These findings imply the presence of chronic inflammation in women with PCOS. Metformin decreases the levels of plasma inflammatory indices. Further investigation is required to determine whether these findings may prove to be of clinical significance for PCOS patients.

Background  Women with polycystic ovary syndrome (PCOS) carry a pattern of cardiovascular risk factors. Endothelial dysfunction and chronic inflammation are early findings in the atherosclerotic process. The purpose of the study was to investigate the coexistence of active inflammation markers and endothelial dysfunction in young women with PCOS, and their relationship with metabolic and hormonal abnormalities of the syndrome. Materials and methods  Twenty‐five young women with PCOS and 25 controls of similar age and body mass index (BMI) were studied. Endothelial function was assessed by flow‐mediated dilatation (FMD) on the brachial artery and smooth muscle cells injury was excluded by nitrate‐induced dilatation (NID). Plasma levels of endothelin‐1 (ET‐1), soluble intercellular adhesion molecule‐1 (sICAM‐1), soluble vascular cell adhesion molecule‐1 (sVCAM‐1) and high sensitivity C‐reactive protein (hsCRP) were measured. Hormonal and metabolic profiles were determined in both groups. Results  Flow‐mediated dilatation (FMD) was statistically lower in PCOS (P < 0·001), whereas nitrate‐induced dilatation (NID) was similar within the two groups. Polycystic ovary syndrome (PCOS) had statistically higher levels of ET‐1 (P = 0·03), sICAM‐1 (P = 0·01), sVCAM‐1 (P = 0·02) and hsCRP (P = 0·01). Furthermore FMD was statistically higher in PCOS population with hsCRP  1 mg L−1 when compared with PCOS population with hsCRP > 1 mg L−1 (P = 0·02). Flow‐mediated dilatation (FMD) was negatively related to hsCRP (r = −0·512, P = 0·015); ET‐1 was positively related to free androgen index (r = 0·27, P = 0·05) and negatively to sex hormone‐binding globulin (r = −0·465, P = 0·022); sVCAM‐1 was positively related to total testosterone (r = 0·431, P = 0·036); hsCRP was positively related to BMI (r = 0·647, P = 0·001), and negatively related to FMD (r = −0·512, P = 0·015), quantitative insulin sensitivity check index (QUICKI) (r = −0·499, P = 0·018), and MATSUDA index (r = −0·445, P = 0·038). Conclusions  The present study demonstrates that endothelial dysfunction coexists and is influenced by the presence of increased serum levels of inflammation and endothelial activation markers in young women with PCOS. These parameters appear to be interrelated with hyperandrogenaemia in this insulin‐resistant population.

Polycystic ovary syndrome (PCOS) is probably the most common endocrinopathy of reproductive age. PCOS represents a disorder that not only enhances the risk for type 2 diabetes (T2D) but is also associated with an increased number of cardiovascular risk factors known to facilitate atherogenesis. On the other hand, inflammation is thought to play an important role in the progression and development of complications of atherosclerosis. Evidence of low-grade chronic inflammation in PCOS is indicated by the presence of elevated C-reactive protein (CRP) levels, inflammatory cytokines (i.e., IL-6 and IL-18), and increased leucocyte count. CRP, a nonspecific marker of inflammation, has been proven to be one of the strongest predictors of the risk of cardiovascular events in patients with or without cardiovascular disease. The levels of the adhesion molecules (AM), sIVAM-1, sVCAM-1, and sE-selectin in serum reflect low-grade chronic inflammation of the endothelium and independently predict coronary heart disease (CHD) and T2D. In a recent study in a large number of PCOS women we demonstrated elevated levels of sIVAM-1 and sE-selectin and we further substantiated the existence of a low-grade chronic inflammatory process in PCOS. However, it remains to be assessed with long-term studies whether the early presence of markers of chronic inflammation in young women with this syndrome has clinical significance.

No abstract

Visceral adiposity index is increased in patients with PCOS in concordance with the severity of anovulation, insulin resistance and inflammation. This index could be a very easy and helpful clinical tool in daily practice to predict insulin resistance in women with PCOS.