Carotid artery intima-media thickness in polycystic ovary syndrome: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder associated with cardiovascular disease (CVD) risk factors and metabolic disturbances. This systematic review and meta-analysis was conducted to determine whether carotid intima-media thickness (CIMT), a marker of subclinical atherosclerosis, is higher in women with PCOS compared with women without PCOS. METHODS: Primary articles reporting the mean CIMT in women with PCOS and controls were identified using Ovid MEDLINE, EMBASE and PUBMED. We performed a random-effects meta-analysis and created forest plots of the mean difference in CIMT and conducted tests for heterogeneity and publication bias. Studies were grouped by quality, defined by reporting reproducibility of CIMT and averaging both common carotid arteries versus one side for CIMT. RESULTS: From the 36 eligible full-text studies, 8 studies were included in the systematic review and 19 studies were included in the meta-analysis (total n= 1123 women with PCOS, n= 923 controls). The summary mean difference in CIMT among women with PCOS compared with controls was 0.072 mm [95% confidence interval (CI) 0.040, 0.105, P < 0.0001] for highest quality studies, 0.084 mm (95% CI 0.042, 0.126, P = 0.0001) for good quality studies, 0.041 (95% CI -0.038, 0.120, P = 0.310) for fair-quality studies and 0.045 (95% CI -0.020, 0.111, P = 0.173) for lower quality studies. CONCLUSIONS: Larger studies with a well-defined PCOS population using rigorous methodology may be required to draw a more robust conclusion. However, these results suggest women with PCOS are at a greater risk of premature atherosclerosis, which emphasizes the importance of screening and monitoring CVD risk factors in women with PCOS.
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Young women and adolescents with PCOS have early atherosclerotic cardiovascular disease, including increased carotid intimal medial thickness and carotid plaque.
“Young women and adolescents with PCOS have been shown to have early atherosclerotic CVD, including increased carotid intimal medial thickness and carotid plaque.86, 87, 88, 89”
From Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort (2024) · cites this paper as [86]
The Conclusions report higher carotid intima-media thickness (CIMT) in women with PCOS than in controls, and note that most studies involved young women. The paper does not establish the claim for adolescents or report increased carotid plaque. It describes CIMT as subclinical atherosclerosis and cautions that CVD risk may not become evident until later in life. (LLM, conf=0.88)
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Complications and challenges associated with polycystic ovary syndrome: current perspectives
Palomba, S., Santagni, S., Falbo, A., & La Sala, G. B. (2015) · International Journal of Women's Health · doi:10.2147/ijwh.s70314 · Cited by 287 · see citing works
Beyond fertility: polycystic ovary syndrome and long-term health
Cooney, L. G., & Dokras, A. (2018) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.08.021 · Cited by 270 · see citing works
Metabolic risk in PCOS: Phenotype and adiposity impact
Moran, L. J., Norman, R. J., & Teede, H. J. (2015) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2014.12.003 · Cited by 245 · see citing works
Metabolic Syndrome and PCOS: Pathogenesis and the Role of Metabolites
Chen, W., & Pang, Y. (2021) · Metabolites · doi:10.3390/metabo11120869 · Cited by 228 · see citing works
The management of patients with polycystic ovary syndrome
Jayasena, C. N., & Franks, S. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.102 · Cited by 196 · see citing works
Polycystic ovary syndrome: a “risk-enhancing” factor for cardiovascular disease
Guan, C. S., Zahid, S., Minhas, A., Ouyang, P., Vaught, A. “. J., Baker, V. L., & Michos, E. D. (2022) · Fertility and Sterility · doi:10.1016/j.fertnstert.2022.03.009 · Cited by 207 · see citing works
Comorbidities and complications of polycystic ovary syndrome: An overview of systematic reviews
Gilbert, E. W., Tay, C. T., Hiam, D. S., Teede, H. J., & Moran, L. J. (2018) · Clinical Endocrinology · doi:10.1111/cen.13828 · Cited by 166 · see citing works
Cardiovascular disease risk in women with PCOS
Dokras, A. (2013) · Steroids · doi:10.1016/j.steroids.2013.04.009 · Cited by 132 · see citing works
Witchel, S. F., Teede, H. J., & Peña, A. S. (2019) · Pediatric Research · doi:10.1038/s41390-019-0615-1 · Cited by 129 · see citing works
Wild, R. A. (2012) · Steroids · doi:10.1016/j.steroids.2011.12.002 · Cited by 117 · see citing works
Self-citationCalderon‐Margalit, R., Siscovick, D. S., Merkin, S. S., Wang, E. T., Daviglus, M. L., Schreiner, P. J., Sternfeld, B., Williams, O. D., Lewis, C. E., Azziz, R., et al. (2014) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.114.304136 · Cited by 105 · see citing works
“Overall, a meta-analysis reported an increased IMT among women with PCOS, but noted the high heterogeneity among studies.(26) In 2 studies, one by Arikan et al(25) and one by Costa et al,(40) negative results were reported for the association between PCOS and CCA-IMT.”
