Riesgo cardiometabólico asociado al síndrome de ovario poliquístico

Manuel Gómez Alzugaray, Yudith García García, Gilda Monteagudo Peña, Gisel Ovies Carballo, Maité Cabrera Gámez

Texto completo:

PDF

Resumen

Introducción: El síndrome de ovario poliquístico se ha relacionado con una mayor frecuencia de alteraciones metabólicas y mayor riesgo de desarrollar enfermedades cardiovasculares.

Objetivo: Realizar una revisión bibliográfica sobre la relación entre los factores de riesgo cardiometabólicos y el síndrome de ovario poliquístico.

Métodos: Se realizó una revisión bibliográfica que incluyó publicaciones que aportaban información sustentada sobre una investigación científica bien estructurada. Se evidenció la relación del síndrome de ovario poliquístico con factores de riesgo cardiometabólico como la resistencia a la insulina, la hiperinsulinemia, la dislipidemia, la disglucemia, la obesidad, la hipertensión arterial y la diabetes gestacional. También con su asociación con el síndrome metabólico, la enfermedad hepática grasa no alcohólica y con marcadores de enfermedad cardiovascular subclínica.

Conclusiones: La exposición a un perfil cardiometabólico adverso a largo plazo podría generar un incremento de eventos cardiovasculares isquémicos y un mayor riesgo de muerte prematura. Sin embargo, no hay evidencia actual que permita confirmarlo en las mujeres con síndrome de ovario poliquístico. No obstante, la información disponible apunta hacia un mayor riesgo de enfermedad cardiovascular. La intervención oportuna desde la juventud con cambios en el estilo de vida y el tratamiento específico dirigido al control de los factores de riesgo podría modificar el riesgo a largo plazo.

Palabras clave: síndrome de ovario poliquístico; factores de riesgo cardiometabólicos; enfermedad cardiovascular.

Referencias

Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057. DOI: https://doi.org/10.1038/nrdp.2016.57

Bajuk K, Pfeifer M. Cardiometabolic risk in polycystic ovary síndrome. Endoc Connect. 2018;7:238-51. DOI: https://doi.org/10.1530/EC-18-0129

Torchen LC. Cardiometabolic Risk in PCOS: More than a Reproductive Disorder. Curr Diab Rep. 2018;17(12):137. DOI: https://doi.org/10.1007/s11892-017-0956-2

Balachandran K, Sumilo D, O'Reilly MW. Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population- based cohort study. Eur J Endocrinol. 2019;180(4):265-72. DOI: https://doi.org/10.1530/EJE-18-0693

Ramezani Binabaj M, Motalebi M, Karimi Sari H, Rezaee Zavareh MS, Alavian SM. Are women with polycystic ovarian syndrome at a high risk of non-alcoholic Fatty liver disease; a meta-analysis. Hepat Monthly. 2014;14:e23235. DOI: https://doi.org/10.5812/hepatmon.23235

Joham AE, Boyle JA, Zoungas S, Teede HJ. Hypertension in reproductive-aged women with polycystic ovary syndrome and association with obesity. Am J Hypertens. 2015;28(7):847-51. DOI: https://doi.org/10.1093/ajh/hpu251

Young HE, Ward WE. The relationship between Polycystic Ovarin Syndrome, Periodontal Disease, and Osteoporosis. Reprod Scienc. 2021;28:950-62. DOI: https://doi.org/10.1007/s43032-020-00310-7

Gnanadass SA, Prabhu YD, Gopalakrishnan AV. Association of metabolic and inflammatory markers with polycystic ovarian síndrome (PCOS): an update. Arch Gynecol Obstet. 2021;303:631-43. DOI: https://doi.org/10.1007/s00404-020-05951-2

Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary síndrome. Hum Reprod. 2018;33(9):1602-18. DOI: https://doi.org/10.1093/humrep/dey256

Osibogun O, Ogunmoroti O, Michos ED. Polycystic ovary syndrome and cardiometabolic risk: Opportunities for cardiovascular disease prevention. Trends Cardiov Med. 2020;30:399-404. DOI: https://doi.org/10.1016/j.tcm.2019.08.010

