Abstract：
OBJECTIVE: We aimed to evaluate the risk of cardiovascular disease (CVD) in women with polycystic ovary syndrome (PCOS) and estimate the global incidence of PCOS-associated CVD.
METHODS: We conducted a meta-analysis across five databases to evaluate the risk of CVD among women with PCOS. Global incidence of PCOS-associated CVD was calculated by a population attributable fraction (PAF) modelling using the pooled RR, PCOS prevalence, CVD incidence number and age-standardized rate (ASIR), from the Global Burden of Diseases 2019. An estimated annual percentage change (EAPC) was used to assess the temporal trend of PCOS-associated CVD.
RESULTS: The risk of CVD was significantly increased in the women with PCOS for all-age group (pooled RR 1.51, 95% CI 1.36-1.69), and 10- to 54-year-old (1.37, 1.17-1.59). Globally, from 1990 to 2019, the PCOS associated CVD cases in women across all-age group has rised from 102 530 to 235 560. The most affected regions were East Asia & Pacific (108 430, 66 090-166 150) in 2019. The South Asia has the highest increase trend of PCOS-associated CVD ASIRs (EAPC 2.61%, 2.49-2.73). The annual increase ASIR in PCOS-CVD incidence for the 10-54 age group (EAPC 0.49%; 0.41-0.56) is faster than that of the all-age group (0.34; 0.27-0.42). The middle- or low-middle sociodemographic index countries, experienced higher increase trend of CVD due to PCOS in the past thirty years.
CONCLUSIONS: Women with PCOS have a significantly increased risk of CVD. Efficient measures to enhance its prevention and treatment are important for regions with high PCOS-associated CVD burden, especially premature CVD in women under 55 years.
Studies have reported cardiovascular disease (CVD) is the leading cause of mortality for women. Meanwhile, women with polycystic ovary syndrome (PCOS) substantially elevate the risk of CVD. However, no studies have quantified the impact of PCOS on the overall CVD burden. This study performed a meta-analysis to assess the risk of CVD in all-age group and 10 to 54 years old women, living with PCOS with 17 articles, and estimated the burdens of PCOS-associated CVD burden, by global, 7 World-bank defined regions, and 204 countries, from 1990 to 2019, using a PAF modelling. Our study implicated women in all-age group, and 10 to 54 years old with PCOS face a 1.51-fold, and 1.37-fold increased risk of CVD compared those without, respectively. Globally, approximately 0.85% of CVD new cases in 2019 were associated with PCOS, corresponded a more than 2-fold increase of PCOS-associated CVD cases from 1990. However, the burden of PCOS-associated CVD varies widely by region; for instance, nearly 1.49% of CVD new cases were attributed to PCOS in North America. Meanwhile, the East Asia & Pacific region had the highest PCOS-associated new CVD case, and the South Asia experienced the highest increase in age-standardised incidence rates of CVD due to PCOS. Notably, we found higher worldwide PAFs, and annual increase ASIR than that in all-age group women. This result suggests that premature CVD in women with PCOS under 55 years deserve more attention.
METHODS: We conducted a meta-analysis across five databases to evaluate the risk of CVD among women with PCOS. Global incidence of PCOS-associated CVD was calculated by a population attributable fraction (PAF) modelling using the pooled RR, PCOS prevalence, CVD incidence number and age-standardized rate (ASIR), from the Global Burden of Diseases 2019. An estimated annual percentage change (EAPC) was used to assess the temporal trend of PCOS-associated CVD.
RESULTS: The risk of CVD was significantly increased in the women with PCOS for all-age group (pooled RR 1.51, 95% CI 1.36-1.69), and 10- to 54-year-old (1.37, 1.17-1.59). Globally, from 1990 to 2019, the PCOS associated CVD cases in women across all-age group has rised from 102 530 to 235 560. The most affected regions were East Asia & Pacific (108 430, 66 090-166 150) in 2019. The South Asia has the highest increase trend of PCOS-associated CVD ASIRs (EAPC 2.61%, 2.49-2.73). The annual increase ASIR in PCOS-CVD incidence for the 10-54 age group (EAPC 0.49%; 0.41-0.56) is faster than that of the all-age group (0.34; 0.27-0.42). The middle- or low-middle sociodemographic index countries, experienced higher increase trend of CVD due to PCOS in the past thirty years.
CONCLUSIONS: Women with PCOS have a significantly increased risk of CVD. Efficient measures to enhance its prevention and treatment are important for regions with high PCOS-associated CVD burden, especially premature CVD in women under 55 years.
Studies have reported cardiovascular disease (CVD) is the leading cause of mortality for women. Meanwhile, women with polycystic ovary syndrome (PCOS) substantially elevate the risk of CVD. However, no studies have quantified the impact of PCOS on the overall CVD burden. This study performed a meta-analysis to assess the risk of CVD in all-age group and 10 to 54 years old women, living with PCOS with 17 articles, and estimated the burdens of PCOS-associated CVD burden, by global, 7 World-bank defined regions, and 204 countries, from 1990 to 2019, using a PAF modelling. Our study implicated women in all-age group, and 10 to 54 years old with PCOS face a 1.51-fold, and 1.37-fold increased risk of CVD compared those without, respectively. Globally, approximately 0.85% of CVD new cases in 2019 were associated with PCOS, corresponded a more than 2-fold increase of PCOS-associated CVD cases from 1990. However, the burden of PCOS-associated CVD varies widely by region; for instance, nearly 1.49% of CVD new cases were attributed to PCOS in North America. Meanwhile, the East Asia & Pacific region had the highest PCOS-associated new CVD case, and the South Asia experienced the highest increase in age-standardised incidence rates of CVD due to PCOS. Notably, we found higher worldwide PAFs, and annual increase ASIR than that in all-age group women. This result suggests that premature CVD in women with PCOS under 55 years deserve more attention.
