Association of Polycystic Ovarian Syndrome with Endothelial Health, Cardiovascular Risk, and Cellular Aging.

OBJECTIVE To study measures of endothelial health, cardiovascular risk, and cellular aging between PCOS patients and a reproductive age normative cohort. DESIGN Cross-sectional study. SUBJECTS Community-based PCOS patients and a normative ovarian aging cohort as controls, aged 45 or younger at the time of evaluation. EXPOSURE Non-invasive measure of endothelial health measured by the EndoPAT reactive hyperemia index (RHI). MAIN OUTCOME MEASURE(S) RHI as measure of endothelial health. Secondary outcomes included Framingham score, telomere length (TL) and mitochondria DNA (mtDNA) copy number from leukocyte cells. RESULTS Our cohort included 63 PCOS participants and 130 non-PCOS participants. Mean age was significantly lower in the PCOS cohort (33.1, SD 4.7 years) compared to the non-PCOS cohort (40.8, SD 2.9 years). In multivariable-adjusted models, we found PCOS was significantly associated with endothelial dysfunction as both a categorical (OR for PCOS 0.31, 95% CI 0.10-0.97, p=0.044) and continuous (PCOS coefficient -0.37, 95% CI -0.69 to -0.05, p=0.026) outcome. For secondary outcomes, PCOS status was not significantly associated with mitochondrial DNA (PCOS coefficient -48.1, 95% CI -175.0 to 78.9, p=0.46), telomere length (PCOS coefficient 0.05, 95% CI -0.05 to 0.15, p=0.33), Framingham score (PCOS coefficient 0.002, 95% CI -0.01 to 0.02, p=0.81), or metabolic syndrome (OR for PCOS 1.29, 95% CI 0.31-5.44, p=0.73). CONCLUSIONS Our findings suggest that PCOS patients have impaired endothelial function compared to non-PCOS patients, though measures of cellular aging and cardiovascular risk as measured by the Framingham score did not differ between the cohorts.