Wild RA, Carmina E, Diamanti Kandarakis E, Dokras A, Escobar Morreale HF, Futterweit W, et al. Assessment of Cardiovascular Risk and Prevention of Cardiovascular Disease in Women with the Polycystic Ovary Syndrome: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010;95:2038-49. DOI: https://doi.org/10.1210/jc.2009-2724

Ovies G, Domínguez E, Verdeja OL, Zamora H. Frecuencia y características clínicas, hormonales y ultrasonográficas sugestivas de síndrome de ovarios poliquísticos en un grupo de mujeres con síndrome metabólico. Rev Cubana Endocrinol. 2008 [acceso: 12/10/2020];19(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532008000100004&lng=es

García García Y, Monteagudo Peña G, Padrón Durán RS, González R. Evaluación de la sensibilidad a la insulina en el síndrome de ovarios poliquísticos. Rev Cubana Endocrinol. 2009 [acceso: 12/10/2020];20(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532009000300006&lng=es&nrm=iso&tlng=es

García García Y, Monteagudo Peña G, Padrón Durán RS, González R. Evaluación de las alteraciones lipídicas en el síndrome de ovarios poliquísticos. Rev Cubana Endocrinol. 2010 [acceso: 12/10/2020];21(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S156129532010000200003&lng=es&nrm=iso&tlng=es

Monteagudo G, González R, Gómez M, Ovies G, Menocal A, Rodríguez K, et al. Resistencia a la insulina en mujeres con Síndrome de Ovario Poliquístico. Rev Cubana Endocrinol. 2019 [acceso: 04/07/2021];21(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532019000200004&lng=es&nrm=iso&tlng=es

Carmenate JV, Monteagudo G, Peix A, Quiroz JJ, Ovies G, González N. Enfermedad cardiovascular subclínica en mujeres de edad mediana con síndrome de ovario poliquístico. Rev Cubana Cardiol Cirug Cardiovasc. 2017 [acceso: 12/04/2021];23(1). Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/678/html_72

Carmenate JV, Cabrera E, Monteagudo G, Peix A, González R, González N. Asociación entre el fenotipo hipertrigliceridemia-obesidad abdominal, la resistencia a la insulina y las variables cardiometabólicas en el síndrome de ovario poliquístico. Rev Cubana Endocrinol. 2021 [acceso: 04/07/2021];32(1). Disponible en: http://www.revendocrinologia.sld.cu/index.php/endocrinologia/article/view/271

Barber TM, Franks S. Obesity and polycystic ovary síndrome. Clin Endocrinol. 2021;00:1-11. DOI: https://doi.org/10.1111/cen.14421

Cassar S, Misso ML, Hopkins WG, Shaw CS, Teede HJ, Stepto NK. Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic-hyperinsulinaemic clamp studies. Hum Reprod. 2016;31(11):2619-31. DOI: https://doi.org/10.1093/humrep/dew243

Stepto NK, Cassar S, Joham AE, Hutchison SK, Harrison CL, Goldstein RF, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod. 2013;28(3):777-84. DOI: https://doi.org/10.1093/humrep/des463

Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38:1165-74. DOI: https://doi.org/10.2337/diab.38.9.1165

Carmina E, Lobo RA. Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. Fertil Steril. 2004;82:661-5. DOI: https://doi.org/10.1016/j.fertnstert.2004.01.041

DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005;83:1454-60. DOI: https://doi.org/10.1016/j.fertnstert.2004.11.070

Butler AE, Abouseif A, Dargham SR, Sathyapalan T, Atkin SL. Metabolic comparison of polycystic ovarian syndrome and control women in Middle Eastern and UK Caucasian populations. Scientifc Reports. 2020;10:18895. DOI: https://doi.org/10.1038/s41598-020-75109-2

Maffazioli GD, Lopes CP, Heinrich Oliveira V, Lobo RA, Hayashida SA, Soares JM, et al. Prevalence of metabolic disturbances among women with polycystic ovary syndrome in different regions of Brazil. Int J Gynecol Obst. 2020;151(3):383-91. DOI: http://doi.org/10.1002/jigo.13374

