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Profili NI, Castelli R, Gidaro A, Manetti R, Maioli M, Petrillo M, Capobianco G, Delitala AP. Possible Effect of Polycystic Ovary Syndrome (PCOS) on Cardiovascular Disease (CVD): An Update. J Clin Med 2024; 13:698. [PMID: 38337390 PMCID: PMC10856325 DOI: 10.3390/jcm13030698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during the fertile period. Women with PCOS have an increased risk of developing major cardiovascular risk factors during the fertile period: obesity, impaired glucose tolerance, diabetes mellitus, dyslipidemia, and metabolic syndrome. The possible effect of PCOS on cardiovascular disease (CVD) has been reported in different studies, but the results are not clear for several reasons. Indeed, most of the studies analyzed a cohort of fertile women who, given their relatively young age, have a low frequency of cardiovascular diseases. In addition, longitudinal studies have a short follow-up period, insufficient to draw firm conclusions on this topic. Finally, pharmacological treatment is limited by the lack of specific drugs available to specifically treat PCOS. In this review, we report on studies that analyzed the possible effect of PCOS on the most common CVD (hypertension, arterial stiffness, atherosclerosis, and cardiovascular event) and available drugs used to reduce CVD in PCOS women.
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Affiliation(s)
- Nicia I. Profili
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Roberto Castelli
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Antonio Gidaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital, 20122 Milan, Italy;
| | - Roberto Manetti
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Margherita Maioli
- Department of Biochemical Science, University of Sassari, 07100 Sassari, Italy;
| | - Marco Petrillo
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Giampiero Capobianco
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Alessandro P. Delitala
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
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Pan H, Xian P, Yang D, Zhang C, Tang H, He X, Lin H, Wen X, Ma H, Lai M. Polycystic ovary syndrome is an independent risk factor for hypertensive disorders of pregnancy: A systematic review, meta-analysis, and meta-regression. Endocrine 2021; 74:518-529. [PMID: 34655376 DOI: 10.1007/s12020-021-02886-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/16/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE The risk of hypertensive disorders of pregnancy (HDP) in women with polycystic ovary syndrome (PCOS) is inconsistent in some studies. The aim of this meta-analysis was to examine the evidence regarding the strength of the association between PCOS and HDP. METHODS PubMed, Web of Science, Embase, and the Cochrane Library were systematically searched to identify observational studies investigating HDP in patients with PCOS. The primary outcome was the pooled odds ratio (OR) of HDP, including pregnancy-induced hypertension (PIH) and pre-eclampsia (PE), in women with PCOS compared with the non-PCOS population. RESULTS A total of 30 studies were eligible for meta-analysis. PCOS was associated with a higher risk of HDP (OR 2.02, 95CI% 1.83-2.22), including PIH (OR 1.94, 95CI% 1.70-2.21), and PE (OR 2.07, 95CI% 1.91-2.24). The association remained significant after adjusting for age, body mass index (BMI), and nulliparity (HDP: OR 1.48, 95CI% 1.48-1.60; PIH: OR 1.42, 95%CI 1.29-1.57; PE: OR 2.07, and 95%CI 1.91-2.24). The increased risk of HDP for the PCOS group remained significant in subgroups of BMI, Age, singleton pregnancy, multiple pregnancy, gestational diabetes mellitus (GDM), hyperandrogenism, and nulliparity, while the finding was not observed in subgroups of nonhyperandrogenic and non-GDM. In the meta-regression, BMI contributed significantly to the heterogeneity in the prevalence of HDP. CONCLUSIONS PCOS is independently associated with a significantly increased risk of HDP. To prevent HDP during pregnancy, our findings highlight the importance of establishing supervision guidelines for PCOS patients, especially in the population with hyperandrogenism and GDM.
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Affiliation(s)
- Haixia Pan
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China
| | - Peiyi Xian
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China
| | - Daopeng Yang
- Organ Transplant Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510240, China
| | - Chunren Zhang
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, NO.195 Dong Feng West Road, Guangzhou, 510240, PR China
| | - Huizhen Tang
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China
| | - Xiaoying He
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China
| | - Han Lin
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China
| | - Xiaohui Wen
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, NO.195 Dong Feng West Road, Guangzhou, 510240, PR China
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China.
| | - Maohua Lai
- Department of Traditional Chinese Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510240, China.
