ASSESSMENT OF CARDIOVASCULAR RISK IN WOMEN WITH PCOS: A NARRATIVE REVIEW

Abstract

Polycystic ovarian syndrome (PCOS) is one of the commonest endocrinopathy of women of reproductive age globally. This clinical condition not only dysregulates the reproductive axis, but also a risk factor for hyperinsulinemia, insulin resistance, dyslipidaemia, T2DM. All these metabolic states aggravate the cardiovascular risk in women with PCOS. The aim of this review is to provide an overview of evidences of subclinical cardiovascular risk in PCOS women and synthesize the result. To attain this aim, the published research articles were reviewed using the databases PubMed, Google scholar and EMBASE employing key words PCOS, cardiovascular risk, arterial stiffness, endothelial function to obtain relevant information. Total 162 articles were searched and after applying eligibility criteria, 12 articles have been included for qualitative synthesis of the information. Most of the studies are cross-sectional, case-control study conducted on pre-, peri and menopausal, obese, lean women with PCOS. The study participants were mostly diagnosed on the basis of Rotterdam criteria. But, other criteria such as National Institutes of Health criteria (NIH), Androgen Excess Society criteria (AES) were also used to diagnose the condition. Mostly these studies recorded arterial stiffness as assessed by pulse wave velocity (PWV), augmentation index (AIx) and endothelial dysfunction as assessed by brachial artery ow mediated vasodilatation (FMD). The ndings of few cardinal systematic review and metaanalysis were also reported. These studies mainly analysed the data obtained for subclinical cardiovascular status of women with PCOS as assessed by carotid intima media thickness (cIMT), carotid artery calcium (CAC) score and FMD. Majority of the studies concluded that women with PCOS display enhanced arterial stiffness and endothelial dysfunction in comparison to age and BMI-matched healthy control group, though controversy exists is the literature. In this regard, the existing traditional cardiovascular risk factors in PCOS women, make them more prone to cardiovascular disease. It needs further prospective study with hard cardiovascular outcome to prove this point undoubtedly. It must be emphasized that regular cardiovascular screening might be advocated for this vulnerable population to prevent any major cardiovascular eventuality.