Moghetti P, Tosi F, Bonin C, Di Sarra D, Fiers T, Kaufman JM, et al. Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2013;98:E628-637. DOI: https://doi.org/10.1210/jc.2012-3908

Zawadki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. En: Dunaif A, Givens JR, Haseltine FP, MerriamGR (eds). Polycystic ovary syndrome. Blackwell Scientific Publications. 1992:377-84. DOI: https://doi.org/10.1016/S1701-2163(16)32915-2

Bil E, Dilbaz B, Cirik DA, Ozelci R, Ozkaya E, Dilbaz S. Metabolic syndrome and metabolic risk profile according to polycystic ovary syndrome phenotype. J Obst Gynaecol Res. 2016;42:837-43. DOI: https://doi.org/10.1111/jog.12985

Livadas S, Macut D, Bothou C, Kulickowska Plaksej J, Vryonidou A, Bjekic Macut J, et al. Insulin resistance, androgens, and lipids are gradually improved in an age-dependent manner in lean women with polycystic ovary síndrome: insights from a large Caucasian cohort. Hormones (Athens). 2020;19(4):531-39. DOI: https://doi.org/10.1007/s42000-020-00211-z

Wild RA, Rizzo M, Clifton S, Carmina E. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertility Sterility. 2011;95(3):1073-079. DOI: https://doi.org/10.1016/j.fertnstert.2010.12.027

Valkenburg O, Steegers Theunissen RP, Smedts HP, Dallinga Thie GM, Fauser BC, Westerveld EH, et al. A more atherogenic serum lipoprotein profile is present in women with polycystic ovary syndrome: a case-control study. J Clin Endocrinol Metab. 2008;93:470-76. DOI: https://doi.org/10.1210/jc.2007-1756

Glintborg D, Hass RK, Nybo M, Abrahamsen B, Andersen M. Morbidity and medicine prescriptions in a nationwide Danish population of patients diagnosed with polycystic ovary syndrome. Eur J Endocrinol. 2015;5:627-38. DOI: https://doi.org/10.1530/EJE-14-1108

Meun C, Gunning MN, Louwers YV, Peters H, Roos Hesselink J, van Lennep JR, et al. The cardiovascular risk profile of middle‐aged women with polycystic ovary síndrome. Clin Endocrinol. 2020;92:150-58. DOI: https://doi.org/10.1111/cen.14117

Toosy S, Sodi R, Pappachan JM. Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. J Diabetes Metab Disord. 2018;17:277-85. DOI: https://doi.org/10.1007/s40200-018-0371-5

Carmina E, Legro RS, Stamets K, Lowell J, Lobo RA. Difference in body weight between American and Italian women with polycystic ovary syndrome: influence of the diet. Hum Reprod. 2003;18:2289-93. DOI: https://doi.org/10.1093/humrep/deg440

Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93:162-68. DOI: https://doi.org/10.1210/jc.2007-1834

Acosta A, Monteagudo G, Menocal A. Patrón hormonal de mujeres con diagnóstico clínico y ecográfico del síndrome de ovarios poliquísticos. Rev Cubana Endocrinol. 2004 [acceso. 04/07/2021];15(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532004000200003

Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(6):618-37. DOI: https://doi.org/10.1093/humupd/dms030

Svendsen PF, Nilas L, Norgaard K, Jensen JE, Madsbad S. Obesity, body composition and metabolic disturbances in polycystic ovary syndrome. Hum Reprod. 2008;23:2113-121. DOI: https://doi.org/10.1093/humrep/den211

Cosar E, Üçok K, Akgün L, Koken G, Sahin FK, Arioz DT. Body fat composition and distribution in women with polycystic ovary syndrome. Gynecol Endocrinol. 2008;24:428-32. DOI: https://doi.org/10.1080/09513590802234253

Barber TM, Golding SJ, Alvey C. Global adiposity rather than abnormal regional fat distribution characterises women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;93(3):999-1004. DOI: https://doi.org/10.1210/jc.2007-2117

Lewis RD. Complement activation in polycystic ovary síndrome occurs in the postprandial and fasted state and is influenced by obesity and insulin sensitivity. Clin Endocrinol (Oxf). 2021;94(1):74-84. DOI: https://doi.org/10.1111/cen.14322

