Title:Cardiovascular Risk in the Different Phenotypes of Polycystic Ovary Syndrome
Volume: 22
Issue: 36
Author(s): Konstantinos Tziomalos
Affiliation:
Keywords:
Polycystic ovary syndrome, phenotypes, diagnostic criteria, anovulation, hyperandrogenemia, polycystic ovaries, cardiovascular
risk.
Abstract: Background: The polycystic ovary syndrome (PCOS) is the commonest endocrine
disorder in women of reproductive age and shows substantial phenotypic variability. According
to the presence of the three diagnostic criteria of PCOS, i.e. oligo- and/or anovulation,
hyperandrogenemia and/or clinical signs of high androgen levels, and polycystic ovaries,
four different phenotypes of PCOS are identified. It appears that these phenotypes differ in
the prevalence of several established and emerging cardiovascular risk factors. Methods: We
searched the literature for studies that compared the cardiovascular risk profile of patients
with the different phenotypes of PCOS. Results: Patients with both anovulation and hyperandrogenemia
have more pronounced insulin resistance and higher levels of proinflammatory
and prothrombotic mediators than patients with polycystic ovaries and either anovulation
or hyperandrogenemia. Conclusion: Given that these differences appear to be mainly
driven by the more pronounced obesity of the former patients, diet and exercise aiming at
weight loss should constitute the cornerstone of management of PCOS and should be particularly emphasized in
patients with the higher risk phenotypes of the syndrome.