Kakoly N S, Moran L J, Teede H J, Joham A E
a Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.
b Endocrine and Diabetes Units , Monash Health , Clayton , Australia.
Expert Rev Endocrinol Metab. 2019 Jan;14(1):23-33. doi: 10.1080/17446651.2019.1556094. Epub 2018 Dec 15.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting up to 18% women of reproductive age. It is associated with a range of metabolic, reproductive, and psychological features. Current evidence indicates a role of PCOS in the development of metabolic and increased cardiovascular risk factors (CVRF) with implications for compromised cardiovascular endpoint disease, which may have a considerable impact on health and health care costs.
Existing studies examining long-term cardiometabolic health in PCOS are heterogeneous with inconsistent findings. In the current review, we aim to explore and critically review retrospective, prospective, meta-analysis and review articles relating to PCOS on cardiometabolic risk factors and clinical consequences to summarize the evidence, note evidence gaps, and suggest implications for future research.
Although there is an established association between PCOS and metabolic health, implications on cardiac health are more uncertain with associations observed for CVRF and subclinical disease, yet limited and conflicting data on actual cardiovascular endpoints. There is a lack of population-based long-term studies examining cardiometabolic morbidity and mortality in PCOS with a need for further research to progress toward a better understanding of the long-term cardiometabolic impacts in women with PCOS.
多囊卵巢综合征(PCOS)是一种常见的内分泌紊乱疾病,影响着高达18%的育龄女性。它与一系列代谢、生殖和心理特征相关。目前的证据表明,PCOS在代谢发展以及心血管危险因素(CVRF)增加方面发挥作用,这对心血管终点疾病产生影响,可能会对健康和医疗成本产生重大影响。
现有研究在检查PCOS患者的长期心脏代谢健康方面存在异质性,结果不一致。在本次综述中,我们旨在探索并批判性地回顾与PCOS相关的关于心脏代谢危险因素和临床后果的回顾性、前瞻性、荟萃分析及综述文章,以总结证据、指出证据空白,并提出对未来研究的启示。
尽管PCOS与代谢健康之间的关联已得到确立,但对心脏健康的影响更不确定,虽观察到其与CVRF及亚临床疾病有关联,但关于实际心血管终点的数据有限且相互矛盾。缺乏基于人群的长期研究来检查PCOS患者的心脏代谢发病率和死亡率,需要进一步研究以更好地了解PCOS女性的长期心脏代谢影响。