Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
J Clin Endocrinol Metab. 2010 May;95(5):2038-49. doi: 10.1210/jc.2009-2724. Epub 2010 Apr 7.
Women with polycystic ovary syndrome (PCOS) often have cardiovascular disease (CVD) risk factors. The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD.
An expert panel in PCOS and CVD reviewed literature and presented recommendations.
Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts, and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described, or methodology precluded evaluation. Inclusion/exclusion criteria were confirmed by at least two reviewers and arbitrated by a third.
Systematic reviews of CVD risk factors were compiled and submitted for approval to the AE-PCOS Society Board.
Women with PCOS with obesity, cigarette smoking, dyslipidemia, hypertension, impaired glucose tolerance, and subclinical vascular disease are at risk, whereas those with metabolic syndrome and/or type 2 diabetes mellitus are at high risk for CVD. Body mass index, waist circumference, serum lipid/glucose, and blood pressure determinations are recommended for all women with PCOS, as is oral glucose tolerance testing in those with obesity, advanced age, personal history of gestational diabetes, or family history of type 2 diabetes mellitus. Mood disorder assessment is suggested in all PCOS patients. Lifestyle management is recommended for primary CVD prevention, targeting low-density and non-high-density lipoprotein cholesterol and adding insulin-sensitizing and other drugs if dyslipidemia or other risk factors persist.
患有多囊卵巢综合征（PCOS）的女性通常存在心血管疾病（CVD）风险因素。雄激素过多和多囊卵巢综合征（AE-PCOS）学会成立了一个专家组，对评估 PCOS-CVD 风险关系的研究进行了循证综述，并制定了预防 CVD 的指南。
PCOS 和 CVD 方面的专家小组审查了文献并提出了建议。
仅纳入了比较 PCOS 与对照患者的研究。所有电子数据库均进行了搜索；综述包括了单独的研究/数据库、系统综述、摘要和专家数据。如果未排除其他高雄激素紊乱、PCOS 诊断不明确、未描述对照或方法学排除评估，则排除了这些文章。纳入/排除标准由至少两名评审员确认，并由第三名评审员仲裁。
对 CVD 风险因素的系统综述进行了汇编，并提交给 AE-PCOS 学会理事会批准。
患有肥胖症、吸烟、血脂异常、高血压、糖耐量受损和亚临床血管疾病的 PCOS 女性存在风险，而患有代谢综合征和/或 2 型糖尿病的女性则存在 CVD 高风险。建议对所有患有 PCOS 的女性进行体重指数、腰围、血清脂质/葡萄糖和血压测定，对肥胖、年龄较大、个人有妊娠糖尿病史或家族有 2 型糖尿病史的女性建议进行口服葡萄糖耐量试验。建议对所有 PCOS 患者进行情绪障碍评估。建议进行生活方式管理，以预防 CVD 为主要目标，针对低密度脂蛋白和非高密度脂蛋白胆固醇，如果血脂异常或其他危险因素持续存在，则添加胰岛素增敏剂和其他药物。
