Polycystic Ovary Syndrome: A Hidden Risk for Metabolic and Cardiovascular Diseases?

METHODOLOGY:

PCOS features intrinsic insulin resistance, regardless of body weight, potentially due to increased liver fat deposition, which may exacerbate adverse clinical outcomes.
To understand the association between PCOS and the risk for cardiometabolic diseases, cancer, and dementia, researchers conducted a prospective study including 1008 women with PCOS and 5017 age- and body mass index–matched control participants without PCOS using data from the UK Biobank.
Liver, cardiac, and brain health were assessed using multiorgan MRI, and the impact of PCOS phenotypes (hyperandrogenic and normoandrogenic) on disease risk was evaluated.
The primary outcomes were the prevalence and incidence of metabolic diseases (T2D, MASLD, and obstructive sleep apnea), all-cause CVD and CVD components, hormone-dependent cancers, and dementia.

Incidence rates of T2D (adjusted hazard ratio [aHR], 1.47) and all-cause CVD (aHR, 1.76) were higher in women with PCOS than in control participants.
Compared with control participants, women with PCOS had a higher prevalence of hepatic steatosis (P = .02) and greater hepatic fibroinflammation (P ≤ .01).
PCOS was significantly associated with the incidence of all-cause CVD in normoandrogenic PCOS (aHR, 1.90) but not in hyperandrogenic PCOS. However, hyperandrogenic PCOS was associated with greater liver fat content and hepatic fibroinflammation than normoandrogenic PCOS (P < .01).
The incidence of cancer or dementia was not significantly different among women with PCOS and control participants.

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