No association effect of genetic polymorphism was observed between polycystic ovary syndrome and cardiovascular diseases risk: a mendelian randomization study

The genetic association between polycystic ovary syndrome and the risk of hypertensive disorders of pregnancy: A Mendelian randomization study

OBJECTIVE

In observational studies, polycystic ovary syndrome (PCOS) has been associated with an increased risk of hypertensive disorders of pregnancy (HDPs); however, the causality between these conditions remains to be determined. This study aimed to investigate the causal relationship between PCOS and HDPs.

METHODS

This genome-wide association study (GWAS), conducted from November to December 2023, aimed to investigate the causal relationships between PCOS and HDPs, gestational hypertension and preeclampsia/eclampsia via two-sample Mendelian randomization (MR) analysis. European-lineage GWAS summary statistics were obtained from a PCOS GWAS meta-analysis, the FinnGen consortium and the UK Biobank. The primary method employed was inverse-variance weighted MR, with several sensitivity analyses and evaluations of instrumental variable strength conducted to ensure result reliability.

RESULTS

The odds ratios (ORs) for the effects of PCOS on the risk of HDPs, gestational hypertension and preeclampsia/eclampsia were 1.007 (95 % confidence interval [CI]: 0.888-1.142; P = 0.911), 1.024 (95 % CI: 0.901-1.163; P = 0.719) and 0.992 (95 % CI: 0.828-1.187; P = 0.926), respectively. These results were found to be robust following confirmation via the Q test, MR-Egger intercept analysis, and MR-PRESSO analysis. Furthermore, a sensitivity analysis excluding the single nucleotide polymorphisms associated with body mass index (BMI) also supported the convincing nature of the findings.

CONCLUSIONS

Our findings do not offer conclusive evidence of the impact of PCOS on HDPs. In light of these results, efforts to prevent HDPs in women with PCOS should focus on women with high-risk features rather than all women with PCOS.

Pregnancy, Reproductive Factors, and Female Heart Failure Risk and Outcomes

PURPOSE OF REVIEW

The purpose of this review is to provide an overview of recent evidence on female-specific risk factors related to reproductive status or pregnancy.

RECENT FINDINGS

Pregnancy-related factors, including hypertensive disorders and gestational diabetes, increase the risk of heart failure in women, while breastfeeding and hormone therapy may offer protection. Hypertensive disorders of pregnancy, gestational diabetes, polycystic ovarian syndrome, placental abruption, younger maternal age at first live birth, younger maternal age at last live birth, number of stillbirths, number of pregnancies, onset of menstruation before 12 years of age, shorter reproductive age, ovariectomy, and prolonged absence of ovarian hormones may increase the risk of heart failure in women. Conversely, breastfeeding status and hormone therapy (for menopause or contraception) may serve as protective factors, while fertility treatments have no discernible effect on the risk of heart failure.

Effects of menstrual disorders and dysmenorrhea on cardiovascular disease: a Mendelian randomization study

Background

Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether these associations are causal. This study is to investigate whether menstrual disorders and dysmenorrhea causally affect the risk of CVD.

Methods

The summary data for menstrual disorders (excessive menstruation and irregular menses) and dysmenorrhea were obtained from FinnGen study, summary data for CVD were obtained from UK Biobank and meta-analysis. The inverse-variance-weighted method was mainly used in the Mendelian randomization for causality analysis. Sensitivity analyses were performed by several methods under different model assumptions.

Results

Genetic liability to excessive menstruation was associated with higher risk of atrial fibrillation (odds ratio (OR), 1.078 [95% confidence interval (CI), 1.015-1.145]; P=0.014), but a lower risk of hypertension (OR, 0.994 [95% CI: 0.989-0.999]; P=0.016). Irregular menses was associated with higher risk of atrial fibrillation (OR, 1.095 [95% CI: 1.015-1.182]; P=0.02), hypertension (OR, 1.007 [95% CI: 1.000-1.013]; P=0.047), myocardial infarction (OR, 1.172 [95% CI: 1.060-1.295]; P=0.02), ischemic heart disease, (OR, 1.005 [95% CI: 1.000-1.010]; P=0.037) and coronary heart disease (OR, 1.004 [95% CI: 1.001-1.008]; P=0.026). Dysmenorrhea was associated with higher risk of atrial fibrillation (OR, 1.052 [95% CI: 1.014-1.092]; P=0.008) and Ischemic stroke (cardioembolic) (OR, 1.122 [95% CI: 1.002-1.257]; P=0.046). After Benjamini-Hochberg correction, irregular menses was associated with higher risk of myocardial infarction.

Conclusion

We confirmed a causal relationship of excessive menstruation, irregular menses and dysmenorrhea on cardiovascular outcomes independent of sex hormone levels, with an emphasis on the link between irregular menses and myocardial infarction. These clinical features can be utilized as markers to identify women at higher risk of developing CVD in the future, recommending early clinical intervention of menstrual diseases.