Polycystic ovary syndrome and cardiovascular risk

Polycystic ovary syndrome (PCOS) has been recognised since 1930 as being a syndrome combining hyperandrogenia (alopecia, seborrhea, acne and hirsutism) chronic anovulation with infertility. Android obesity had been already described at that time in these anovulatory women. In the 1980's hyperinsulinism was demonstrated in this specific population; the association of hyperinsulinemia, abdominal obesity an hyperandrogenic features suggested a relationship between PCOS and a metabolic pathology. Abdominal obesity is found in over 30% patients and insulin resistance in 35-68% of cases. Dyslipemia is common, mainly decreased HDL cholesterol, and hypertension is very prevalent. These abnormalities can occur in teenagers and they are correlated with early endothelial dysfunction. To date, it's unclear if it is obesity or insulin resistance which determines the PCOS but it is obvious that this syndrome can be present in lean women, indicating that the physiopathology remains unclear. Although no premature cardiovascular mortality has been proven so far among these women, this syndrome should be considered at least as a marker for an increased risk and could lead to diet and hygienic lifestyle to limit the negative effects of insulin resistance and cardiovascular complications.