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Review
. 2023 Jul;64(7):642-648.
doi: 10.1007/s00108-023-01529-7. Epub 2023 Jun 8.

[Polycystic ovary syndrome as a gender-specific cardiometabolic risk factor]

[Article in German]
Lukas van Baal  1 , Susanne Tan  2
Affiliations
Review

[Polycystic ovary syndrome as a gender-specific cardiometabolic risk factor]

[Article in German]
Lukas van Baal et al. Inn Med (Heidelb). 2023 Jul.

Abstract
in English, German

With a prevalence of 15%, polycystic ovary syndrome (PCOS) is the most common endocrinopathy in fertile-aged women. Insulin resistance and obesity play a pivotal role in the pathophysiology of PCOS, modulate the severity of symptoms and are associated with an increased risk for cardiometabolic sequelae such as diabetes, non-alcoholic fatty liver disease and atherosclerotic cardiovascular disease. PCOS should be considered as a gender-specific cardiovascular risk factor. Therefore, if traits indicative for PCOS are present, affected women should undergo PCOS diagnostics as a first step, thereby making it possible to initiate cardiovascular primary prevention strategies in this population of young women at high cardiometabolic risk. In women with known PCOS, screening and treatment of cardiometabolic risk factors and/or diseases should be routinely integrated into the concept of PCOS care. The close link between insulin resistance/obesity and PCOS can be used to improve PCOS-specific symptoms and enhance cardiometabolic health.

Das polyzystische Ovarsyndrom (PCOS) ist mit einer Prävalenz von 15 % die häufigste Endokrinopathie bei Frauen im fertilen Alter. Adipositas und Insulinresistenz spielen eine wesentliche Rolle in der Pathophysiologie des PCOS, modulieren das klinische Beschwerdebild und erhöhen das Risiko der betroffenen Frauen für metabolische Komorbiditäten und Folgen wie Diabetes, nichtalkoholische Fettlebererkrankung sowie kardiovaskuläre Erkrankungen. Das PCOS kann damit als genderabhängiger kardiometabolischer Risikofaktor betrachtet werden. Bei Frauen mit Symptomen, die auf ein PCOS hindeuten, sollte konsequent eine entsprechende Abklärung erfolgen. Bei bekannter PCOS-Diagnose sind über die Behandlung der akuten Beschwerden hinaus ein sorgfältiges Screening auf kardiometabolische Risikofaktoren und Komorbiditäten sowie deren Therapie notwendig. Der Zusammenhang zwischen Insulinresistenz/Adipositas und PCOS kann therapeutisch im individuellen Behandlungskonzept genutzt werden, um sowohl PCOS-spezifische Beschwerden als auch die kardiometabolische Gesundheit zu adressieren.

Keywords: Atherosclerotic cardiovascular disease (ASCVD); Diabetes; Insulin resistance; Non-alcoholic fatty liver disease; Obesity.

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