A new study presented at the European Congress of Endocrinology shows that women with polycystic ovary syndrome (PCOS) show higher levels of blood markers associated with cardiovascular disease (CVD) than control groups. These markers show up during a woman's earlier life, but might indicate a greater CVD risk in later life.
PCOS is a common ailment, affecting between 5-10% of women of reproductive age, meaning that there are millions of PCOS sufferers in Europe. Symptoms vary, but women with PCOS can suffer from ovarian cysts, irregular (or missing) periods, acne, higher than normal androgen levels and excess facial and body hair. PCOS may be associated with obesity and/or insulin resistance and is also one of the main causes of female infertility.
Past studies have shown no conclusive link between PCOS and these risk markers. Doctors can test for cardiovascular risk markers during the normal reproductive period of a woman's life. These markers don't directly predict cardiovascular risk, but higher levels of these markers are associated with cardiovascular risk in the future. This means that women with raised levels of these markers will, in later years, tend to have a higher rate of cardiovascular disease than is found in the general population.
Working at the Aristotle University of Thessaloniki, Greece, Dr Konstantinos Toulis and co-workers Assistant Professor Dimitrios Goulis and Professor Basil Tarlatzis, carried out a major 'study of studies' (meta-analysis) on risk markers for cardiovascular disease in women with PCOS.
They reviewed 130 previous studies, involving in total 6260 women with PCOS and 4546 controls. They looked at whether the levels of biochemical blood markers for CVD differed in women with PCOS compared to controls. They found that 7 of the 10 markers they looked at were elevated in women with PCOS (see table below), meaning that these women might be more susceptible to developing heart disease.
As yet the researchers don't know if these elevated risk markers lead directly to a higher level of heart disease in PCOS women, but this is the next thing they hope to investigate.
Researcher Dr Konstantinos Toulis said: "This analysis shows that increased levels of risk markers for cardiovascular disease are firmly associated with PCOS. PCOS is a difficult condition to study, because the range and severity of symptoms vary so much that it has been difficult to draw conclusions. Recently an expert panel1 reviewed the evidence and concluded that women with PCOS did seem to have an elevated risk of cardiovascular disease in later life. This meta-analysis of biochemical markers shows that the CVD risk factors are present in earlier life, and that they seem to be independent of other factors which can lead to cardiovascular disease in later life, such as obesity. The association between CVD risk and CVD markers depends on the nature of the individual marker and the magnitude of the difference; this, plus the fact that there are several of these biochemical markers raised, is what makes this a potential warning.
"Cardiovascular disease is the number one cause of death for women in the western world, and as so many women suffer from PCOS, then any increase in cardiovascular disease risk may translate into later problems for an appreciable amount of women. We need to remember that at the moment this is just an association between the biochemical markers and cardiovascular disease in PCOS women, rather than proof of a cause and effect. We do need to follow this up by looking at women with PCOS and cardiovascular disease, and seeing if they had shown higher levels of the risk markers."
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