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Liu Q, Wang J, Xu Q, Kong L, Wang J. A retrospective cohort study of obstetric complications and birth outcomes in women with polycystic ovarian syndrome. J OBSTET GYNAECOL 2021; 42:574-579. [PMID: 34392796 DOI: 10.1080/01443615.2021.1931066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women and a high risk factor for adverse pregnancy complications. Therefore, we aimed to analyse the relationship between PCOS and pregnancy complications in a large sample from China. Additionally, since obesity and assisted reproductive technology (ART) are common in women with PCOS, we also aimed to determine whether both of these factors increased the complication incidence for women with PCOS. A retrospective cohort study that included 1357 pregnant women with PCOS and 6940 without PCOS was performed. Our results indicated women with PCOS had higher incidence of gestational diabetes mellitus (GDM), hypertension, postpartum haemorrhage, preterm birth, macrosomia and cervical incompetence. Additionally, obesity was associated with an increased incidence of hypertension and GDM in women with PCOS generally. ART did not result in an increase in the obstetric complication rate in women with PCOS. In conclusion, PCOS appeared to result in an increased risk of adverse pregnancy complications. Obesity may further increase the risks of hypertension and GDM among women with PCOS. However, ART did not increase the risk of pregnancy complications, which suggests that ART is a relatively safe and effective method to address infertility problems in women with PCOS.IMPACT STATEMENTWhat is already known on this subject? There are several studies evaluating the associations of PCOS with the risk of pregnancy complications. However, reports about the risk of pregnancy complications between PCOS women with and without obesity or ART are limited.What do the results of this study add? PCOS appeared to increase the risk of adverse pregnancy complications, including GDM, pregnancy-induced hypertension, postpartum haemorrhage, preterm birth, macrosomia and cervical incompetence. Obesity further increased the risks of hypertension and GDM in women with PCOS, but it did not increase the incidence of macrosomia and postpartum haemorrhage. Additionally, ART did not increase the risk of adverse pregnancy complications among women with PCOS, except for postpartum haemorrhage.What are the implications of these findings for clinical practice and/or further research? This study contributes to the literature because it showed that PCOS independently increased the risk of adverse pregnancy complications in a large sample of patients. Second, obesity is a high risk factor for adverse complications in pregnant women with PCOS. Third, ART is a relatively safe and effective method for addressing infertility problems for women with PCOS.
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Affiliation(s)
- Qiwei Liu
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jingxue Wang
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Qian Xu
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Liang Kong
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jinjuan Wang
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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Zhou S, Ji Y, Wang H. The risk factors of gestational hypertension in patients with polycystic ovary syndrome: a retrospective analysis. BMC Pregnancy Childbirth 2021; 21:336. [PMID: 33906610 PMCID: PMC8080329 DOI: 10.1186/s12884-021-03808-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The hypertensive disorders complicating pregnancy (HDCP) is common in patients with polycystic ovary syndrome (PCOS), yet the potential influencing factors remained unclear. We aimed to assess the independent risk factors of HDCP in patients with PCOS, to provide clinical evidences for the management of PCOS. METHODS Pregnant PCOS patients treated in our hospital from June 1, 2018 to November 30, 2020 were approached. The personal and clinical characteristics of patients with and without gestational hypertension were evaluated. Logistic regressions were conducted to identify the independent risk factors of HDCP, Receiver operating characteristics (ROC)curve analysis was conducted to evaluate the predicting value. RESULTS A total of 188 PCOS patients were included, the incidence of HDCP in patients with PCOS was 27.66 %. There were significant differences in the age, BMI, family history of hypertension, the history of adverse pregnancy, history of contraceptive pills use and family history of HDCP between HDCP group and no-HDCP group (all p < 0.05), and there were no significant differences in the family history of diabetes, multiple pregnancy and long-term smoking history between HDCP group and no-HDCP group (all p > 0.05). Age ≥ 27y(OR2.048, 95 %CI1.121 ~ 3.208), BMI ≥ 24 kg/m2(OR1.463, 95 %CI1.069 ~ 2.011), family history of hypertension(OR2.129, 95 %CI1.093 ~ 3.042), the history of adverse pregnancy(OR2.435, 95 %CI1.264 ~ 4.085), history of contraceptive pills use(OR3.806, 95 %CI1.184 ~ 6.102), family history of HDCP(OR1.934, 95 %CI1.016 ~ 2.774) were the independent risk factors of HDCP in patients with PCOS (all p < 0.05). ROC curve analyses indicated that those factors had good predictive value on HDCP in PCOS patients. CONCLUSIONS The incidence of HDCP in PCOS patients is relatively high. In clinical practice, medical workers should carry out early prevention and intervention measures for these risk factors to reduce the incidence of HDCP.
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Affiliation(s)
- Shu Zhou
- Department of gynaecology, The 5th Affiliated Hospital of Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Yiping Ji
- Department of gynaecology, Lian Shui county People's Hospital, Huai'an, China.
| | - Haimei Wang
- Department of Urology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, No.62, Huaihai Road, Jiangsu, 223002, Huai'an, China.
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