{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:17:47Z","timestamp":1783426667243,"version":"3.54.6"},"reference-count":45,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Polycystic ovary syndrome (PCOS) is increasingly recognized as a condition associated with cardiometabolic risk, yet its relationship with subclinical atherosclerosis in premenopausal women remains unclear. This systematic review aimed to synthesize and critically appraise the available evidence on the association between PCOS and markers of subclinical atherosclerosis. Methods: A systematic search of PubMed\/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library was conducted for studies published between January 2021 and January 2026. Eligible studies included premenopausal women with PCOS and assessed direct vascular markers or validated surrogate indicators of subclinical atherosclerosis. Data were synthesized narratively following PRISMA guidelines. Results: Nine studies were included, comprising five human clinical studies and four bioinformatics analyses. Evidence from imaging-based studies demonstrated increased carotid intima-media thickness, reduced wall shear stress, and a higher prevalence of subclinical vascular abnormalities in women with PCOS, particularly in some hyperandrogenic phenotypes. In contrast, adolescent populations showed predominantly metabolic and inflammatory alterations without clear structural vascular changes. Biochemical studies reported adverse lipid profiles and elevated atherogenic markers, while mechanistic studies highlighted inflammatory and mitochondrial pathways. Conclusions: Current evidence suggests that PCOS may be associated with early vascular alterations in premenopausal women; however, findings are limited by heterogeneity and observational designs. Further large-scale, phenotype-stratified prospective studies using standardized vascular assessments are needed to clarify cardiovascular risk in this population.<\/jats:p>","DOI":"10.3390\/jcm15135197","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:52:24Z","timestamp":1783007544000},"page":"5197","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Polycystic Ovary Syndrome and Markers of Subclinical Atherosclerosis in Premenopausal Women: A Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Eman","family":"Elsheikh","sequence":"first","affiliation":[{"name":"Internal Medicine Department, College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"},{"name":"Cardiology Department, Faculty of Medicine, Tanta University Hospital, Tanta 31111, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil Ibrahim","family":"Bograin","sequence":"additional","affiliation":[{"name":"Alahas PHC Center, Alahsa 35353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourah Mashari","family":"Alqadri","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Khalid","family":"Alquaymi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad Ahmad","family":"Alhikan","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad Adel","family":"Balghonaim","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad Salah","family":"Alsaleem","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalal Saad","family":"Alsulaiman","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raneem Khalid","family":"Alateeq","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadeem Khalid","family":"Almulhim","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala Mohammed","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Mohammed","family":"Al Dhaif","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al-Ahsa 36362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"26334941251384195","DOI":"10.1177\/26334941251384195","article-title":"Prevalence of polycystic ovary syndrome (PCOS) and its associated hormonal and comorbid risk factors in Northeast India: A cross-sectional comparative study","volume":"19","author":"Yasmin","year":"2025","journal-title":"Ther. 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