Comparative Study of Myocardial Biomarkers Among Women with and Without Polycystic Ovarian Syndrome (PCOS) in Nigeria

Abstract

Polycystic Ovarian Syndrome (PCOS) is a common endocrinopathy associated with chronic low-grade inflammation, insulin resistance, and dyslipidemia, all of which elevate the long-term risk of cardiovascular disease (CVD). While subclinical myocardial injury is recognized in Western populations with PCOS, data from Nigerian women, who may face distinct genetic and environmental risk factor profiles, remain scarce. This study aims to compare the circulating levels of specific myocardial injury biomarkers between Nigerian women with and without PCOS. This was a case-control study conducted at selected healthcare centers and fertility clinics in Lokoja, Okene, and Anyigba, Kogi State, Nigeria, where PCOS cases are commonly reported. This study comprises of 150 samples, with 110 women diagnosed with PCOS based on the Rotterdam criteria (PCOS Group) were recruited and compared to 40 age- and BMI-matched healthy women (Control Group). Fasting blood samples were analyzed for quantitative measurement of three cardiac biomarkers: Myoglobin (MYO), Cardiac Troponin I (cTnI), and Creatine Kinase-MB (CK-MB). Anthropometric data and standard lipid profiles were also collected. Data were analyzed using independent samples t-tests and multivariate analysis of variance (MANOVA), with significance set at p < 0.05. The multivariate test using Pillai’s Trace indicated a significant overall group effect, V = 0.202, F(3, 146) = 12.32, p < 0.001, partial η² = 0.202, suggesting that the combined biomarker profile differed between groups. Follow-up univariate ANOVAs revealed that women with PCOS had significantly higher mean serum levels of cTnI (F(1,148) = 5.91, p = .016, partial η² = 0.038), CK-MB (F(1,148) = 20.43, p < 0.001, partial η² = .121), and MYO (F(1,148) = 21.65, p < .001, partial η² = 0.128) compared to controls. The estimated marginal means confirmed consistently elevated concentrations of all three biomarkers in the PCOS group (MYO: 57.88 ± 3.51 ng/ml; CK-MB: 1.87 ± 0.08 ng/ml; cTnI: 0.074 ± 0.005 ng/ml) relative to the control group (MYO: 26.28 ± 5.82 ng/ml; CK-MB: 1.21 ± 0.13 ng/ml; cTnI: 0.053 ± 0.008 ng/ml). Collectively, these findings indicate that PCOS is associated with significantly elevated serum concentrations of myocardial biomarkers, suggesting the presence of early or subclinical myocardial stress in affected women, independent of age matching. Furthermore, regression analysis suggested that significant factor, like MYO was an independent predictor of the outcome variable. Nigerian women with PCOS exhibit significantly elevated circulating levels of myocardial biomarkers (MYO, cTnI, and CK-MB), suggesting the presence of chronic, subclinical myocardial injury in this population. These findings underscore the need for early and aggressive cardiovascular risk assessment and management strategies for women with PCOS in the Nigerian clinical setting.