Soluble E-selectin and QRISK3-based Cardiovascular Risk Assessment in Women with Polycystic Ovary Syndrome: A Prospective Case–control Study from India

A BSTRACT Background: Polycystic ovary syndrome (PCOS) is associated with metabolic abnormalities and increased long-term cardiovascular risk. Endothelial dysfunction is considered an early event in atherogenesis, and soluble E-selectin has been proposed as a marker of endothelial activation. However, its role in cardiovascular risk assessment in PCOS remains uncertain. Aim: The study aimed to compare circulating soluble E-selectin levels between women with PCOS and healthy controls and evaluate their association with metabolic parameters and QRISK3-based cardiovascular risk scores. Settings and Design: Prospective hospital-based case–control study. Materials and Methods: Two hundred women with PCOS diagnosed according to the Rotterdam criteria and 50 age-matched healthy controls aged 18–40 years were enrolled. Clinical assessment, anthropometry, fasting blood glucose, HbA1c, lipid profile, C-reactive protein and soluble E-selectin levels were evaluated. Estimated 10-year cardiovascular risk was calculated using the QRISK3 algorithm. Statistical Analysis Used: Group comparisons, correlation analyses and multivariable linear regression were performed. Results: Mean soluble E-selectin levels were comparable between women with PCOS and controls (0.61 ± 0.33 vs. 0.61 ± 0.29 ng/mL, P = 0.935). Within the PCOS group, soluble E-selectin correlated positively with HbA1c ( r = 0.326, P = 0.001) and fasting blood glucose ( r = 0.271, P = 0.001), while no significant associations were observed with anthropometric measures, lipid parameters, blood pressure or QRISK3 scores. In multivariable analysis, fasting blood glucose remained independently associated with soluble E-selectin. Conclusion: Soluble E-selectin levels did not differ between women with PCOS and controls and showed limited associations with cardiovascular risk factors. These findings do not support a major role for soluble E-selectin in cardiovascular risk assessment among young women with PCOS.