Department of Gynecology and Reproductive Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Hum Reprod Update. 2011 Jul-Aug;17(4):495-500. doi: 10.1093/humupd/dmr001. Epub 2011 Feb 18.
Patients with polycystic ovary syndrome (PCOS) are at risk of arterial disease. We examined the risk of (non)fatal coronary heart disease (CHD) or stroke in patients with PCOS and ovulatory women without PCOS, and assessed whether obesity might explain a higher risk of CHD or stroke.
We performed a systematic review and meta-analysis of controlled observational studies. Four definitions of PCOS were considered: World Health Organization type II anovulation, National Institutes of Health criteria, Rotterdam consensus and Androgen-excess criteria. Obesity was defined as BMI > 30 kg/m(2) and/or waist circumference >88 cm. Study quality was assessed using the Newcastle-Ottawa Scale. Primary outcome was fatal/non-fatal CHD or stroke. Definitions of CHD and stroke were based on criteria used by the various authors. The effect measure was the pooled relative risk in a random effects model. Risk ratios and rate ratios were combined here.
After identifying 1340 articles, 5 follow-up studies published between 2000 and 2008 were included. The studies showed heterogeneity in design, definitions and quality. In a random effects model the relative risk for CHD or stroke were 2.02 comparing women with PCOS to women without PCOS (95% confidence interval 1.47, 2.76). Pooling the two studies with risk estimates adjusted for BMI showed a relative risk of 1.55 (1.27, 1.89).
This meta-analysis showed a 2-fold risk of arterial disease for patients with PCOS relative to women without PCOS. BMI adjustment did not affect this finding, suggesting the increased risk for cardiovascular events in PCOS is not completely related to a higher BMI in patients with PCOS.
多囊卵巢综合征（PCOS）患者存在动脉疾病风险。我们研究了 PCOS 患者与不伴 PCOS 的排卵正常女性的非致死性冠心病（CHD）或卒中风险，并评估了肥胖是否可能导致 CHD 或卒中风险增加。
我们对对照观察性研究进行了系统综述和荟萃分析。考虑了 4 种 PCOS 定义：世界卫生组织 2 型排卵障碍、美国国立卫生研究院标准、鹿特丹共识和雄激素过多症标准。肥胖定义为 BMI＞30kg/m²和/或腰围＞88cm。使用纽卡斯尔-渥太华量表评估研究质量。主要结局为致死性/非致死性 CHD 或卒中。CHD 和卒中的定义基于各作者使用的标准。效应量为随机效应模型中的汇总相对风险。风险比和速率比在此处合并。
在确定了 1340 篇文章后，纳入了 5 项 2000 年至 2008 年发表的随访研究。这些研究在设计、定义和质量方面存在异质性。在随机效应模型中，PCOS 患者与非 PCOS 患者相比，CHD 或卒中的相对风险为 2.02（95%置信区间 1.47，2.76）。汇总了两项经 BMI 校正风险估计的研究，显示相对风险为 1.55（1.27，1.89）。
本荟萃分析显示，与非 PCOS 女性相比，PCOS 患者动脉疾病风险增加 2 倍。BMI 调整并未影响这一发现，表明 PCOS 患者发生心血管事件的风险增加与患者 BMI 较高并不完全相关。
