SAT LB98 Early Atherosclerosis in Polycystic Ovary Syndrome. a Systematic Review, Meta Analysis and Meta Regression
Abstract Backgroung. Polycystic ovary syndrome (PCOS) is a common disorder affecting reproductive age women and is a cluster of endocrine and metabolic alterations ranging from impaired ovulation and androgen excess to abdominal obesity and metabolic syndrome leading to increased cardiovascular risk profile. Aim. To perform a meta analysis on the effect of PCOS on surrogate markers of atherosclerosis, namely intima media thickness (IMT) flow mediated dilation (FMD) and pulse wave velocity (PWV) and to run a meta regression on the potential determinants of preclinical atherosclerosis. Methods. A search through Pubmed/Medline and ISI web of knowledge retrieved 90 studies that were used for meta analysis. Selected outcomes were IMT (n=6199) FMD (n=3090) and PWV (n=2477) while age, BMI, waist circumference, total testosterone, free androgen index (FAI) total HDL and LDL cholesterol, HOMA index, systolic and diastolic blood pressure were used for meta regression analysis. Results. Random effect meta analysis showed that IMT was significantly increased (ES 0.47, 95% C.I. 0.64 to 0.30, p<0.0001) FMD was significantly impaired (ES 0.92, 95% C.I. 0.69 to 1.15, p<0.0001) and PWV was significantly increased (ES 0.28, 95% C.I. 0.48 to 0.08, p=0.006) in PCOS compared to controls. Meta regression analysis showed that FMD was positively correlated with FAI (p=0.018) while negative correlations were found between Effect Size (IMT) and BMI (p=0.02) waist circumference (p=0.05) and total cholesterol (p=0.02) Conclusions. This meta analysis shows a clear effect of PCOS on all markers of preclinical atherosclerosis (IMT, FMD and PWV) Heterogeneity of results is explained in part by the androgen status that was positively linked to impairment of FMD while increasing of anthropometric and metabolic variables (waist, BMI and total cholesterol) seem to overcome PCOS on preclinical atherosclerosis.
Journal of the Endocrine Society