COL18A1 and endothelial dysfunction: This study found a statistically significant increase in endostatin levels in PCOS. Endostatin inhibits angiogenesis (formation of new vessels) and lowers vascular endothelial growth factor (VEGF). Endothelin is also a cardiovascular biomarker. The cardiometabolic risk factors including endothelial dysfunction is seen in PCOS women. The rise in endothelin level thereby signifies vascular and myocardial damage in PCOS women.