Cardiovascular and Metabolic Risk Profiles Across Different Phenotypes of Polycystic Ovary Syndrome

Öz

Aim: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder affecting 5–10% of women of reproductive age and is increasingly recognized as a female-specific cardiometabolic condition. Although metabolic risk factors such as insulin resistance, dyslipidemia, and hypertension are well established in PCOS, their distribution across distinct phenotypes remains controversial. Material and Methods: In this retrospective study, 240 women diagnosed with PCOS based on the 2003 Rotterdam criteria and 116 healthy controls aged 18–42 years were evaluated. Patients with PCOS were categorized into four phenotypes: (i) hyperandrogenism + oligo/anovulation + polycystic ovaries (HA+OA+PCO), (ii) hyperandrogenism + oligo/anovulation (HA+OA), (iii) hyperandrogenism + polycystic ovaries (HA+PCO), and (iv) polycystic ovaries + oligo/anovulation (PCO+OA). Anthropometric measurements, hormonal profiles, lipid panels, glucose-insulin parameters, and HOMA-IR indices were compared between groups. Results: Compared with controls, women with PCOS had significantly higher triglycerides, fasting insulin, HOMA-IR, total testosterone, DHEAS, and LH/FSH ratio, while HDL cholesterol was lower (all p<0.05). Waist-to-hip ratio was elevated in the PCOS group despite similar BMI. Mean systolic BP was comparable, whereas diastolic BP was slightly lower in PCOS; both SBP and DBP varied significantly across phenotypes. Lipid and hormone profiles did not differ among subgroups. Although glucose and overall HbA1c were similar between PCOS and controls, HbA1c was significantly higher in the PCO+OA subgroup compared with HA+OA. Conclusion: PCOS is associated with adverse cardiometabolic risk factors independent of phenotype. These findings underscore the need for early cardiometabolic screening in all women with PCOS, while larger multicenter studies are warranted to delineate subtle inter-phenotypic variations.

Anahtar Kelimeler

• Polycystic ovary syndrome
• phenotypes
• insulin resistance
• cardiovascular risk;
• metabolic syndrome

Polikistik Over Sendromu Fenotipleri Arasında Kardiyovasküler ve Metabolik Risk Profillerinin Karşılaştırılması

Öz

Amaç: Polikistik over sendromu (PCOS), üreme çağındaki kadınların %5–10’unu etkileyen heterojen bir endokrin bozukluktur ve giderek kadınlara özgü bir kardiyometabolik durum olarak tanınmaktadır. İnsülin direnci, dislipidemi ve hipertansiyon gibi metabolik risk faktörleri PCOS’ta iyi tanımlanmış olsa da, bunların farklı fenotipler arasındaki dağılımı tartışmalıdır. Gereç ve Yöntem: Bu retrospektif çalışmada, 2003 Rotterdam kriterlerine göre PCOS tanısı almış 240 kadın ve 18–42 yaş aralığında 116 sağlıklı kontrol değerlendirildi. PCOS’lu hastalar dört fenotipe ayrıldı: (i) hiperandrojenizm + oligo/anovulasyon + polikistik overler (HA+OA+PCO), (ii) hiperandrojenizm + oligo/anovulasyon (HA+OA), (iii) hiperandrojenizm + polikistik overler (HA+PCO), (iv) polikistik overler + oligo/anovulasyon (PCO+OA). Gruplar arasında antropometrik ölçümler, hormonal profiller, lipid panelleri, glukoz-insülin parametreleri ve HOMA-IR indeksleri karşılaştırıldı. Bulgular: Kontrollerle karşılaştırıldığında, PCOS’lu kadınlarda trigliserid, açlık insülini, HOMA-IR, total testosteron, DHEAS ve LH/FSH oranı anlamlı derecede yüksek; HDL kolesterol ise daha düşüktü (tümü p<0,05). VKİ benzer olmasına rağmen bel/kalça oranı PCOS grubunda daha yüksekti. Ortalama sistolik kan basıncı benzerken, diyastolik kan basıncı PCOS’ta biraz daha düşüktü; hem SBP hem de DBP fenotipler arasında anlamlı farklılık gösterdi. Lipid ve hormon profilleri alt gruplar arasında farklılık göstermedi. Glukoz ve HbA1c genel olarak PCOS ve kontroller arasında benzer olsa da, HbA1c PCO+OA alt grubunda HA+OA’ya göre anlamlı derecede yüksekti. Sonuç: PCOS, fenotipten bağımsız olarak olumsuz kardiyometabolik risk faktörleri ile ilişkilidir. Bu bulgular, tüm PCOS’lu kadınlarda erken kardiyometabolik taramanın önemini vurgulamaktadır. İnter-fenotipik ince farklılıkları ortaya koymak için daha geniş çok merkezli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Polikistik over sendromu
• fenotipler
• insülin direnci
• kardiyovasküler risk
• metabolik sendrom

Kaynakça

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