Cardiometabolic Risk in First Degree Relatives of Women With Polycystic Ovary Syndrome (PCOS)

Objective: Polycystic ovary syndrome (PCOS) is a common multisystem disorder with reproductive, cardiometabolic and psychological implications. Genetic factors play a role in the pathogenesis of PCOS. We sought to investigate the cardiometabolic health of first degree relatives (FDR) of women with PCOS. Design: Systematic review and meta-analysis. Methods: Medline, Embase, PsycInfo, allEBM (Ovid), clinicaltrials.gov and WHO ICTRP were searched from inception until 1st November 2023. Randomised controlled trials, observational studies, evidence-based guidelines, systematic reviews and health technology assessments reporting on cardiometabolic health of FDRs of women with PCOS compared to participants without a family history of PCOS (controls) were included. Primary outcomes of interest were cardiovascular disease and cardiometabolic risk factors. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to for the systematic review and meta-analysis. Results: The search strategy identified 20,639 publications of which 68 publications representing 34 unique studies were included. FDRs of women with PCOS had higher rates of metabolic syndrome (OR: 2.50; 95% CI: 1.40–4.45, I² = 65%; six studies; 2059 participants; p = 0.002), hypertension (OR: 2.05; 95% CI: 1.08–3.92, I² = 0%; three studies; 302 participants; p = 0.03) and diabetes (OR: 2.46; 95% CI: 1.31–4.62, I2 = 9%; five studies; 778 participants; p = 0.005) compared with controls. Additionally, measures of glucose control and lipid profile were worse in FDRs of women with PCOS compared with controls. Most studies were judged as moderate risk of bias. No published data on CVD were identified. Conclusions: FDRs of women with PCOS are at increased risk of cardiometabolic disorders.