PCOS, which affects five to 10 percent of reproductive aged women, is closely linked with several serious health conditions such as diabetes, obesity, CVD and metabolic syndrome. Signs of PCOS include hirsutism (hair growth), menstrual irregularities and obesity. As rates of obesity increase around the world, doctors and researchers are taking a closer look at related conditions, such as PCOS, to better understand associated health risks. The May issue of JCEM contains two studies that help to establish the link between cardiovascular disease and PCOS.
In one study, Dr. Zeev Blumenfeld and researchers at Rambam Medical Center in Haifa, Israel, conducted a retrospective, cross-sectional study on 116 PCOS patients and 94 BMI-matched controls to determine whether levels of C-reactive protein (CRP)--a protein that is nonspecifically increased in inflammatory states and is an early indicator of CVD--are increased in PCOS patients. The researchers measured two forms of CRP in both groups as well as glucose, cholesterol and triglycerides. Tests indicated that 36.8 percent of PCOS patients had extremely high (above 5 mg/liter) levels of CRP compared to only 9.6 percent of control women (p< 0.001).
"Our study confirms preliminary research on the relationship between PCOS and cardiovascular disease," explained Dr. Blumenfeld, the senior author on the study. "These findings, when combined with previous research in this area, indicate that women with PCOS may be at risk for early-onset cardiovascular disease. Based on these findings, women who suffer from PCOS should be closely monitored for CVD risk factors."
In a related study, Dr. Saara Taponen and researchers at the University of Oulu, Finland and Imperial College, London used a symptom-based approach to investigate whether there is an association between CVD and type 2 diabetes risk factors and irregular menstruation and hirsutism--both symptoms of PCOS. The researchers examined whether women with the symptoms of PCOS would have different metabolic or inflammatory CVD risk factor profiles when compared with controls.
"While past studies have shown that menstrual irregularity, which is a sign of PCOS, may be a metabolic marker for CVD, solid evidence linking PCOS to CVD disease has been difficult to acquire because of the lack of a clear definition of PCOS and the varying clinical picture of the syndrome," explained Dr. Taponen, the study's first author.
Dr. Taponen and her colleagues studied 518 cases (women who reported symptoms of hirsutism or irregular menstruation) and 1036 controls who were followed from birth until the age of 31 as part of the Northern Finland Birth Cohort 1966. Results of several tests including blood pressure, cholesterol, CRP, insulin and body mass index (BMI) indicated that subjects with PCOS symptoms had higher levels of several CVD risk factors. The researchers concluded that self-reported symptoms of PCOS are a feasible screening tool for CVD among women. They also noted that in both groups, increases in BMI correlated with unfavorable changes in metabolic measurements for CVD.
"Obesity obviously is a central part of the development of metabolic abnormalities related to PCOS, perhaps due to genetic susceptibility or changes in intrauterine programming of the body functions," note the authors. "Based on our study, particularly obese women with PCOS symptoms seem to be at higher CVD risk."
JCEM is one of four journals published by The Endocrine Society. Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Endocrinologists are specially trained doctors who diagnose, treat and conduct basic and clinical research on complex hormonal disorders such as diabetes, thyroid disease, osteoporosis, obesity, hypertension, cholesterol and reproductive disorders. Today, The Endocrine Society's membership consists of over 11,000 scientists, physicians, educators, nurses and students, in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit the Society's web site at www.endo-society.org