ResultDuică, F., Dănilă, C. A., Boboc, A. E., Antoniadis, P., Condrat, C. E., Onciul, S., Suciu, N., Creţoiu, S. M., Varlas, V. N., & Crețoiu, D. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.614679 · Cited by 106 · see citing works
Oxidative stress and cardiovascular complications in polycystic ovarian syndrome
Hyderali, B. N., & Mala, K. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.05.005 · Cited by 95 · see citing works
Baldani, D. P., Škrgatić, L., & Ougouag, R. (2015) · International Journal of Endocrinology · doi:10.1155/2015/786362 · Cited by 81 · see citing works
Do GLP-1 Analogs Have a Place in the Treatment of PCOS? New Insights and Promising Therapies
Szczesnowicz, A., Szeliga, A., Niwczyk, O., Bala, G., & Meczekalski, B. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12185915 · Cited by 83 · see citing works
“Markers of these dysfunctions often correlate with flow-mediated dilatation, carotid intima-media thickness, and the presence of coronary artery disease [12].”
BackgroundKahal, H., Aburima, A., Ungvari, T., Rigby, A. S., Coady, A. M., Vince, R. V., Ajjan, R. A., Kilpatrick, E. S., Naseem, K. M., & Atkin, S. L. (2015) · BMC Endocrine Disorders · doi:10.1186/s12902-015-0005-6 · Cited by 74 · see citing works
“Despite the lack of long term cardiovascular (CV) outcome data, PCOS has been linked to several CV risk markers including type 2 diabetes [3], increased carotid intima-media wall thickness (cIMT) [4] and impaired platelet function [5,6].”
BackgroundEly, B. R., Francisco, M. A., Halliwill, J. R., Bryan, S. D., Comrada, L. N., Larson, E. A., Brunt, V. E., & Minson, C. T. (2019) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00078.2019 · Cited by 74 · see citing works
Samimi, M., Dadkhah, A., Kashani, H. H., Ebrahimi, M. T., Hosseini, E. S., & Asemi, Z. (2018) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-018-9405-z · Cited by 73 · see citing works
“creased in PCOS due to dyslipidemia [42].”
Are women with polycystic ovary syndrome at increased cardiovascular disease risk later in life?
Gunning, M. N., & Fauser, B. C. J. M. (2017) · Climacteric · doi:10.1080/13697137.2017.1316256 · Cited by 72 · see citing works
“The summary estimate of the mean difference in CIMT among women with PCOS compared with controls was 0.072 mm (95% CI 0.040 – 0.105, p 0.0001) for highest-quality studies and 0.084 mm (95% CI 0.042 – 0.126, p ¼ 0.0001) for good-quality studies, with higher CIMTs for women with PCOS 25 .”
