OBJECTIVE: Polycystic Ovary Syndrome (PCOS) is associated with increased cardiometabolic risk factors and incidence of cardiovascular disease (CVD). Currently, early screening of dyslipidemia, atherosclerotic CVD (ACVD) and heart function are not routine in the primary care of high-risk young women with and without PCOS. The aim of this study was to provide evidence-based research to aid the development of assessment guidelines for early detection of dyslipidaemia, cardiac dysfunction and ACVD in high-risk young women with and without PCOS. 

METHODS: A case-control study in high-cardiometabolic risk (body mass index (BMI>25) women aged 25-45 years with and without PCOS, matched for age and body mass index, and healthy weight controls was conducted. The main outcome measures included blood lipids, apoB-lipoproteins, carotid intima-media thickness (cIMT), carotid plaque and cardiac function using ultrasound and 2D/3D echocardiography. 

RESULTS: High-risk women with (n-45) and without PCOS (n=20) had a 25% higher total apoB, 30% higher non-HDL-C and 50% higher triglycerides compared to age-matched health weight controls (n=10). PCOS tended to have higher plasma triglycerides, total ApoB, non-HDL-C and remnant cholesterol compared to BMI-matched controls Those with PCOS had a significantly lower HDL-C compared to both BMI-age-matched and health-weight controls. Carotid plaque was 3- and 8-fold higher in those with PCOS compared to BMI-matched and healthy weight controls, respectively. Those with PCOS and BMI-matched controls had increased cIMT by 15% and early left ventricular global longitudinal strain by 10%, compared to healthy-weight controls.

CONCLUSIONS: High-risk PCOS and BMI-matched controls have early impairment in global cardiac function and increased ACVD, and this is associated with an atherogenic dyslipidemic profile. These results suggest early primary prevention screening and a risk-stratification model may be warranted in this high-risk population of young women to reduce risk of premature development and incidence of CVD.

This research is funded by Women and Children’s Health Research Institute and Mazankowski Heart Research Institute


Early Atherosclerosis in High-Risk Young Women With and Without Polycystic Ovary Syndrome 

OBJECTIVE: PCOS is the most common metabolic-endocrine disorder that can impact health and quality of life over a lifespan. It is important we understand the scope of health outcomes that impact the health and quality of life of those with PCOS in order to improve health care in this population. The aim of this study was to determine the incidence of co-morbidities in PCOS compared to an age-matched population. 
METHODS: We conducted a retrospective observational case-control study in those diagnosed with PCOS and age-matched controls using the Alberta Health Services Health Analytics database from 2002-2019 in Alberta, Canada. 
RESULTS: The incidence of high blood pressure, high blood lipids, diseases of the heart, kidney, gastrointestinal tract, pre-diabetes, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections and all cancers was 20-40% (p<0.0001) higher in PCOS (n=16531) compared to controls (n=49335). Overweight-obesity, non-alcoholic liver disease, Type 1 diabetes (T1D) and T2D had a 3-fold greater incidence in PCOS (p<0.0001). Cardiovascular disease and cerebrovascular disease were 60% higher in PCOS compared to controls (p<0.0001). 
CONCLUSION: These findings indicate PCOS is associated with a significantly greater incidence of co-morbidities and adverse health outcomes. This data provides evidence of the potential economic health care burden and lower quality of life in those with PCOS. The data may also indicate a need to improve education of patients and clinicians in raising awareness of health risks and implementation of preventative health care in this high-risk population. 
This work was funded by the Women and Children’s Health Research Institute and University of Alberta Medical Research Foundation.


Donna Vine

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