Recent advances in cardiovascular aspects of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) has been associated with increased cardiovascular risk (CVR) markers, but population studies have not clarified whether there is an increase in cardiovascular morbidity and mortality. Four different PCOS phenotypes resulted from the Rotterdam criteria that may differ...

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Veröffentlicht in:European journal of endocrinology 2012-04, Vol.166 (4), p.575-583
Hauptverfasser: SATHYAPALAN, T, ATKIN, S. L
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ATKIN, S. L
description Polycystic ovary syndrome (PCOS) has been associated with increased cardiovascular risk (CVR) markers, but population studies have not clarified whether there is an increase in cardiovascular morbidity and mortality. Four different PCOS phenotypes resulted from the Rotterdam criteria that may differ in their CVR potential, thus introducing further complexity. This has led to studies using surrogate CVR markers including biomarkers in blood and imaging such as flow-mediated vasodilatation. In PCOS, both peripheral and central insulin resistance (IR) have been shown. Weight loss has been shown to improve IR and visceral fat, while insulin sensitizer therapies with metformin or thiazolidinediones improve IR and endothelial dysfunction. IR is also found in non-alcoholic fatty liver disease that in turn is very common in PCOS; studies have suggested that IR may be improved by treatment with metformin and omega-3 fish oils. PCOS patients have a more dyslipidemic phenotype that is worse in 'classical PCOS' associated with a higher CVR. Studies with atorvastatin and simvastatin have reported a decrease in the lipid parameters and an improvement in CVR indices including IR, but it is unclear whether this is due to their lipid-lowering action or a pleiotropic effect of the statin. In this expert opinion review, the relevant literature published during the last 2 years was considered. It focuses on some recent important data that has emerged while also exposing the gaps that remain in our knowledge that need to be addressed.
doi_str_mv 10.1530/EJE-11-0755
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source MEDLINE; Oxford University Press Journals All Titles (1996-Current)
subjects Biological and medical sciences
Biomarkers - blood
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - etiology
Cardiovascular Diseases - physiopathology
Cardiovascular System - physiopathology
Cohort Studies
Diagnostic Imaging - methods
Endocrinology - trends
Endocrinopathies
Female
Female genital diseases
Fundamental and applied biological sciences. Psychology
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Non tumoral diseases
Phenotype
Polycystic Ovary Syndrome - blood
Polycystic Ovary Syndrome - complications
Polycystic Ovary Syndrome - physiopathology
Risk Factors
Vertebrates: endocrinology
title Recent advances in cardiovascular aspects of polycystic ovary syndrome
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