InfluentialThe cardiovascular risk profile of middle‐aged women with polycystic ovary syndrome
Meun, C., Gunning, M. N., Louwers, Y. V., Peters, H. E., Roos‐Hesselink, J. W., van Lennep, J. E. R., Rueda-Ochoa, O. L., Appelman, Y., Lambalk, C. B., Boersma, E. H., et al. (2019) · Clinical Endocrinology · doi:10.1111/cen.14117 · Cited by 65 · see citing works
Exercise and Polycystic Ovary Syndrome
Woodward, A., Klonizakis, M., & Broom, D. R. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-981-15-1792-1_8 · Cited by 64 · see citing works
Gender Differences in Atherosclerotic Vascular Disease: From Lipids to Clinical Outcomes
Vakhtangadze, T., Tak, R. S., Singh, U., Baig, M. S., & Bezsonov, E. E. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.707889 · Cited by 64 · see citing works
“conducted a meta-analysis showing that CIMT is increased in women with PCOS compared to controls, indicating an increased risk of accelerated atherosclerosis in PCOS patients (17).”
BackgroundCardiometabolic risk in polycystic ovary syndrome
Studen, K. B., & Pfeifer, M. (2018) · Endocrine Connections · doi:10.1530/ec-18-0129 · Cited by 65 · see citing works
Cardiometabolic risks in PCOS: a review of the current state of knowledge
Kakoly, N. S., Moran, L., Teede, H. J., & Joham, A. E. (2018) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2019.1556094 · Cited by 64 · see citing works
“072 mm between women with and without PCOS, with a thicker carotid intima seen among women with PCOS [78].”
BackgroundLong‐term health outcomes in young women with polycystic ovary syndrome: A narrative review
Allen, L. A., Shrikrishnapalasuriyar, N., & Rees, A. (2021) · Clinical Endocrinology · doi:10.1111/cen.14609 · Cited by 73 · see citing works
Update on sex specific risk factors in cardiovascular disease
Nguyen, A. H., Hurwitz, M., SULLIVAN, S. A., Saad, A. F., Kennedy, J. L. W., & Sharma, G. V. (2024) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2024.1352675 · Cited by 61 · see citing works
Inflammatory biomarkers and telomere length in women with polycystic ovary syndrome
Pedroso, D. C. C., Furtado, C. L. M., Kogure, G. S., Meola, J., Okuka, M., Silva, C., Calado, R. T., Ferriani, R. A., Keefe, D. L., & dos Reis, R. M. (2014) · Fertility and Sterility · doi:10.1016/j.fertnstert.2014.10.035 · Cited by 58 · see citing works
Jamilian, M., Bahmani, F., Siavashani, M. A., Mazloomi, M., Asemi, Z., & Esmaillzadeh, A. (2015) · Biological Trace Element Research · doi:10.1007/s12011-015-0570-6 · Cited by 57 · see citing works
“(IL-18) [4] and biomarkers of oxidative stress in patients with PCOS may promote atherosclerosis by accelerating endothelial dysfunction [5].”
Joham, A. E., Kakoly, N. S., Teede, H. J., & Earnest, A. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab134 · Cited by 53 · see citing works
Hughan, K. S., Tfayli, H. M., Warren-Ulanch, J., Barinas‐Mitchell, E., & Arslanian, S. A. (2015) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2015.09.082 · Cited by 53 · see citing works
“In addition, numerous adult studies have shown adverse structural changes in cIMT in premenopausal women with PCOS compared with age and/or BMI-matched controls without PCOS.(27) Furthermore, coronary artery and aortic calcification are increased in women with PCOS compared with controls, with the presence of PCOS, ag…”
BackgroundResultVine, D., Ghosh, M., Wang, T., & Bakal, J. (2024) · CJC Open · doi:10.1016/j.cjco.2023.12.010 · Cited by 53 · see citing works
Ouyang, P., WENGER, N. K., Taylor, D. A., Rich-Edwards, J. W., Steiner, M. S., Shaw, L. J., Berga, S. L., Miller, V. M., & Merz, C. N. B. (2016) · Biology of Sex Differences · doi:10.1186/s13293-016-0073-y · Cited by 51 · see citing works
“While the etiology of PCOS is multifactorial and involves excess androgen secretion by ovaries and adrenal glands (primarily androstenedione), genetic, epigenetic factors, and environmental factors, such as insulin resistance/diabetes and obesity, there is insufficient robust prospective data to clearly determine whet…”
