The association of oxidative stress and cardiovascular risk factors in adolescents with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a disorder frequently diagnosed during adolescence and early adulthood, often accompanied by significant comorbidities. While important metabolic and cardiovascular (CV) comorbidities have been observed in women with PCOS, it remains unclear whether the onset of CV morbidity symptoms begin during adolescence. In this study, we aimed to assess the potential increase in oxidative stress involved in the pathogenesis of PCOS and to examine whether metabolic and CV findings in adolescents begin at this age. The study included 33 adolescents with PCOS (19 obese/overweight, 14 normal weight) and 43 healthy adolescents (20 obese/overweight, 23 normal weight). Participants were evaluated through physical examination, laboratory tests, oxidative stress tests, conventional echocardiography (ECHO), tissue Doppler ECHO, and strain ECHO. When comparing the PCOS and control groups, the PCOS group had higher values in waist-to-hip ratio, liver enzymes, triglycerides, triglyceride-glucose index, left atrium (LA) systolic diameter, and LA/aorta ratio, while the control group had higher left ventricular (LV) global peak longitudinal strain A4. In subgroup analyses based on weight, systolic and diastolic blood pressure, LA systolic diameter, LV mass, and interventricular septum diameter were higher in the obese/overweight PCOS and control groups compared to those of normal weight. There was no significant difference between groups in terms of oxidative stress and 24-hour rhythm Holter data. Two-way analyses of variance also indicated that disease and weight status had similar effects on most parameters. These findings suggest that the metabolic comorbidities observed in PCOS and the signs of subclinical LV diastolic dysfunction begin during adolescence. However, the fact that similar findings can also be observed solely in the presence of obesity highlights the necessity of prioritizing the prevention and management of obesity in adolescents with PCOS as a primary strategy to prevent PCOS-related comorbidities.