Polycystic ovary syndrome and cardiometabolic risk: current approaches to multidisciplinary prevention and follow-up care

Introduction. Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder in women of reproductive age associated with high cardiometabolic risk.

Aim: to analyze current data on the prevalence, developmental mechanisms, and clinical significance of cardiometabolic disorders in patients with PCOS, and to substantiate approaches to multidisciplinary prevention and follow-up care.

Materials and Methods. A narrative review of publications from 2017 to 2026 was conducted using PubMed/MEDLINE, ScienceDirect, Google Scholar, and eLibrary databases. For this, international clinical guidelines, systematic reviews, meta-analyses, randomized controlled trials, and clinically relevant cohort studies were prioritized.

Results. Cardiometabolic risk in PCOS is driven by a high prevalence of insulin resistance, dyslipidemia, arterial hypertension, and obesity. In clinical practice, assessment of glycemic status (preferably via an oral glucose tolerance test), lipid profile, blood pressure, and anthropometric parameters, rather than routine calculation of insulin resistance indices should be prioritized. The importance of comprehensive non-pharmacological prevention (diet, exercise, psychotherapeutic support) and the use of metformin or anti-obesity drugs according to indications is substantiated.

Conclusion. PCOS is associated with a high prevalence of cardiometabolic disorders driven by insulin resistance, visceral obesity, hyperandrogenism, and chronic inflammation, warranting a long-term multidisciplinary follow-up model with continuous prevention and pharmacotherapy when indicated.

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