BackgroundMukherjee, A. G., Wanjari, U. R., Kannampuzha, S., Murali, R., Namachivayam, A., Ganesan, R., Dey, A., Babu, A., Renu, K., Vellingiri, B., et al. (2023) · Metabolites · doi:10.3390/metabo13010129 · Cited by 52 · see citing works
Sex and Gender Aspects in Vascular Ageing – Focus on Epidemiology, Pathophysiology, and Outcomes
Seeland, U., Nemcsik, J., Lønnebakken, M. T., Kublickiene, K. R., Schluchter, H., Park, C. M., Pucci, G., Mozos, I. M., & Bruno, R. M. (2021) · Heart Lung and Circulation · doi:10.1016/j.hlc.2021.07.006 · Cited by 47 · see citing works
Armeni, E., Stamatelopoulos, K. S., Rizos, D., Georgiopoulos, G., Kazani, M. V., Kazani, A., Kolyviras, A., Stellos, K., Panoulis, K. P. C., Alexandrou, A. P., et al. (2013) · Journal of Hypertension · doi:10.1097/hjh.0b013e3283630362 · Cited by 46 · see citing works
Increased thrombin generation in women with polycystic ovary syndrome
Glintborg, D., Sidelmann, J. J., Altinok, M. L., Mumm, H., & Andersen, M. (2015) · Metabolism · doi:10.1016/j.metabol.2015.06.011 · Cited by 45 · see citing works
“Patients with PCOS have increased levels of cardiovascular risk markers [3] increased risk of venous thromboembolism [4,5] and significant subclinical atherosclerosis compared with healthy controls [6–8].”
BackgroundCardiometabolic Risk in Polycystic Ovary Syndrome
Cooney, L. G., & Dokras, A. (2021) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2020.11.001 · Cited by 44 · see citing works
“0001; meta-analysis of 19 studies).(51) In the general population, for every 0.”
MethodJabbour, R., Ott, J., Eppel, W., & Frigo, P. (2020) · PLOS ONE · doi:10.1371/journal.pone.0232299 · Cited by 43 · see citing works
Polycystic Ovary Syndrome as a Paradigm for Prehypertension, Prediabetes, and Preobesity
Luque‐Ramírez, M., & Escobar-Morreale, H. F. (2014) · Current Hypertension Reports · doi:10.1007/s11906-014-0500-6 · Cited by 42 · see citing works
Taskin, M. I., Bulbul, E., Adali, E., Hismiogulları, A. A., & Inceboz, U. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.03.006 · Cited by 36 · see citing works
“Established cardiovascular risk factors, such as age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, BMI, LDL cholesterol, and smoking are associated with CIMT [19].”
BackgroundStudy of early atherosclerotic markers in women with polycystic ovary syndrome
Karoli, R., Fatima, J., Siddiqi, Z., Vatsal, P., Sultania, A., & Maini, S. (2012) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.103021 · Cited by 36 · see citing works
“,[29] after 21 years follow-up in PCOS women of postmenopausal age does not entail an evident increase in cardiovascular events, Meyer et al.”
Polycystic Ovary Syndrome, Insulin Resistance, and Cardiovascular Disease
Dubey, P., Reddy, S., Sharma, K., Johnson, S., Hardy, G., & Dwivedi, A. K. (2024) · Current Cardiology Reports · doi:10.1007/s11886-024-02050-5 · Cited by 38 · see citing works
“A meta-analysis in women with PCOS has found higher CIMT (SMD 0.072 mm; 95% CI, 0.040–0.105; p < 0.0001; n = 19 studies) [48].”
InfluentialThe impact of ageing and menopause in women with polycystic ovary syndrome
Helvaci, N., & Yildiz, B. O. (2022) · Clinical Endocrinology · doi:10.1111/cen.14558 · Cited by 32 · see citing works
Krentowska, A., Łebkowska, A., Jacewicz‐Święcka, M., Hryniewicka, J., Leśniewska, M., Adamska, A., & Kowalska, I. (2021) · Endocrine · doi:10.1007/s12020-020-02596-8 · Cited by 32 · see citing works
Rees, E., Coulson, R.-M. K., Dunstan, F., Evans, W. D., Blundell, H. L., Luzio, S. D., Dunseath, G. J., Halcox, J., Fraser, A. G., & Rees, A. (2014) · Human Reproduction · doi:10.1093/humrep/deu180 · Cited by 32 · see citing works
“08 mm greater than matched controls (Meyer et al., 2012).”