Toulis KA, Goulis DG, Mintziori G, Kintiraki E, Eukarpidis E, Mouratoglou SA, et al. Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome. Hum Reprod Update. 2011;17:741-60. DOI: https://doi.org/10.1093/humupd/dmr025

Mu L, Li R, Lai Y, Zhao Y, Qiao J. Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome. J Endocrinol Invest. 2019;42:541-48. DOI: https://doi.org/10.1007/s40618-018-0949-2

Zhang Z, Hong Y, Chen M, Tan N, Liu S, Nie X, Zhou W. Serum metabolomics reveals metabolic profling for women with hyperandrogenism and insulin resistance in polycystic ovary syndrome. Metabolomics. 2020;16:20. DOI: https://doi.org/10.1007/s11306-020-1642-y

Marchesan LB, Spritzer PM. ACC/AHA 2017 definition of high blood pressure: implications for women with polycystic ovary syndrome. Fertility Sterility. 2019;111(3):579-87. DOI: https://doi.org/10.1016/j.fertnstert.2018.11.034

Cascella T, Palomba S, Tauchmanovà L, Manguso F, Di Biase S, Labella D, et al. Serum aldosterone concentration and cardiovascular risk in women with polycystic ovarian syndrome. J Clin Endocrinol Metab. 2006;91(11):4395-400. DOI: https://doi.org/10.1210/jc.2006-0399

Elting MW, Korsen TJ, Bezemer PD, Schoemaker J. Prevalence of diabetes mellitus, hypertension and cardiac complaints in a follow-up study of a Dutch PCOS population. Human Reproduction. 2001;3:556-60. DOI: https://doi.org/10.1093/humrep/16.3.556

Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol. 2000;5:595-600. DOI: https://doi.org/10.1046/j.1365-2265.2000.01000.x

Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2010;16(4):347-363. DOI: https://doi.org/10.1093/humupd/dmq001

Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA. Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol. 2006;154:141-5. DOI: https://doi.org/10.1530/eje.1.02058

Ezeh U, Ida Chen YD, Azziz R. Racial and ethnic differences in the metabolic response of polycistic ovary síndrome. Clin Endocrinol. 2020;93(2):163-72. DOI: https://doi.org/10.1111/cen.14193

Kazemi M, Kim JY, Parry SA, Azziz R, Lujan ME. Disparities in cardio metabolic risk between Black and White women with polycystic ovary syndrome: a systematic review and meta-analysis. AJOG. 2021;224(5):428-44. DOI: https://doi.org/10.1016/j.ajog.2020.12.019

Rubin KH, Glintborg D, Nybo M, Abrahamsen B, Andersen M. Development and risk factors of type 2 diabetes in a nationwide population of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2017;102(10):3848-57. DOI: https://doi.org/10.1210/jc.2017-01354

Norman RJ, Masters L, Milner CR, Wang JX, Davies MJ. Relative risk of conversion from normoglycaemia to impaired glucose tolerance or non-insulin dependent diabetes mellitus in polycystic ovarian syndrome. Human Reproduction. 2001; 9:1995-998. DOI: https://doi.org/10.1093/humrep/16.9.1995

Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2010;16(4):347-63. DOI: https://doi.org/10.1093/humupd/dmq001

Sabán M. Metabolismo de los hidratos de carbono en el síndrome de ovario poliquístico. Rev Argent Endocrinol Metab. 2012 [acceso: 04/07/2021];49(2). Disponible en: http://www.scielo.org.ar/pdf/raem/v49n2/v49n2a05.pdf

Boudreaux MY, Talbott EO, Kip KE, Brooks MM, Witchel SF. Risk of T2DM and impaired fasting glucose among PCOS subjects: results of an 8-year follow-up. Current Diabetes Reports. 2006;1:77-83. DOI: https://doi.org/10.1007/s11892-006-0056-1

Ollila ME, West S, Keinanen Kiukaanniemi S, Jokelainen J, Auvinen J, Puukka K, et al. Overweight and obese but not normal weight women with PCOS are at increased risk of type 2 diabetes mellitus-a prospective, population-based cohort study. Hum Reprod. 2017;2:423-31. DOI: https://doi.org/10.1093/humrep/dew329

