Shroff R et al. (2007) Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis. J Clin Endocrinol Metab [doi: 10.1210/jc.2007-1343]

Polycystic ovary syndrome (PCOS) is an endocrine disorder that occurs in about 1 in 10 women of reproductive age. Symptoms include infrequent periods, hyperandrogenism, and/or polycystic ovaries detectable by ultrasound. Various risk factors for coronary artery disease are also apparent, including insulin resistance, type 2 diabetes, metabolic syndrome, elevated triglyceride:HDL ratio, and vascular dysfunction. PCOS may therefore account for a significant proportion of atherosclerotic heart disease observed in women but the precise level of cardiovascular disease (CVD) risk in women with PCOS is unclear.

Detection of coronary artery calcium (CAC) confirms coronary atherosclerosis independently of symptoms or risk factors, and the quantity of CAC relates directly to the risk of sudden cardiac death. Shroff et al., therefore, investigated the presence of CAC, a marker for subclinical atherosclerosis, in 24 young obese women with PCOS and in 24 controls matched for age and weight. Traditional CVD risk factors, insulin resistance, and markers of inflammation were also compared between the two groups.

The authors detected CAC in eight of the women with PCOS but in only two of the controls. No significant difference was observed in traditional CVD risk factors and markers of inflammation. The authors conclude that young, obese women with PCOS have an increased risk of early asymptomatic coronary atherosclerosis compared with obese controls that is independent of traditional CVD risk factors. They recommend that young women with PCOS are screened, aggressively counselled and treated to prevent symptomatic CVD.