Chiu, W.-L., Boyle, J. A., Vincent, A. J., Teede, H. J., & Moran, L. (2016) · Neuroendocrinology · doi:10.1159/000455233 · Cited by 31 · see citing works
Kim, M. S., Dao-Tran, A., Davidowitz, E., Tseng, T., Gilsanz, V., Ryabets‐Lienhard, A., Nguyen, E., & Geffner, M. E. (2016) · Hormone Research in Paediatrics · doi:10.1159/000444169 · Cited by 28 · see citing works
Dwivedi, A. K., Vishwakarma, D., Dubey, P., & Reddy, S. (2023) · European Journal of Endocrinology · doi:10.1093/ejendo/lvad067 · Cited by 27 · see citing works
Polycystic Ovarian Syndrome: a Risk Factor for Cardiovascular Disease
Alvarez, Y. R., Pico, M. G., Ashokprabhu, N. D., Abou-Amro, K., Bailey, S., Pung, E., Oberholster, E., & Quesada, O. (2023) · Current Atherosclerosis Reports · doi:10.1007/s11883-023-01168-1 · Cited by 26 · see citing works
“Individuals with PCOS have a 0.072–0.084 mm higher CIMT compared to controls [45] .”
InfluentialLactonase activity and status of paraoxonase 1 in Chinese women with polycystic ovarian syndrome
Zhang, Y., Liu, H., He, J., Xu, K., Bai, H., Wang, Y., Zhang, F., Zhang, J., Cheng, L., & Fan, P. (2015) · European Journal of Endocrinology · doi:10.1530/eje-14-0863 · Cited by 26 · see citing works
Talari, H. R., Poladchang, S., Hamidian, Y., Samimi, M., Gilasi, H. R., Ebrahimi, F. A., & Asemi, Z. (2018) · Oman Medical Journal · doi:10.5001/omj.2018.88 · Cited by 26 · see citing works
Woodward, A., Broom, D. R., Harrop, D., Lahart, I. M., Carter, A., Dalton, C., Metwally, M., & Klonizakis, M. (2019) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-019-00425-y · Cited by 24 · see citing works
Possible Effect of Polycystic Ovary Syndrome (PCOS) on Cardiovascular Disease (CVD): An Update
Profili, N. I., Castelli, R., Gidaro, A., Manetti, R., Maioli, M., Petrillo, M., Capobianco, G., & Delitala, A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13030698 · Cited by 24 · see citing works
“The authors followed the participants for a median of 15.4 years and found that silent coronary artery disease was similar between the two groups [84].”
BackgroundInfluentialKhorshidi, A., Azami, M., Tardeh, S., & Tardeh, Z. (2019) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2019.06.008 · Cited by 23 · see citing works
Gencer, M., Gazı, E., Hacıvelioğlu, S., Binnetoğlu, E., Barutçu, A., Türkön, H., Temız, A., Altun, B., Vural, A., Cevızcı, S., et al. (2014) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2014.07.032 · Cited by 23 · see citing works
“It has been reported that CIMT was increased in patients with PCOS more than in control subjects [26].”
