Early Impairment of Endothelial Structure and Function in Young Normal-Weight Women with Polycystic Ovary Syndrome

Abstract

The aim of this study was to evaluate the presence of early vascular damage in young normal-weight women with polycystic ovary syndrome (PCOS). Thirty young normal-weight women with PCOS, who had no additional metabolic or cardiovascular diseases, and 30 healthy women (controls) matched for age and body mass index were studied. A complete hormonal assay was performed in each subject. Serum insulin and glucose levels were measured at baseline and after the oral glucose tolerance test. Plasma endothelin-1 levels and serum lipid profile were also assessed. The endothelial function was studied by flow-mediated dilation on the brachial artery, and arterial structure was evaluated by intima-media thickness measurement using Doppler ultrasound of both common carotid arteries.A significant (P < 0.05) difference in flow-mediated dilation (14.3 +/- 1.9% vs. 18.1 +/- 2.0% for PCOS patients and controls, respectively) and in intima-media thickness (0.53 +/- 0.09 mm vs. 0.39 +/- 0.08 mm for PCOS patients and controls, respectively) was found between PCOS and control subjects. Serum endothelin-1 levels were also significantly (P < 0.05) higher in PCOS patients compared with controls (1.1 +/- 0.4 pmol/liter vs. 0.5 +/- 0.2 pmol/liter for PCOS patients and controls, respectively).In conclusion, our data show that young, normal-weight, nondyslipidemic, nonhypertensive women with PCOS have an early impairment of endothelial structure and function.

Long-term consequences of polycystic ovary syndrome on cardiovascular risk

“…Other studies demonstrated increased pulse wave velocity of the brachial artery and increased stiffness of both internal and external carotid arteries (22,23). Alterations in both endothelium-dependent and independent vasodilator responses of the brachial artery in women with PCOS have been also reported (24)(25)(26)(27)(28). Further, morphological studies have shown that women with PCOS have increased carotid intima media thickness as well as higher incidence of coronary and aortic arterial calcification (29)(30)(31)(32).…”

The polycystic ovary syndrome: an example of obesity-related cardiovascular complication affecting young women

“…In uno studio recente abbiamo dimostrato che i livelli sierici di ET-1 erano significativamente più alti nella PCOS in confronto ai controlli [27]. In accordo con Diamanti-Kandarakis et al [22], abbiamo riscontrato che i livelli sierici di ET-1 erano significativamente più elevati in donne di peso normale con PCOS che nei controlli sani sovrapponibili per BMI, suggerendo che le aumentate concentrazioni di ET-1 sono tali nella PCOS indipendentemente dall'obesità.…”

“…Relativamente a questo aspetto abbiamo dimostrato una differenza significativa nell'IMT tra pazienti con PCOS e controlli [27]. In accordo con i nostri risultati, altri Autori [12] hanno dimostrato un'associazione tra la PCOS e l'aterosclerosi precoce della carotide e una differenza nell'IMT carotideo BMI-indipendente tra pazienti e controlli; la rilevanza dei nostri dati consiste nel fatto che quell'IMT risulta aumentato anche in giovani donne.…”

“…I dati che riguardano la disfunzione endoteliale in pazienti con PCOS sono pochi e contrastanti [18,27,61].…”

“…L'effetto della PCOS sulla mortalità cardiovascolare è attualmente poco chiaro. La crescente evidenza [27,51,66,67] riporta che diversi fattori di rischio cardiovascolare sono chiaramente presenti e più elevati nella PCOS rispetto alle donne sane.…”