CIMT as a sensitive indicator of cardiovascular risk in PCOS: a case–control study of sortilin and sclerostin

Background: Polycystic ovary syndrome (PCOS) is associated with increased cardiometabolic risk, and subclinical vascular damage can be evaluated using carotid intima–media thickness (CIMT) and arterial stiffness measures such as pulse wave velocity (PWV). Sortilin and sclerostin have been proposed as cardiometabolic biomarkers, but their value in identifying early cardiovascular risk in PCOS remains unclear. To compare serum sortilin and sclerostin levels and subclinical vascular markers (CIMT and PWV) between women with PCOS and controls, and to evaluate whether these biomarkers are independently associated with CIMT. Methods: In this case–control study, women with PCOS and age-matched controls were assessed for clinical and metabolic variables. Serum sortilin and sclerostin concentrations were measured, and CIMT and PWV were obtained using standardized protocols. Between-group comparisons were performed, and multivariable linear regression models were constructed with CIMT as the dependent variable. Results: CIMT was significantly higher in women with PCOS compared with controls, whereas PWV did not differ significantly between groups. Circulating sortilin and sclerostin levels were comparable between groups and were not independently associated with CIMT after multivariable adjustment. Conclusion: CIMT appears to be a more sensitive marker of early subclinical atherosclerosis in young women with PCOS than circulating sortilin or sclerostin. These biomarkers cannot currently be recommended for early cardiovascular risk assessment in PCOS. Larger, phenotype-stratified and longitudinal studies are needed to clarify their potential prognostic relevance in specific subgroups.