具有多囊卵巢综合征表型绝经女性心血管疾病发病风险研究

Risk analysis of cardiovascular events in postmenopausal women with PCOS phenotype

目的探讨具有多囊卵巢综合征(PCOS)表型的绝经女性心血管疾病的发生风险。方法以2005-01-01—2007-12-31于苏州大学附属第二医院健康体检的绝经女性346例为研究对象,根据有无PCOS表型分为2组:PCOS表型组(57例)和非PCOS表型组(289例)。随访以电话随访为主,辅以住院随访、门诊随访等。随访间歇为3个月,随访终点为主要不良心血管事件(MACE),随访截止日期为2014-12-31。生存率估算应用Kaplan-Meier法,组间生存率曲线差异采用log-rank检验,应用多变量Cox比例风险回归分析MACE的独立危险因素。结果非PCOS表型组有10例出现MACE,PCOS表型组有7例出现MACE。Kaplan-Meier曲线显示PCOS表型组无MACE生存率显著下降(χ2=4.754,P=0.023)。多变量Cox比例风险回归分析发现高密度脂蛋白胆固醇(HDL-C)较低、超敏C反应蛋白(hsCRP)较高和存在PCOS表型是MACE的独立预测因素。结论 PCOS表型是绝经女性发生心血管疾病的独立危险因素,有助于进一步行危险分层,且提示PCOS与心血管疾病密切相关。

Objective To explore the tisk of cardiovascular events in postmenopausal women with polycystic ovary syn- drome （PCOS） phenotype. Methods This study was a prospective follow-up study which included 346 postmenopausal women with PCOS phenotype between 2005-01-01 and 2007-12-31.These subjects were divided into two groups according to the presence or absence of PCOS phenotype： 57 cases in PCOS group and 289 in non-PCOS group.The main form of follow-up was telephone follow-up, supplemented by in patient follow-up and out-patient follow-up, the interval being 3 months.Follow-up endpoint events were the major adverse cardiovascular events （MACE）.The deadline of the fol- low-up was 12/31/2014.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared using the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACE.Results Ten patients in non-PCOS phenotype group had MACE, and 7 patients in PCOS phenotype group had MACE.Compared with non-PCOS phenotype group, PCOS phenotype group had a significantly decreased MACE-free survival （X2=4.754, P=0.023）.Multivariate Cox proportional hazards regression analysis showed that lower level of HDL-C, presence of PCOS phenotype and higher level of hs-CRP were independent predictors for MACE.Conclusion PCOS phenotype is an independent risk factor for cardiovascular disease in postmenopausal wom- en, which will help to make further risk stratification and suggests that cardiovascular disease are closely related to PCOS.