Summary:
Introduction: Women with polycystic ovary syndrome (PCOS) are characterized by
an accumulation of cardiovascular risk factors, which possibly increase the
risk of cardiovascular disease (CVD), from a relatively young age. Menopause on
the other hand, presents an additional negative effect towards metabolic
dysfunction. However, the association between cardiovascular risk and PCOS
after menopause has not been adequately investigated. We aimed to evaluate the
effect of PCOS on markers of subclinical atherosclerosis in non-diabetic
postmenopausal women.
Methods: 286 postmenopausal women with intact ovaries participated in this
cross-sectional analysis. Presence of 3 characteristics corresponded to the
PCOS phenotype: central obesity, insulin resistance, current hyperandrogenism
or history of clinical androgen excess, history of irregular menses or
infertility. We compared markers of vascular structure and function
[intima-media thickness, atheromatous plaques presence as well as flow-mediated
dilation, pulse wave velocity (PWV) and augmentation index, respectively]
between women with a PCOS phenotype and the rest of the sample, who served as
controls.
Results: Higher levels of PWV were observed in women with PCOS when compared
with controls (9.46±1.74 vs. 8.60±1.51 m/s, P=0.001, univariate). Increasing
components of PCOS associated with higher levels of PWV (P-value for linear
trend < 0.001). Multivariate regression analysis showed that PWV was predicted
by the PCOS phenotype, age and SBP.
Conclusion: Asymptomatic, non-diabetic, postmenopausal women with a putative
PCOS phenotype exhibit increased arterial stiffness, independently of age, BMI
or blood pressure. This might present one mechanism explaining the effect of
PCOS towards the development of CVD later in life.