Kakoly NS, Earnest A, Teede HJ, Moran LJ, Joham AE. The impact of obesity on the incidence of type 2 diabetes among women with polycystic ovary syndrome. Diabetes Care. 2019;42(4):560-67. DOI: https://doi.org/10.2337/dc18-1738

Salley KE, Wickham EP, Cheang KL, Essah PA, Karjane NW, Nestler JE. Glucose intolerance in polycystic ovary syndrome a position statement of the Androgen Excess Society. J Clin Endocrinol Metab. 2007;92(12):4546-56. DOI: https://doi.org/10.1210/jc.2007-1549

Macut D, Bjekic Macut J, Livadas S. Nonalcoholic Fatty Liver Disease in Patients with Polycystic Ovary Syndrome. Curr Pharm Des. 2018;24(38):4593-7. DOI: https://doi.org/10.2174/1381612825666190117100751

Jones H, Sprung VS, Pugh CJ, Daousi C, Irwin A, Aziz N, et al. Polycystic ovary syndrome with hyperandrogenism is characterized by an increased risk of hepatic steatosis compared to nonhyperandrogenic PCOS phenotypes and healthy controls, independent of obesity and insulin resistance. J Clin Endocrinol Metab. 2012;97(10):3709-16. DOI: https://doi.org/10.1210/jc.2012-1382

Setji TL, Holland ND, Sanders LL, Pereira KC, Diehl AM, Brown AJ. Nonalcoholic steatohepatitis and nonalcoholic Fatty liver disease in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:1741-7. DOI: https://doi.org/10.1210/jc.2005-2774

Ayonrinde OT, Adams LA, Doherty DA, Mori TA, Beilin LJ, Oddy WH, et al. Adverse metabolic phenotype of adolescent girls with non-alcoholic fatty liver disease plus polycystic ovary syndrome compared with other girls and boys. J Gastroent Hepat. 2016;31:980-87. DOI: https://doi.org/10.1111/jgh.13241

Cree Green M, Bergman BC, Coe GV, Newnes L, Baumgartner AD, Bacon S, et al. Hepatic steatosis is common in adolescents with obesity and PCOS and relates to de novo lipogenesis but not insulin resistance. Obesity. 2016;24:2399-406. DOI: https://doi.org/10.1002/oby.21651

Targher G, Rossini M, Lonardo A. Evidence that non-alcoholic fatty liver disease and polycystic ovary syndrome are associated by necessity rather than chance: a novel hepato-ovarian axis? Endocrine. 2016;51:211-21. DOI: https://doi.org/10.1007/s12020-015-0640-8

Glintborg D, Rubin KH, Nybo M, Abrahamsen B, Andersen M. Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome. Cardiovasc Diabetol. 2018;17(1):37. DOI: https://doi.org/10.1186/s12933-018-0680-5

Zhao L, Zhu Z, Lou H, Zhu G, Huang W, Zhang S, et al. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Oncotarget. 2016;7(23):33715-21. DOI: https://doi.org/10.18632/oncotarget.9553

Zhou Y, Wang X, Jiang Y, Ma H, Chen L, Lai C, et al. Association between polycystic ovary syndrome and the risk of stroke and all-cause mortality: insights from a meta-analysis. Gynecol Endocrinol. 2017;33(12):904-10. DOI: https://doi.org/10.1080/09513590.2017.1347779

de Groot PC, Dekkers OM, Romijn JA, Dieben SW, Helmerhorst FM. PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis. Hum Reprod Update. 2011;17(4):495-500. DOI: https://doi.org/10.1093/humupd/dmr001

Carmina E, Lobo RA. Is There Really Increased Cardiovascular Morbidity in Women with Polycystic Ovary Syndrome? J Women’s Health. 2018;27(11):1385-8. DOI: https://doi.org/10.1089/jwh.2018.7162

