Exploring cardiovascular risk factors in patients with polycystic ovary syndrome by principal component analysis

Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular disease (CVD); however, the underlying mechanisms remain incompletely understood. This study aimed to identify significant CVD risk factors among women with PCOS using principal component analysis (PCA). This cross-sectional study was conducted on 172 females diagnosed with PCOS. The CVD risk among participants was assessed using a modified cardiovascular risk score (CVRS). We measured thiobarbituric acid reactive substances (TBARS), oxidized low-density lipoproteins (ox-LDL), and total antioxidant capacity (TAC), along with the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) as markers of oxidative stress. Additionally, we evaluated high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin as markers of inflammation. Serum levels of TBARS, ox-LDL, hs-CRP, TNF-α, IL-6, sICAM-1, sVCAM-1, and E-selectin significantly increased, while serum TAC and SOD activity decreased across increasing tertiles of CVRS. PCA identified three significant factors that together account for 52.46% of the explained variance in the investigated parameters. These factors include the oxidative stress-related factor, the vascular inflammation and atherosclerosis-related factor, and the systemic inflammation-related factor, which account for 20.63%, 17.18%, and 14.65% of the variance, respectively. Given that oxidative stress, vascular inflammation, atherosclerosis-related factors, and systemic inflammatory factors are the three primary contributors to an increased risk of developing CVRS in women with PCOS, implementing strategies to manage these factors may significantly help prevent the progression of CVD in this population.