Risk Assessment Of Cardiovascular Disease In Polycystic Ovary Syndrome

Objective:To assess the risk of cardiovascular disease in PCOS,exploring the risk factors for the increased cardiovascular risk of PCOS,and to analyze its ability to predict an increased risk of cardiovascular disease.Methods:（1）Using case-control retrospective study,301 PCOS patients from 2018 to2021 were collected as case group and 174 non-PCOS patients were collected as control group.Two groups of general data were collected and measured sex hormone,fasting blood glucose,fasting insulin,glycosylated hemoglobin,blood lipid,C reactive protein,homocysteine,vitamin D and so on.Cardiovascular risk score for all subjects（CVRS）.（2）SPSS26.0 and Graph Pad Prism 8 software were used for statistical analysis.First of all,all the data are tested for normality（K-S test）,the normal distribution is represented by mean±standard deviation（（?）±s）,and the non-normal distribution is represented by median（quartile）[M（Q₁,Q₃）];The comparison between the two groups was carried out by independent sample T test or Mann-Whitney（Mann-Whitney U test）non-parametric test,between the three groups the statistical differences were tested by the Kuscar-Wallis（Kruskal-Wallis H）test,after that,there are significant differences in the indicators after the pairwise comparison（Bonferroni correction method,correction inspection level P=0.017）.Correlation analysis adopts Spearman correlation analysis.Binary Logistic regression was used to analyze the influencing factors.Draw ROC curve to calculate the area,sensitivity and specificity of the curve.P<0.05 was statistically significant.Results:（1）There was no significant difference in age between the two groups（P>0.05）.The CVRS of PCOS group was 14（10～17）,which was significantly higher than that of control group 12（9～14）,P<0.05.The BMI、FPG、FINS、HOMA-IR、TC、TG、LDL-C、Apo B、T、FAI、HCY、CRP of PCOS group was significantly higher than that of the control group,while the HDL-C、Apo A1、vitamin D was significantly lower than that of the control group,P<0.05.（2）Spearman correlation analysis:PCOS group was positively correlated with BMI、FPG、FINS、HOMA-IR、HCY、CRP、Apo B,the correlation coefficient is 0.15、0.30、0.14、0.30、0.23、0.27、0.48,respectively,but negatively correlated with Apo A1、vitamin D,with correlation coefficients of-0.13,-0.22,respectively.（3）Comparison of different risk stratification（low,medium and high risk groups）in PCOS groups:There were significant differences in age、FINS、FPG、HOMA-IR、TG、TC、HDL-C、LDL-C and CRP between the three groups,P<0.05.After further comparison,the age、FPG、HOMA-IR、TC、LDL-C and CRP levels of high risk group were significantly higher than those of middle risk group and low risk group,P<0.0017（adjusted P=0.05/3）;The HDL-C of high risk group was significantly higher than that of low risk group,P<0.0017.（4）Binary Logistic regression analysis:HOMA-IR and CRP are the risk factors for increased cardiovascular risk in PCOS[1.40（95%CI:1.26,1.56）,1.12（95%CI:1.03,1.22）,P<0.05].（5）ROC curve analysis:HOMA-IR predicts points for increased cardiovascular risk in PCOS as 5.35（AUC=0.65,95%CI:0.56～0.75,sensitivity=76.74%,specificity=60.19%,P<0.05）;CRP predicts tangent values for increased cardiovascular risk in PCOS as 5.55（AUC=0.83,95%CI:0.75～0.91,sensitivity=100%,specificity=71.25%,and P<0.001）.Conclusion:The cardiovascular risk of PCOS is significantly higher than the normal population,with its metabolic disorders and prominent inflammatory response,among which IR and CRP play a core role in increasing cardiovascular risk,providing a reference for clinical intervention of CVD.