately 5% of premenopausal women. An association of PCOS with peripheral insulin resistance (IR) as the cause of its predisposition to develop a metabolic syndrome (MS) has been established. Therefore, early screening for metabolic parameters is of great importance regarding the prevention of cardiovascular diseases (CVD). In 259 PCOS women (age 27±5.9 years) cardiovascular risk factors were evaluated by physical examination, blood testing and a personal interview. MS was defined according to the NCEP ATP III criteria. The 10-year estimated CVD risk was determined by the Framingham score and projected to the age of 60. In PCOS patients 34.7% were smokers and 47% exercised frequently. Obesity was found in 49.6%, waist-circumference >88cm in 55.6%, IR in 58.8%, impaired glucose tolerance in 6.2%, type 2 diabetes mellitus (DM) in 3.5%, increased total cholesterol in 52.6%, LDL cholesterol ≥ 115mg/dl in 59.5%, low HDL in 48.3%, elevated triglycerides in 24.2% and an increased sensitive CRP in 46.4% of PCOS subjects. MS was present in 33.6% of PCOS patients. Family history of obesity was found in 71.1%, DM in 50.0%, apoplexy in 42.7%, peripheral vascular disease in 29.7% and coronary heart disease in 47.9% of affected women. The average calculated risk at the age of 60 to suffer an acute coronary event in the next ten years was 12.9%, provided that no additional risk factors develop. In conclusion, a third of our PCOS cohort fulfilled the ATP III criteria of MS before the age of 30. It is unclear whether the high incidence of cardiovascular risk factors also leads to greater expectation of morbidity and mortality.