Alalami Huda, Sathyapalan Thozhukat, Atkin Stephen L
Weill Cornell Medicine Qatar, Research Department, Doha, Qatar.
Department of Diabetes and Endocrinology, University of Hull, Hull, UK.
Ther Adv Endocrinol Metab. 2018 Nov 6;10:2042018818805674. doi: 10.1177/2042018818805674. eCollection 2019.
Women with polycystic ovary syndrome (PCOS) have an adverse metabolic profile with an increased risk of prediabetes and type 2 diabetes (T2DM); however, it is unclear if PCOS is associated with increased cardiovascular events in later years independent of the presence of T2DM. Many therapies have been used to treat the differing facets of PCOS, including those for menstrual irregularity, hirsutism, acne and anovulatory infertility. The aim of this review was to evaluate the cardiovascular profiles associated with the medications used in the management of PCOS and evaluate whether they have cardiovascular benefit, detriment or are neutral. The medications reviewed include oral contraceptive pills, antiandrogens, clomiphene and drugs specifically used in diabetes therapy; metformin, glitazones, dipeptidyl peptidase IV inhibitors and glucagon-like peptide-1 receptor agonists. This review concludes that therapies that are used to treat these patients appear not to add to the cardiovascular risk and that there is no evidence that any interventional medical therapy may prevent the onset of diabetes in patients with PCOS, though in the case of metformin, this agent may be beneficial in preventing development of gestational diabetes.
多囊卵巢综合征（PCOS）女性具有不良的代谢特征，患糖尿病前期和2型糖尿病（T2DM）的风险增加；然而，尚不清楚PCOS是否与晚年心血管事件增加相关，而与T2DM的存在无关。许多疗法已被用于治疗PCOS的不同方面，包括治疗月经不调、多毛症、痤疮和无排卵性不孕的疗法。本综述的目的是评估与PCOS管理中使用的药物相关的心血管特征，并评估它们是否具有心血管益处、危害或呈中性。所审查的药物包括口服避孕药、抗雄激素药物、克罗米芬以及专门用于糖尿病治疗的药物；二甲双胍、格列酮类、二肽基肽酶IV抑制剂和胰高血糖素样肽-1受体激动剂。本综述得出结论，用于治疗这些患者的疗法似乎不会增加心血管风险，并且没有证据表明任何介入性药物治疗可以预防PCOS患者糖尿病的发生，不过就二甲双胍而言，该药物可能有助于预防妊娠期糖尿病的发展。
