Polycystic Ovary Syndrome patients frequently have increased heart disease risk. This is related to abnormal lipid profile, hypertension, insulin resistance and obesity. Patients with PCOS have increased facial hair, loss of scalp hair, elevated andogen levels, lack of ovulation and infertility. The normal ovulation does not occur in PCOS patients and LH levels are elevated while FSH levels are normal or slightly low. Because of elevated estrogen (estradiol) levels FSH is low (due to negative feedback). This causes theca cells in the ovaries to proliferate and that leads to increased androgen secretion. Lack of periods and ovulation follows.
Metabolic syndrome and cardiometabolic syndrome findings are also present in PCOS. Obesity, high blood pressure and insulin resistance are seen in these syndromes. It is known that insulin resistance , hyperinsulinemia (high blood levels of insulin) are also related to abnormal lipid profiles. This is because in these patients with high insulin and androgen levels the fat cells release the FFA’s (free fatty acids) into the circulation. Also these FFA’s cause the liver to make more VLDL (very low-density lipoprotein) which lead to high triglyceride levels.
Additionally some of these patients have elevated CRP (C-reactive protein) which is a marker of heart disease including myocardial infarction, sudden cardiac death, peripheral vascular disease and stroke. Some patient could have no apparent cardiovascular problem and normal lipid levels, but high CRP (over 5 mg/L). If the hsCRP (high sensitivity C-reactive protein) is high, these patient may benefit from treatment to lower these levels and reduce their cardiovascular risk. PCOS patient can benefit from screening for cardiovascular risk and proper intervention.