Assessment of Early Markers of Cardiovascular Risk in Polycystic Ovary Syndrome.

TouchREVIEWS in endocrinology Pub Date : 2021-04-01 Epub Date: 2021-04-28 DOI:10.17925/EE.2021.17.1.37
Krystallenia I Alexandraki, Eleni A Kandaraki, Kalliopi-Anna Poulia, Christina Piperi, Eirini Papadimitriou, Theodoros G Papaioannou
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引用次数: 2

Abstract

Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome, with long-term sequelae from birth to senescence. The long-term effects of PCOS are attributed to several metabolic aberrations ensuing the syndrome. In a systematic review of literature regarding the cardiovascular risk factors that accompany PCOS, we found that macrovascular function has been assessed by flow-mediated dilatation (FMD), microvascular function by venous occlusion plethysmography (VOP), and arterial structure by ultrasonographic assessment of intima-media thickness (IMT) usually of the carotid artery. Contradictory results have been reported; however, in most studies, endothelial dysfunction, an early marker of atherosclerosis assessed either by haemodynamic methods such as FMD or by biochemical methods such as endothelin-1 levels, was found to be impaired. VOP is a less-studied method, with few indices altered. IMT was found to be altered in most of the included studies, but the population was more heterogeneous. Inflammatory markers, including C-reactive protein, were also found to be altered in most studies. On the other hand, a number of interventions have been shown beneficial for the markers of cardiovascular risk, in the context of insulin-sensitizers. However, other interventions such as oral contraceptive pills or statins did not consistently show a similar beneficial effect. In summary, the early identification and eventual treatment of cardiovascular clinical and biochemical risk factors may be used in clinical practice to prevent potential 'silent' triggers of cardiovascular disease.

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多囊卵巢综合征心血管风险早期标志物的评估。
多囊卵巢综合征(PCOS)是一种异质性综合征,具有从出生到衰老的长期后遗症。多囊卵巢综合征的长期影响是由于几种代谢异常引起的综合征。在系统回顾了有关PCOS伴有心血管危险因素的文献后,我们发现大血管功能通过血流介导扩张(FMD)评估,微血管功能通过静脉闭塞容积描画(VOP)评估,动脉结构通过超声评估颈动脉内膜-中膜厚度(IMT)评估。报道了相互矛盾的结果;然而,在大多数研究中,通过血流动力学方法(如FMD)或生化方法(如内皮素-1水平)评估的动脉粥样硬化的早期标志物内皮功能障碍被发现受损。VOP是一种研究较少的方法,几乎没有改变指标。在大多数纳入的研究中,发现IMT发生了改变,但人群的异质性更大。在大多数研究中,包括c反应蛋白在内的炎症标志物也被发现发生了改变。另一方面,在胰岛素增敏剂的背景下,许多干预措施已被证明对心血管风险标志物有益。然而,其他干预措施,如口服避孕药或他汀类药物并没有始终显示出类似的有益效果。总之,心血管临床和生化危险因素的早期识别和最终治疗可用于临床实践,以预防潜在的“沉默”触发心血管疾病。
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