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The Cardiovascular Risk of Young Women with Polycystic Ovary Syndrome: An Observational, Analytical, Prospective Case-Control Study

Department of Molecular and Clinical Endocrinology and Oncology (F.O., T.C., L.T., G.L., A.C.) and Internal Medicine (L.S.), University Federico II, 80131 Naples, Italy; and Department of Obstetrics and Gynecology, University of Catanzaro (S.P., F.Z.), 88100 Catanzaro, Italy

Address all correspondence and requests for reprints to: Dr. Francesco Orio, Department of Molecular and Clinical Endocrinology and Oncology, University Federico II, Via S. Pansini 5, 80131 Naples, Italy. E-mail: francescoorio{at}virgilio.it.

To evaluate the cardiovascular risk of polycystic ovary syndrome (PCOS), we investigated lipid profile, metabolic pattern, and echocardiography in 30 young women with PCOS and 30 healthy age- and body mass index (BMI)-matched women. PCOS women had higher fasting glucose and insulin levels, homeostasis model assessment score of insulin sensitivity, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels, and TC/high density lipoprotein cholesterol (HDL-C) ratio and lower HDL-C levels than controls. Additionally, PCOS women had higher left atrium size (32.0 ± 4.9 vs. 27.4 ± 2.1 mm; P < 0.0001) and left ventricular mass index (80.5 ± 18.1 vs. 56.1 ± 5.4 g/m²; P < 0.0001) and lower left ventricular ejection fraction (64.4 ± 4.1 vs. 67.1 ± 2.6%; P = 0.003) and early to late mitral flow velocity ratio (1.6 ± 0.4 vs. 2.1 ± 0.2; P < 0.0001) than controls. When patients and controls were grouped according to BMI [normal weight (BMI, >18 and <25 kg/m²), overweight (BMI, 25.1–30 kg/m²), and obese (BMI, >30 kg/m²)], the differences between PCOS women and controls were maintained in overweight and obese women. In normal weight PCOS women, a significant increase in left ventricular mass index and a decrease in diastolic filling were observed, notwithstanding no change in TC, LDL-C, HDL-C, TC/HDL-C ratio, and TG compared with controls. In conclusion, our data show the detrimental effect of PCOS on the cardiovascular system even in young women asymptomatic for cardiac disease.

We are grateful to Dr. Francesco Manguso (Department of Clinical and Experimental Medicine, Gastroenterology Unit, "Federico II" University, Naples, Italy) for his invaluable assistance in statistical analysis.

Abbreviations: BMI, Body mass index; CV, cardiovascular; CVD, CV disease; DBP, diastolic blood pressure; E/A, maximal early diastolic flow velocity/maximal late diastolic flow velocity ratio; EDV, end-diastolic volume; ESV, end-systolic volume; FAI, free androgen index; HDL-C, high density lipoprotein cholesterol; HOMA, homeostasis model assessment; LDL-C, low density lipoprotein cholesterol; LV, left ventricular; LVEF, LV ejection fraction; LVH, LV hypertrophy; LVM, LV mass; LVMi, LV mass index; PCOS, polycystic ovary syndrome; PRL, prolactin; SBP, systolic blood pressure; TC, total cholesterol; TG, triglycerides.

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