Vascular abnormalities and low-grade chronic inflammation in women with polycystic ovary syndrome: Relationships with insulin resistance, obesity and hyperandrogenemia

Abstract

Polycystic ovary syndrome (PCOS) is possibly the most common endocrinopathy of reproductive age, characterized by hyperandrogenism
and oligomenorrhea. Additionally, approximately one-third to one-half of all women and adolescent girls with PCOS tend to
fulfill many of the metabolic syndrome criteria, and many view PCOS as a premetabolic syndrome condition, predisposing to
a high risk for cardiovascular disease. Endothelial dysfunction, impaired arterial structure, or proinflammatory markers are
early features of atherosclerosis, and can be used as surrogate indicators of future coronary artery disease in women with
PCOS. However, as the latest studies show, these symptoms are the result of deleterious effects that cardiovascular risk factors,
in particular insulin resistance and obesity, produce on the vascular wall, rather than to the presence of PCOS per se. The
relationship between hyperandrogenemia and the risk of cardiovascular disease is controversial and needs to be clarified.
Further research is warranted to understand the pathogenesis of cardiovascular disease in PCOS, and to identify subtypes of
PCOS in which the presence of cardiovascular risk factors may result in increased cardiovascular events, leading to high morbidity
or mortality rates caused by cardiovascular disease.