Cardiometabolic risk in patients with polycystic ovary syndrome

Objectives: Polycystic ovary syndrome (PCOS) is a common endocrinopathy in premenopausal women, associated with risk of metabolic syndrome and cardiovascular disease (CVD). CVD risk evaluation is recommended for PCOS patients. This study aimed to evaluate the risk of CVD in PCOS patients and to identify the best predictors for metabolic and cardiovascular disturbances. Material and methods: The study included 169 PCOS patients and 110 healthy women in reproductive age. We estimated cardiovascular risk according to American Heart Association and Androgen Excess-PCOS Society criteria that classified patients as metabolically unhealthy (MU) or metabolically healthy (MH). Results: The PCOS group had significantly higher body mass index (BMI), waist circumference, and waist-to-hip ratio (P<0.000001). Metabolic syndrome was only defined among PCOS patients (8.9%). No obesity was observed in the control group. Waist circumference >= 80 cm was presented in 44% of PCOS patients in comparison to 14.5% of control participants (P<0.000001). There was a significant tendency for higher fasting insulin levels in the PCOS population (P<0.00001). Surprisingly, the PCOS-MH group had the highest high-density lipoprotein (HDL) levels. ROC curves were used to indicate parameters diagnosing metabolically unhealthy women and revealed that WC, BMI and HC seem to be the strongest predictors of metabolic disturbances in PCOS but in the healthy population in reproductive age biochemical findings such as low HDL or increased fasting glycemia presented stronger predictive value than patients' anthropometric features. Conclusions: Physicians need to remember to adopt different diagnostic approach while seeking metabolic complications in these different groups of women.