International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
Subclinical cardiac alterations and cardiometabolic profile in adolescents with newly diagnosed polycystic ovary syndrome: A cross-sectional comparative echocardiographic study.
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Aygün Ari Demet, Pehlivantürk Kizilkan Melis, Öztürk Musa, Ertuğrul İlker, Aykan Hayrettin Hakan, Karagöz Tevfik, Kanbur Nuray, Derman Orhan, Akgül Sinem
Аннотация
OBJECTIVE: While cardiometabolic comorbidities have been well established in adults with polycystic ovary syndrome (PCOS), it remains unclear whether the early signs of cardiovascular morbidity emerge during adolescence. This study aimed to investigate whether metabolic and cardiovascular alterations begin in adolescents with PCOS.
METHODS: The study included adolescents with PCOS and age and body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) matched healthy controls who were further grouped based on weight status as overweight/obese and normal weight. All participants underwent metabolic assessment through physical examination, laboratory tests, conventional echocardiography, tissue Doppler imaging, strain echocardiography, and 24-h Holter monitoring.
RESULTS: The PCOS group (n = 33) consisted of 19 overweight/obese and 14 normal-weight participants, while the control group (n = 43) included 20 overweight/obese and 23 normal-weight participants. Compared to controls, the PCOS group exhibited higher waist-to-hip ratio, liver enzymes, triglycerides, triglyceride-glucose index, and lower high-density lipoprotein cholesterol (P < 0.05). Among BMI subgroups, overweight/obese PCOS group had the highest insulin and homeostasis model assessment of insulin resistance levels compared to all other groups. The PCOS group showed higher left atrial (LA) end-systolic diameter, LA/aortic ratio, and lower left ventricular global peak longitudinal strain in the apical four-chamber view than controls (P < 0.05). Among BMI subgroups, the combination of PCOS and overweight/obesity was associated with the most unfavorable metabolic and cardiovascular profiles. The markers of LA diameter, LA/aortic ratio, and left ventricular mass were highest in the overweight/obese PCOS group.
CONCLUSION: Selected metabolic and echocardiographic markers showed modest differences when PCOS coexisted with obesity, suggesting a potentially higher cardiometabolic risk compared with PCOS or obesity alone. Early identification and targeted management are essential to mitigate long-term cardiometabolic complications in this high-risk group.
METHODS: The study included adolescents with PCOS and age and body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) matched healthy controls who were further grouped based on weight status as overweight/obese and normal weight. All participants underwent metabolic assessment through physical examination, laboratory tests, conventional echocardiography, tissue Doppler imaging, strain echocardiography, and 24-h Holter monitoring.
RESULTS: The PCOS group (n = 33) consisted of 19 overweight/obese and 14 normal-weight participants, while the control group (n = 43) included 20 overweight/obese and 23 normal-weight participants. Compared to controls, the PCOS group exhibited higher waist-to-hip ratio, liver enzymes, triglycerides, triglyceride-glucose index, and lower high-density lipoprotein cholesterol (P < 0.05). Among BMI subgroups, overweight/obese PCOS group had the highest insulin and homeostasis model assessment of insulin resistance levels compared to all other groups. The PCOS group showed higher left atrial (LA) end-systolic diameter, LA/aortic ratio, and lower left ventricular global peak longitudinal strain in the apical four-chamber view than controls (P < 0.05). Among BMI subgroups, the combination of PCOS and overweight/obesity was associated with the most unfavorable metabolic and cardiovascular profiles. The markers of LA diameter, LA/aortic ratio, and left ventricular mass were highest in the overweight/obese PCOS group.
CONCLUSION: Selected metabolic and echocardiographic markers showed modest differences when PCOS coexisted with obesity, suggesting a potentially higher cardiometabolic risk compared with PCOS or obesity alone. Early identification and targeted management are essential to mitigate long-term cardiometabolic complications in this high-risk group.