Women with polycystic ovary syndrome (PCOS) have increased serum concentrations of cardiovascular disease (CVD) risk factors as compared with controls, according to Greek researchers reporting on their meta-analysis at ENDO 2011: the 93rd Annual Meeting & Expo of the Endocrine Society in Boston. As the relation between PCOS and CVD remains unclear, Konstantinos A. Toulis, MD, and colleagues systematically reviewed the relevant analyses of CVD risk factors in women with PCOS (CRP, Hcy, TNF-α, PAI-1, Lp[a], AGEs, VEGF, IL-6, ADMA, and fibrinogen) compared with controls. The search was conducted in the MEDLINE, EMBASE, and CENTRAL databases. Weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated in each of the CVD risk markers for all eligible studies and combined using a random effects model. To ensure synthesis of the best available evidence, the researchers performed sensitivity analyses.
They researched 30 studies included in 11 different meta-analyses involving a total of 6260 women with PCOS and 4546 controls. After data analysis, women with PCOS demonstrated significantly elevated CRP [weighted mean difference (WMD] (95% CI)=0.96 (0.74 to 1.19)], Hcy [2.25 (1.46 to 3.03)], PAI-1 antigen [16.96 (7.65 to 26.28)], PAI-1 activity [0.70 (0.17 to 1.23)], VEGF [1.72 (0.96 to 2.48)], ADMA [0.19 (0.08 to 0.3)], and AGEs [3.91 (2.36 to 5.45)] levels as compared to controls, yet with significant between-study heterogeneity. Borderline significance was detected for TNF-α [0.75 (0.07 to 1.44)] and fibrinogen [0.20 (0.01 to 0.39)] whereas no significance was detected for IL-6 [0.71 (-0.16 to 1.59)]. As seen, women with PCOS were seen to have increased serum concentrations of CVD risk factors as compared with controls. “If this apparent risk is translated into increased incidence of CVD in later life remains to be elucidated,” Dr. Toulis and colleagues concluded.