摘要：
目的：我们旨在评估多囊卵巢综合征（PCOS）女性患心血管疾病（CVD）的风险，并估计PCOS相关CVD的全球发病率。
方法：我们在5个数据库中进行了meta分析，以评估PCOS女性患CVD的风险。PCOS相关CVD的全球发病率通过使用合并RR的人群归因分数（PAF）模型计算。PCOS患病率,CVD发病率和年龄标准化率(ASIR)，来自2019年全球疾病负担。估计的年度百分比变化（EAPC）用于评估PCOS相关CVD的时间趋势。
结果：所有年龄段的PCOS女性患CVD的风险显著增加（合并RR1.51,95%CI1.36-1.69），10至54岁（1.37，1.17-1.59）。全球范围内,从1990年至2019年,全年龄组女性PCOS相关CVD病例从102530例上升至235560例.2019年受影响最严重的地区是东亚和太平洋地区（108430,66090-166150）。南亚PCOS相关的CVDASIR的增长趋势最高(EAPC2.61%,2.49-2.73)。10-54岁年龄组（EAPC0.49%;0.41-0.56）的PCOS-CVD发病率ASIR的年增长率快于所有年龄组（0.34;0.27-0.42）。社会人口指数中等或中等偏下的国家，在过去的30年中，由于PCOS，CVD的增加趋势更高。
结论：患有PCOS的女性患CVD的风险显著增加。加强预防和治疗的有效措施对于PCOS相关CVD负担较高的地区非常重要。尤其是55岁以下女性的早熟CVD。
研究报告心血管疾病（CVD）是女性死亡的主要原因。同时,多囊卵巢综合征(PCOS)女性患CVD的风险显著升高.然而,尚无研究量化PCOS对总体CVD负担的影响.这项研究进行了一项荟萃分析，以评估所有年龄段和10至54岁女性的CVD风险。与PCOS一起生活17篇文章，并估计PCOS相关CVD负担的负担，全球,7个世界银行定义的区域，204个国家,从1990年到2019年，使用PAF模型。我们的研究涉及所有年龄段的女性，10到54岁的PCOS患者面临1.51倍，与没有CVD的人相比，CVD的风险增加1.37倍，分别。全球范围内,2019年约0.85%的CVD新病例与PCOS相关，从1990年开始，PCOS相关CVD病例增加了2倍以上。然而,PCOS相关CVD的负担因地区而异；例如，在北美,近1.49%的CVD新病例归因于PCOS.同时,东亚和太平洋地区的PCOS相关新CVD病例最高，而南亚地区则经历了由PCOS引起的年龄标准化CVD发病率的最高增长.值得注意的是,我们发现全球范围内的PAF更高，ASIR的年增长率高于所有年龄段的女性。这一结果表明，55岁以下PCOS女性的过早CVD值得更多关注。
方法：我们在5个数据库中进行了meta分析，以评估PCOS女性患CVD的风险。PCOS相关CVD的全球发病率通过使用合并RR的人群归因分数（PAF）模型计算。PCOS患病率,CVD发病率和年龄标准化率(ASIR)，来自2019年全球疾病负担。估计的年度百分比变化（EAPC）用于评估PCOS相关CVD的时间趋势。
结果：所有年龄段的PCOS女性患CVD的风险显著增加（合并RR1.51,95%CI1.36-1.69），10至54岁（1.37，1.17-1.59）。全球范围内,从1990年至2019年,全年龄组女性PCOS相关CVD病例从102530例上升至235560例.2019年受影响最严重的地区是东亚和太平洋地区（108430,66090-166150）。南亚PCOS相关的CVDASIR的增长趋势最高(EAPC2.61%,2.49-2.73)。10-54岁年龄组（EAPC0.49%;0.41-0.56）的PCOS-CVD发病率ASIR的年增长率快于所有年龄组（0.34;0.27-0.42）。社会人口指数中等或中等偏下的国家，在过去的30年中，由于PCOS，CVD的增加趋势更高。
结论：患有PCOS的女性患CVD的风险显著增加。加强预防和治疗的有效措施对于PCOS相关CVD负担较高的地区非常重要。尤其是55岁以下女性的早熟CVD。
研究报告心血管疾病（CVD）是女性死亡的主要原因。同时,多囊卵巢综合征(PCOS)女性患CVD的风险显著升高.然而,尚无研究量化PCOS对总体CVD负担的影响.这项研究进行了一项荟萃分析，以评估所有年龄段和10至54岁女性的CVD风险。与PCOS一起生活17篇文章，并估计PCOS相关CVD负担的负担，全球,7个世界银行定义的区域，204个国家,从1990年到2019年，使用PAF模型。我们的研究涉及所有年龄段的女性，10到54岁的PCOS患者面临1.51倍，与没有CVD的人相比，CVD的风险增加1.37倍，分别。全球范围内,2019年约0.85%的CVD新病例与PCOS相关，从1990年开始，PCOS相关CVD病例增加了2倍以上。然而,PCOS相关CVD的负担因地区而异；例如，在北美,近1.49%的CVD新病例归因于PCOS.同时,东亚和太平洋地区的PCOS相关新CVD病例最高，而南亚地区则经历了由PCOS引起的年龄标准化CVD发病率的最高增长.值得注意的是,我们发现全球范围内的PAF更高，ASIR的年增长率高于所有年龄段的女性。这一结果表明，55岁以下PCOS女性的过早CVD值得更多关注。