Deveer, M., Deveer, R., Basaran, O., Turkcu, U. O., Akbaba, E., Cullu, N., Turhan, N., Kucuk, M., & Kasap, B. (2015) · Journal of Clinical Medicine Research · doi:10.14740/jocmr2375w · Cited by 22 · see citing works
Zoet, G. A., Meun, C., Benschop, L. H., Boersma, E. H., Budde, R. P. J., Fauser, B. C. J. M., de Groot, C. J. M., van der Lugt, A., Maas, A. H. E. M., Moons, K. G. M., et al. (2017) · BMC Women s Health · doi:10.1186/s12905-017-0415-x · Cited by 21 · see citing works
Sun, D., Wu, Y., Ding, M., & Zhu, F. (2022) · Angiology · doi:10.1177/00033197211072598 · Cited by 20 · see citing works
Zhang, W., Wu, Y., Yuan, Y., Wang, L., Yu, B., Li, X., Yao, Z., & Liang, B. (2024) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2024.109239 · Cited by 20 · see citing works
Gonadal hormones and stroke risk: PCOS as a case study
Stewart, C. E., & Sohrabji, F. (2020) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2020.100853 · Cited by 19 · see citing works
Targets to treat androgen excess in polycystic ovary syndrome
Luque‐Ramírez, M., & Escobar-Morreale, H. F. (2015) · Expert Opinion on Therapeutic Targets · doi:10.1517/14728222.2015.1075511 · Cited by 18 · see citing works
“Women with PCOS have a higher prevalence of weight excess and central obesity [19], gestational diabetes [4], glucose intolerance, type 2 diabetes mellitus, and metabolic syndrome [4,20], dyslipidemia [21], hypertension [22], subclinical atherosclerosis [23,24], endothelial dysfunction [25], chronic subclinical inflam…”
BackgroundTalari, H. R., Azad, Z. J., Hamidian, Y., Samimi, M., Gilasi, H. R., Afshar, F. E., Ostadmohammadi, V., & Asemi, Z. (2019) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_2_18 · Cited by 18 · see citing works
Vine, D. F., Beilin, L. J., Burrows, S., Huang, R.-C., Hickey, M., Hart, R., Proctor, S. D., & Mori, T. A. (2020) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaa061 · Cited by 17 · see citing works
“Women with PCOS are reported to have increased incidence of type-2 diabetes and premature cardiovascular disease (CVD) [1-4].”
BackgroundKim, J., Choi, Y. M., Kang, J. H., Hwang, K. R., Chae, S. J., Kim, S. M., Ku, S., Kim, S. H., Kim, J. G., & Moon, S. Y. (2013) · Obstetrics & Gynecology Science · doi:10.5468/ogs.2013.56.4.249 · Cited by 17 · see citing works
“Recently, systematic review and meta-analysis has been reported [18].”
BackgroundBarcellos, C. R. G., Rocha, M. P., Hayashida, S. A. Y., Dantas, W. S., Yance, V. D. R. V., & Marcondes, J. A. M. (2015) · HORMONES · doi:10.14310/horm.2002.1584 · Cited by 17 · see citing works
Mažibrada, I., Djukic, T. I., Perović, S., Pljesa-Ercegovac, M. S., Plavšić, L., Bojanin, D., Bjekić-Macut, J., Simić, P. D., Simic, T. P., Savic-Radojevic, A. R., et al. (2018) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2017-0511 · Cited by 17 · see citing works
Garoufi, A., Pagoni, A., Papadaki, M., Marmarinos, A., Karapostolakis, G., Michala, L., & Soldatou, A. (2021) · Children · doi:10.3390/children9010004 · Cited by 18 · see citing works
“Some studies have demonstrated higher cIMT values in those with PCOS compared to age- and/or BMI-matched non-PCOS controls, whereas others have shown no difference between PCOS women and controls, independently of obesity, and between obese and normal-weight women independently of PCOS [19,20,24,43,44].”
BackgroundResultMidlife women’s health consequences associated with polycystic ovary syndrome
Ali, A. T., & Guidozzi, F. (2019) · Climacteric · doi:10.1080/13697137.2019.1679111 · Cited by 16 · see citing works
Kılıç, D., Kılıç, İ. D., Sevgican, C. İ., Kilic, O., Alataş, E., Arslan, M., Avcı, E., & Güler, T. (2020) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.14543 · Cited by 15 · see citing works
Pazderska, A., Tun, T. K., Phelan, N., McGowan, A., Sherlock, M., Behan, L., Boran, G. P., & Gibney, J. (2017) · Clinical Endocrinology · doi:10.1111/cen.13542 · Cited by 16 · see citing works
“Number 103 102 80 80 Age (y)a 28 (8) 32 (10) <.”
