Dokras Anuja
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa, USA.
Semin Reprod Med. 2008 Jan;26(1):39-44. doi: 10.1055/s-2007-992923.
Polycystic ovary syndrome (PCOS) is a common endocrinopathy associated with an increasing number of cardiovascular comorbidities. The relationship between insulin resistance and PCOS was described more than 3 decades ago. Women with PCOS also have an increased prevalence of several established cardiovascular risk factors such as diabetes, hypertension, and dyslipidemia. These factors contribute to the increased risk of endothelial dysfunction, increased carotid artery intima media thickness, and coronary artery calcification noted in women with PCOS compared with controls. Although truncal obesity is very prevalent in PCOS, these surrogate markers of atherosclerosis have been shown to be independent of body weight in young, asymptomatic subjects. Metabolic syndrome is a cluster of risk factors that also confer an increased risk of cardiovascular disease. Women with PCOS have also been shown to have a significantly higher prevalence of metabolic syndrome compared with age-matched controls. Currently, there are no longitudinal studies confirming increased cardiovascular morbidity and/or mortality in women with PCOS. However, the early presence of traditional and other cardiovascular risk factors underscores the need to screen and aggressively counsel and treat these women to prevent future symptomatic cardiovascular disease.
多囊卵巢综合征(PCOS)是一种常见的内分泌疾病,与越来越多的心血管合并症相关。胰岛素抵抗与PCOS之间的关系在30多年前就已被描述。患有PCOS的女性患几种已确定的心血管危险因素(如糖尿病、高血压和血脂异常)的患病率也有所增加。与对照组相比,这些因素导致PCOS女性出现内皮功能障碍、颈动脉内膜中层厚度增加和冠状动脉钙化的风险增加。尽管腹部肥胖在PCOS中非常普遍,但在年轻无症状的受试者中,这些动脉粥样硬化的替代标志物已被证明与体重无关。代谢综合征是一组危险因素,也会增加心血管疾病的风险。与年龄匹配的对照组相比,患有PCOS的女性代谢综合征的患病率也显著更高。目前,尚无纵向研究证实PCOS女性的心血管发病率和/或死亡率增加。然而,传统和其他心血管危险因素的早期存在凸显了对这些女性进行筛查、积极咨询和治疗以预防未来有症状心血管疾病的必要性。