Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Curr Vasc Pharmacol. 2019;17(6):579-590. doi: 10.2174/1570161116666180828154006.
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting women of reproductive age. The hormonal alterations of PCOS have been linked with a higher risk of metabolic disturbances in young, reproductively active women. However, it remains to be clarified whether the presence of PCOS increases the risk of cardiovascular disease (CVD) later in life. Aging ameliorates the clinical manifestations of PCOS; hyperandrogenaemia and metabolic abnormalities, however, persist beyond the menopause. On the other hand, aging and menopause increase CVD risk in the general female population. The results of the limited available studies in aging women with a previous diagnosis of PCOS demonstrate early atherosclerosis. However, studies addressing clinical CVD outcomes in women with PCOS report inconsistent findings. A possible explanation for this heterogeneity is the difficulty in diagnosing PCOS after the menopausal transition, due to the absence of validated diagnostic criteria for this population. Larger prospective studies of women diagnosed during their reproductive years will shed more light on the longer-term CVD implications of PCOS.
多囊卵巢综合征(PCOS)是影响育龄妇女的最常见内分泌疾病之一。PCOS 的激素改变与年轻、生殖活跃的女性代谢紊乱的风险增加有关。然而,目前尚不清楚 PCOS 是否会增加女性日后患心血管疾病(CVD)的风险。随着年龄的增长,PCOS 的临床表现会有所改善;然而,高雄激素血症和代谢异常会持续到绝经后。另一方面,在一般女性人群中,衰老和绝经会增加 CVD 的风险。在以前被诊断为 PCOS 的老年女性中进行的有限的可用研究结果表明存在早期动脉粥样硬化。然而,在患有 PCOS 的女性中进行的关于 CVD 临床结局的研究报告结果不一致。造成这种异质性的一个可能原因是,由于没有针对这一人群的经过验证的诊断标准,绝经后诊断 PCOS 存在困难。对在生育期被诊断为 PCOS 的女性进行更大规模的前瞻性研究,将更深入地了解 PCOS 对 CVD 的长期影响。