Cardiovascular Risk in Postmenopausal Women with Polycystic Ovary Syndrome
Armeni, E., & Lambrinoudaki, I. V. (2018) · Current Vascular Pharmacology · doi:10.2174/1570161116666180828154006 · Cited by 15 · see citing works
Mahboobifard, F., Rahmati, M., Niknam, A., Rojhani, E., Momenan, A. A., Azizi, F., & Tehrani, F. R. (2021) · Archives of Medical Research · doi:10.1016/j.arcmed.2021.11.001 · Cited by 14 · see citing works
Biomediators in Polycystic Ovary Syndrome and Cardiovascular Risk
Pandurevic, S., Μacut, D., Fanelli, F., Pagotto, U., & Gambineri, A. (2021) · Biomolecules · doi:10.3390/biom11091350 · Cited by 14 · see citing works
Joham, A. E., Rees, A., Shinkai, K., Forslund, M., Tay, C. T., & Teede, H. J. (2025) · Reproduction · doi:10.1530/rep-25-0121 · Cited by 13 · see citing works
Female-specific risk factors for cardiovascular disease: an update
Theodorou, A., Karagiannakis, D. S., Stefanaki, K., Kassi, E., Peppa, Μ., Vryonidou, A., & Paschou, S. Α. (2024) · HORMONES · doi:10.1007/s42000-024-00576-5 · Cited by 13 · see citing works
“Women with hyper-androgenism exhibit a higher progression ratio of coronary artery calcium (CAC) [65], an increased thickness of the carotid intimal medial and carotid plaque [66], and lower flow-mediated brachial artery dilation [67].”
Polycystic ovary syndrome and metabolic syndrome: the worrisome twosome?
Shah, D., & Rasool, S. (2015) · Climacteric · doi:10.3109/13697137.2015.1116505 · Cited by 13 · see citing works
van der Ham, K., Koster, M. P. H., Velthuis, B. K., Budde, R. P. J., Fauser, B. C. J. M., Laven, J. S. E., & Louwers, Y. V. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12165226 · Cited by 12 · see citing works
“Some studies also described an increased risk for subclinical atherosclerosis and endothelial dysfunction in young women with PCOS compared to controls, reflected in increased carotid intima-media thickness (CIMT) and Coronary Artery Calcification Scores (CACs) [6,7].”
BackgroundAssociation of serum androgens and coronary artery calcium scores in women
Penn, C. A., Chan, J. L., Mesaros, C., Snyder, N. W., Rader, D. J., Sammel, M. D., & Dokras, A. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2019.04.024 · Cited by 12 · see citing works
“Also, young premenopausal women with PCOS have reduced flow-mediated dilatation independent of BMI (35) and increased prevalence of high CIMT compared to controls (36).”
BackgroundXue-lan, L., Yang, J., Blockeel, C., Lin, M., Tian, X., Wu, H., Cao, Y., Deng, L., Zhou, X., Xie, J., et al. (2024) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14863 · Cited by 10 · see citing works
“8,9 These findings emphasize the importance of assessing “cardiometabolic risk” in women with PCOS in clinical practice.”
BackgroundGambineri, A., Rosa, S., Pandurevic, S., Cecchetti, C., Rotolo, L., Dionese, P., Belardinelli, E., Solmi, B., Zavatta, G., Fanelli, F., et al. (2025) · European Journal of Endocrinology · doi:10.1093/ejendo/lvaf027 · Cited by 11 · see citing works
Pandurevic, S., Bergamaschi, L., Pizzi, C., Patton, L., Rucci, P., Corzani, F., Cecchetti, C., Pelusi, C., Altieri, P., Vicennati, V., et al. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0725 · Cited by 11 · see citing works
Nejabati, H. R., Samadi, N., Roshangar, L., & Nouri, M. (2019) · Life Sciences · doi:10.1016/j.lfs.2019.116843 · Cited by 11 · see citing works
Godtfredsen, A. C., Sidelmann, J. J., Gram, J., Andersen, M., & Glintborg, D. (2020) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.13825 · Cited by 11 · see citing works
Wu, Y., Yang, X., Hu, Y., Hu, X., Zhang, Y., An, T., Lv, B., Tao, S., Liu, Q. F., & Jiang, G. (2023) · Food Science & Nutrition · doi:10.1002/fsn3.3473 · Cited by 10 · see citing works
Aspects of Cardiometabolic Risk in Women with Polycystic Ovary Syndrome
Paterakis, T., & Diamanti‐Kandarakis, E. (2014) · Current Obesity Reports · doi:10.1007/s13679-014-0127-6 · Cited by 10 · see citing works
Abalı, R., Taşdemir, N., Alpsoy, Ş., Tasdemir, U. G., Güzel, S., Yüksel, M. A., Yüksel, İ. T., & Yılmaz, M. (2014) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-014-3499-7 · Cited by 10 · see citing works
“072 mm for women with PCOS for the high-quality studies, similar to our finding [26].”
