Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu 90029, Finland.
Institute of Reproductive and Developmental Biology, Imperial College London, London W12 0NN, United Kingdom.
Eur J Endocrinol. 2023 Jul 20;189(1):96-105. doi: 10.1093/ejendo/lvad077.
Polycystic ovary syndrome (PCOS) is associated with many cardiovascular disease (CVD) risk factors, such as obesity, type 2 diabetes mellitus and hypertension. However, it remains debatable whether the presence of multiple CVD risk factors translates to increased CVD events.
A prospective, population-based Northern Finland Birth Cohort 1966.
Individuals with an expected date of birth in 1966 in Northern Finland have been followed from birth. Women in the cohort were classified as having PCOS according to either the National Institute of Health (NIH) criteria (n = 144) or the Rotterdam criteria (n = 386) at age 31, and they were compared to women without any PCOS features. The study population was re-examined at age 46, and the incidence of major adverse cardiovascular events (MACE), including myocardial infarction (MI), stroke, heart failure and cardiovascular mortality, was recorded up to age 53.
During the 22-year follow-up, both women with NIH-PCOS and women with Rotterdam-PCOS had a significantly higher risk for cardiovascular events than control women. The BMI-adjusted hazard ratio (HR) for MACE in the Rotterdam-PCOS group and the NIH-PCOS group was 2.33 (1.26-4.30) and 2.47 (1.18-5.17), respectively. The cumulative hazard curves in both diagnostic categories began to diverge at age 35. Regarding the individual CVD endpoints, MI was significantly more prevalent in both women with NIH-PCOS (P = .010) and women with Rotterdam-PCOS (P = .019), when compared to control women.
PCOS should be considered a significant risk factor for CVD. Future follow-up will show how the risk of CVD events develops after menopausal age.
多囊卵巢综合征（PCOS）与许多心血管疾病（CVD）风险因素有关，如肥胖、2 型糖尿病和高血压。然而，目前仍存在争议，即是否存在多种 CVD 风险因素会导致 CVD 事件的增加。
前瞻性、基于人群的芬兰北部出生队列 1966 年研究。
芬兰北部出生于 1966 年的个体自出生起就被纳入该队列进行随访。该队列中的女性在 31 岁时根据美国国立卫生研究院（NIH）标准（n = 144）或 Rotterdam 标准（n = 386）被诊断为 PCOS，并与没有任何 PCOS 特征的女性进行比较。在 46 岁时对研究人群进行了重新检查，并记录了主要不良心血管事件（MACE）的发生率，包括心肌梗死（MI）、中风、心力衰竭和心血管死亡率，直至 53 岁。
在 22 年的随访期间，NIH-PCOS 女性和 Rotterdam-PCOS 女性发生心血管事件的风险明显高于对照组女性。 Rotterdam-PCOS 组和 NIH-PCOS 组的 MACE 校正后风险比（HR）分别为 2.33（1.26-4.30）和 2.47（1.18-5.17）。在这两个诊断类别中，累积风险曲线在 35 岁时开始出现分歧。关于个体 CVD 终点，与对照组女性相比，NIH-PCOS 女性（P =.010）和 Rotterdam-PCOS 女性（P =.019）中 MI 的发生率明显更高。
PCOS 应被视为 CVD 的一个重要危险因素。未来的随访将显示绝经后 CVD 事件风险的发展情况。
