Early atherosclerotic cvd and impaired cardiac function and relationship to atherogenic dyslipidemia in high-risk young women with and without polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common reproductive-endocrine disorder affecting 15% of women across the lifespan. PCOS and obesity are associated with increased cardiovascular disease (CVD) risk, yet there remains limited research on early atherogenic dyslipidemia, atherosclerotic CVD (ACVD) and cardiac function in these conditions. We have shown those with PCOS have an exacerbated atherogenic lipid profile compared to BMI-matched individuals. The aim of this study was to examine the relationship between atherogenic dyslipidemia, ACVD and the cardiac function in high-risk young obese women with and without PCOS. Overweight-obese (BMI >25kg/m2) females aged 18-45 years with and without PCOS matched for age and BMI (non-PCOS). Healthy-weight controls were recruited as a reference group. Lipid profile, apoB-lipoproteins and remnant-cholesterol (C) were determined. Carotid intimal-medial thickness (cIMT), carotid plaque height (CPH), and cardiac function were determined by 2-D ultrasound and 3D-echocardiography. CVD risk scores including Framingham Risk Score (FRS), 10-yr CVD risk and ACVD risk were calculated. Multivariate regression analyses were used to determine the relationship of lipids and apoB lipoproteins with ACVD and cardiac function indices. Results: PCOS and non-PCOS groups were shown to have increased fasting and non-fasting triglycerides (TG), remnant-C, total ApoB, ApoB48, blood pressure, cIMT, left ventricular (LV) mass and LV posterior wall thickness compared to healthy-weight controls. Individuals with PCOS had 25-50% increased plasma TG and remnant-C, 30% higher CPH and A Peak ratio, and lower E/A ratio compared to the non-PCOS group. PCOS and non-PCOS groups also demonstrated a 3-4 fold higher FRS and 10-Year CVD risk compared to health-weight controls, and PCOS had higher ACVD Risk scores. cIMT and CPH were predicted by ApoB, LDL-C and remnant-C. Our results demonstrate early subclinical ACVD, impaired cardiac function and altered LV morphology in high-risk young females with and without PCOS, and this is associated with atherogenic dyslipidemia. Assessment of atherogenic dyslipidemia, ACVD, and cardiac function can be used to screen and re-stratify premature cardiovascular risk in the early management of CVD in young high-risk females with and without PCOS.