Resultda Silva, A. V., de Melo, A. S., Barboza, R. P., Martins, W. P., Ferriani, R. A., & Vieira, C. S. (2016) · Reproductive Sciences · doi:10.1177/1933719115623648 · Cited by 10 · see citing works
Wu, X., Wilke, M., Batara, J., Proctor, S. D., Cree‐Green, M., Ghosh, M., Raggi, P., Windram, J. D., Becher, H. H., & Vine, D. F. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1520922 · Cited by 9 · see citing works
Woodward, A., Klonizakis, M., Lahart, I. M., Carter, A., Dalton, C., Metwally, M., & Broom, D. R. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1030-8 · Cited by 9 · see citing works
Nandi, A., Singh, K. D., & Sharma, K. (2025) · Microchimica Acta · doi:10.1007/s00604-025-07187-w · Cited by 9 · see citing works
“…load consists of cardiovascular diseases (dyslipidemia [7], hypertension [8], myocardial infarction, stroke [9], carotid intima-media thickness [10]), metabolic risk (obesity [11], insulin resistance [12], nonalcoholic fatty liver disease [13], obstructive sleep apnea [14]), endometrial cancer…”
Adams, Z. H., Berbrier, D. E., Schwende, B. K., Huckins, W., Richards, C. T., Rees, A., Usselman, C. W., & Lord, R. N. (2025) · The Journal of Physiology · doi:10.1113/jp287288 · Cited by 8 · see citing works
Dharmalingam, M., Garg, N., Prabhu, V. M. D., & Murthy, N. S. (2016) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.190552 · Cited by 8 · see citing works
“Materials and Methods: The cross‑sectional case‑control study was conducted in a tertiary care Hospital in South India.”
BackgroundResultInfluentialCardiovascular health and menopause in aging women with polycystic ovary syndrome
Helvacı, N., & Yıldız, B. O. (2020) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2020.1719067 · Cited by 8 · see citing works
“Moreover, surrogate markers of early subclinical arterial disease such as increased carotid intima media thickness [29] and coronary artery calcification [30] or”
Background
- Authors
- Meyer, M. L., Malek, A. M., Wild, R. A., Korytkowski, M. T., & Talbott, E. O.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of Pittsburgh (US)
- OU Health (US)
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Meyer, Michelle L.
- Venue
- Human Reproduction Update
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-11-22
- Volume
- 18
- Issue
- 2
- Pages
- 112-126
- ISSN
- 1355-4786 (ISSN-L)
- 1460-2369
- PMC
- PMC3383099
- OpenAlex
- W2165694459
- Cited by
- 175
- References
- 79
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 12 · 2023: 10 · 2022: 10 · 2021: 17 · 2020: 12 · 2019: 18 · 2018: 12 · 2017: 9 · 2016: 7 · 2015: 22 · 2014: 16 · 2013: 7 · 2012: 1
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Human Reproduction Update (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32 5T32HL007055-35, T32HL083825, T32HL007055)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- polycystic ovary syndrome, carotid intima-media thickness, subclinical atherosclerosis, cardiovascular risk, premature atherosclerosis, women's cardiovascular health, study quality heterogeneity
- MeSH terms
- Female, Humans, Polycystic Ovary Syndrome, Risk Factors, Atherosclerosis, Carotid Intima-Media Thickness
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