Comparison of fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome and women with simple obesity

Abstract

The present study aimed to assess the fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome (PCOS) and to compare them in obese PCOS patients and women with simple obesity. We studied 19 obese women with PCOS (age: 25.1 +/- 4.6 years, body mass index (BMI): 34.7 +/- 3.9 kg/m2; mean +/- standard deviation) and 20 age- and BMI-matched ovulatory controls. We measured blood levels of 17beta-estradiol, testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucose and insulin. The following fibrinolytic tests were also performed: euglobulin clot lysis time, plasminogen level, alpha2-antiplasmin activity, plasminogen activator inhibitor-1 activity, fibrinogen concentration and estimated fibrinolytic activity. Testosterone and LH levels were significantly higher in obese women with PCOS (p < 0.01 and p < 0.001, respectively). The groups did not differ with regard to 17beta-estradiol, prolactin, FSH, DHEAS, TC, TG, HDL-C, LDL-C, glucose and insulin. All of the fibrinolysis parameters with the exception of plasminogen were comparable between the two groups. Serum plasminogen level was lower in obese PCOS patients than in women with simple obesity (p < 0.05). Euglobulin clot lysis time was positively correlated with insulin (r = 0.88, p < 0.05) in both groups. Our results show that fibrinolysis is not suppressed in women with PCOS and that there is no difference in fibrinolytic activity between obese patients with PCOS and women with simple obesity.

Plasma plasminogen activator inhibitor-1 levels in the different phenotypes of the polycystic ovary syndrome

“…In contrast to normal weight subjects, overweight/ obese patients with PCOS had higher PAI-1 levels than BMI-matched controls, a finding that concurs with most previous studies [13][14][15][16]23]. However, plasma PAI-1 levels did not correlate with markers of IR in overweight/obese women with PCOS in our study and this is in contrast to previous reports [13,14,24,25].…”

Android fat distribution affects some hemostatic parameters in women with polycystic ovary syndrome compared with healthy control subjects matched for age and body mass index

“…It has been well established that both overweight and android obesity with increased waist circumference constitute risk factors for CVD (34)(35)(36)(37)(38). It is also known that for the general population, the older the age and the higher the BMI, the greater the risk of thromboembolic phenomena (39)(40)(41)(42)(43)(44). A recent relevant study from Denmark reported that PCOS was associated with a twofold greater risk of stroke and thrombosis, whereas there was no increased risk of other CVD (4).…”

Metabolic Aspects of Polycystic Ovary Syndrome

“…These findings might elucidate some discrepancies regarding fibrinolytic activity in PCOS, as earlier studies indicate both increased PAI-1 activity [15,100,101,160] and normal PAI-1 activity in PCOS patients [102,103] [159]. Thus, it is plausible studies indicating no difference in PAI-1 activity have included a more heterogeneous population of PCOS patients with regard to hyperandrogenism.…”

“…Increased mass concentration of tPA, as a marker of endothelial disturbances, is possibly a better predictor for coronary heart mortality [98] than PAI-1 activity and is specifically associated with myocardial infarction in young women [99]. The triad obesity, raised triglycerides and, raised insulin levels is the most consistent predictor of impaired fibrinolysis and is often found in PCOS women [15,[100][101][102][103]. Earlier studies on PCOS women suggest both increased and normal levels of PAI-1 activity [15,[100][101][102][103], while studies on tPA-mass in PCOS patients are less ambiguous with increased levels [104][105][106], although at least one study reported unchanged levels [107].…”

“…Thus, it is plausible studies indicating no difference in PAI-1 activity have included a more heterogeneous population of PCOS patients with regard to hyperandrogenism. For example, Atiomo et al [102] do not assess biochemical hyperandrogenism and, in two studies [103,159], only high testosterone is used for the assessment of hyperandrogenism. One prior study [100] uses increased FAI as the hyperandrogenism criterion in PCOS patients, while adjusting for BMI, and report increased PAI-1 activity in the PCOS group: this finding is in accordance with the findings of this study.…”