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Cardiometabolic features of polycystic ovary syndrome

Nature Clinical Practice Endocrinology & Metabolism volume 4, pages 215–222 (2008)Cite this article

Abstract

Polycystic ovary syndrome (PCOS) is a complex disorder comprising both hormonal and metabolic abnormalities that include impaired glucose tolerance, type 2 diabetes, vascular disease, dyslipidemia, and obstructive sleep apnea. Insulin resistance is a central pathogenetic factor in PCOS that seems to result from a post-receptor-binding defect in insulin action. Insulin resistance and the consequent development of hyperinsulinemia contribute to the constellation of cardiometabolic abnormalities noted above. Although there is a paucity of data in regard to cardiovascular event rates and mortality in PCOS, an increased prevalence of cardiovascular risk factors has been well documented. Attention to the metabolic risks associated with PCOS, starting as early as adolescence, is essential to the medical care of these patients.

Key Points

  • Metabolic abnormalities including impaired glucose tolerance, type 2 diabetes, dyslipidemia, and obstructive sleep apnea are common in women with polycystic ovary syndrome (PCOS)

  • Insulin resistance and compensatory hyperinsulinemia contribute to both metabolic derangements and hyperandrogenemia in PCOS

  • Markers of early cardiovascular disease, such as impaired vascular-flow-mediated dilation, coronary artery calcification, and echocardiocardiographic changes, are evident in patients with PCOS at a young age (under 40 years)

  • A hereditary basis for many of these cardiometabolic abnormalities has been documented

  • Treatment of women with PCOS should address both hormonal and metabolic abnormalities

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  1. Department of Medicine, LK Hoffman is a Fellow, and DA Ehrmann is a Professor of Medicine, in the Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, IL, USA.,

    Leslie K Hoffman & David A Ehrmann

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Correspondence to David A Ehrmann.

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DA Ehrmann is a Consultant for Takeda Pharmaceuticals. LK Hoffman declared no competing interests.

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Hoffman, L., Ehrmann, D. Cardiometabolic features of polycystic ovary syndrome. Nat Rev Endocrinol 4, 215–222 (2008). https://doi.org/10.1038/ncpendmet0755

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