Title:Cardiometabolic Risk, Peripheral Arterial Disease and Cardiovascular
Events in Polycystic Ovary Syndrome: Time to Implement Systematic
Screening and Update the Management
Volume: 21
Issue: 6
Author(s): Andrej Janez, Rok Herman, Pavel Poredos, Dimitri P. Mikhailidis, Ales Blinc, Miso Sabovic, Katica Bajuk Studen, Mateja Kaja Jezovnik, Gerit-Holger Schernthaner, Panagiotis Anagnostis, Pier Luigi Antignani and Mojca Jensterle*
Affiliation:
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana,
Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Keywords:
Polycystic ovary syndrome, atherosclerosis, peripheral arterial disease, cardiovascular risk, cardiovascular events, cardiometabolic risk.
Abstract: 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.