Oncul M, Uzun H. Polycystic ovary síndrome and endotelial dysfunction: A potencial role for soluble lectin-like oxidized low density lipoprotein receptor-1. Reprod Biol.2020;20(3):396-401. DOI: https://doi.org/10.1016/j.repbio.2020.04.006

Tripathy P, Sahu A, Sahu M, Nagy A. Ultrasonographic evaluation of intra-abdominal fat distribution and study of its influence on subclinical atherosclerosis in women with polycystic ovarian syndrome. Eur J Obs Gynecol Reprod Biol. 2017;217:18-22. DOI: https://doi.org/10.1016/j.ejogrb.2017.08.011

Christian RC, Dumesic DA, Behrenbeck T, Oberg AL, Sheedy PF, Fitzpatrick LA. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88(6):2562-68 . DOI: https://doi.org/10.1210/jc.2003-030334

Talbott EO, Zborowski JV, Rager JR, Boudreaux MY, Edmundowicz DA, Guzick DS. Evidence for an association between metabolic cardiovascular syndrome and coronary and aortic calcification among women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2004;89(11):5454-61. DOI: https://doi.org/10.1210/jc.2003-032237

Chang AY, Ayers C, Minhajuddin A, Jain T, Nurenberg P, de Lemos JA, et al. Polycystic ovarian syndrome and subclinical atherosclerosis among women of reproductive age in the Dallas heart study. Clin Endocrinol (Oxf). 2011;74(1):89-96. DOI: https://doi.org/10.1111/j.1365-2265.2010.03907.x

Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:1929-35. DOI: https://doi.org/10.1210/jc.2004-1045

Dokras A. Cardiovascular disease risk in women with PCOS. Steroids. 2013;8:773-6. DOI: https://doi.org/10.1016/j.steroids.2013.04.009

Meyer ML, Malek AM, Wild RA, Korytkowski MT, Talbott EO. Carotid artery intima-media thickness in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(2):112-26 . DOI: https://doi.org/10.1093/humupd/dmr046

Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman's long-term health using data linkage. J Clin Endocrinol Metab. 2015;3:911-9. DOI: https://doi.org/10.1210/jc.2014-3886

Ding T, Hardiman PJ, Petersen I, Wang FF, Qu F, Baio G. The prevalence of polycystic ovary syndrome in reproductive aged women of different ethnicity: a systematic review and meta-analysis. Oncotarget. 2015;8:96351-8. DOI: https://doi.org/10.18632/oncotarget.19180

Schmidt J, Landin Wilhelmsen K, Brännström M, Dahlgren E. Cardiovascular disease and risk factors in PCOS women of postmenopausal age: a 21-year controlled follow-up study. J Clin Endocrinol Metabol. 2011;96;3794-803. DOI: https://doi.org/10.1210/jc.2011-1677

Iftikhar S, Collazo Clavell ML, Roger VL, St Sauver J, Brown RD, Cha S, et al. Risk of cardiovascular events in patients with polycystic ovary syndrome. Neth J Med. 2012 [acceso: 04/07/2021];70(2):74-80. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582228/pdf/nihms434045.pdf

Anderson SA, Barry JA, Hardiman PJ. Risk of coronary heart disease and risk of stroke in women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Cardiol. 2014;2:486-7. DOI: http://dx.doi.org/10.1016/j.ijcard.2014.06.079

Wekker V, van Dammen L, Koning A, Heida KY, Painter RC, Limpens J, et al. Long-term cardiometabolic disease risk in women with PCOS: a systematic review and meta-analysis. Humn Reprod Update. 2020;26(6):942-60. DOI: https://doi.org/10.1093/humupd/dmaa029

Heida KY, Bots ML, de Groot CJ, van Dunné FM, Hammoud NM, Hoek A, et al. Cardiovascular risk management after reproductive and pregnancy-related disorders: A Dutch multidisciplinary evidence-based guideline. Eur J Prev Cardiol. 2016;23(17):1863-79. DOI: https://doi.org/10.1177/2047487316659573

Enlaces refback

  • No hay ningún enlace refback.


Copyright (c) 2022 Manuel Gomez Alzugaray, Yudith García García, Gilda Monteagudo Peña, Gisel Ovies Carballo, Maité Cabrera Gamez

Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.