Is polycystic ovary syndrome associated with elevated muscle sympathetic nerve activity?

Polycystic ovary syndrome (PCOS) is a complex disorder characterized by reproductive abnormalities, cardiometabolic disturbances and a heightened risk of cardiovascular disease. A small but compelling body of research demonstrates that females with PCOS present with elevated muscle sympathetic nerve activity (MSNA) at rest. Heightened MSNA is present in lean, overweight and obese females with PCOS, but limited evidence suggests that androgens may be more strongly linked to elevated MSNA in lean females with PCOS than in obese females with PCOS. Although the specific mechanisms underlying elevated MSNA in PCOS remain elusive, sympathetic activation is implicated in the progression of several cardiovascular diseases and may contribute to the cardiovascular pathophysiology of PCOS. Encouragingly, MSNA appears responsive to non-pharmacological intervention, making the sympathetic nervous system a promising therapeutic target to mitigate cardiovascular risk in PCOS. This brief review summarizes the existing evidence regarding elevated MSNA, cardiovascular risk profile and vascular function, as well as the potential for clinical intervention and future research directions in females with PCOS.

Automated summary

Polycystic ovary syndrome (PCOS) is a complex disorder associated with reproductive abnormalities, cardiometabolic disturbances, and an increased risk of cardiovascular disease. Research has shown that females with PCOS have elevated muscle sympathetic nerve activity (MSNA) at rest. Both lean and obese females with PCOS exhibit heightened MSNA, but there is evidence suggesting that androgens may have a stronger association with elevated MSNA in lean individuals with PCOS. Understanding the mechanisms behind elevated MSNA in PCOS is important as it may contribute to the development of cardiovascular diseases and provide a potential therapeutic target for mitigating cardiovascular risk.