Endocrine Abstracts

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder amongst women of reproductive age and is associated with various cardiometabolic perturbations, in addition to chronic anovulation and factors related to androgen excess. Indeed androgen excess has been associated with increased cardiovascular risk in women; serum testosterone correlates with indices of subclinical atherosclerosis and cardiovascular disease (CVD). Moreover, women with PCOS, as compared with age- and body mass index-matched women without the syndrome, appear to have a higher risk of insulin resistance, hyperinsulinemia, glucose intolerance, dyslipidemia, and an increased prothrombotic state, possibly resulting in a higher rate of type 2 diabetes mellitus, fatty liver disease, subclinical atherosclerosis, vascular dysfunction, and potentially cardiovascular disease and mortality. Obesity, an independent risk factor for CVD, is also more prevalent in PCOS women as compared to age-matched controls, and is aggravated by androgen excess and has an detrimental android pattern of distribution. Further alterations in PCOS include an increased prevalence of sleep apnoea, as well as various changes in the secretion and/or function of adipokines and adipose tissue-derived pro-inflammatory factors, all of them with direct or indirect influences on the complex signaling network that regulates metabolism, insulin sensitivity, and energy homeostasis. The literature is full of conflicting data and this is partly due to the definition(s) used to identify women with PCOS and also the phenotypic variability of PCOS, which in itself generates significant influence on the cardiometabolic risks.