Flow‐mediated dilatation in overweight and obese women with polycystic ovary syndrome

Abstract

Objective There remains a large degree of disagreement about the association of polycystic ovary syndrome (PCOS) with impaired endothelial dysfunction and cardiovascular disease (CVD) risk. The purpose of this study was to determine whether overweight and obese women with PCOS have impaired endothelial function compared with weight-matched controls without PCOS and whether endothelial function is associated with cardiovascular risk markers and hormonal parameters.Design Cross-sectional analysis. Setting An outpatient trial at the Commonwealth Scientific Industrial Research Organisation Clinical Research Unit.Population Overweight and obese women with PCOS (n = 12) and weight-matched controls without PCOS (n = 10).Methods Endothelial function, cardiovascular risk markers and hormonal parameters were assessed in the patients.Main outcome measures Endothelial function was assessed by flow-mediated dilatation (FMD) of the brachial artery using highresolution ultrasound. Lipid profile, fasting insulin level, glucose level, insulin resistance, C-reactive protein level, folate level, Vitamin B 12 level and hormonal parameters.Results Women with PCOS had significantly higher testosterone levels (P < 0.001) and free androgen index (P = 0.006) compared with the controls without PCOS. Both groups were normoinsulinaemic, and there were no significant differences in any of the markers of CVD between women with and without PCOS. Furthermore, FMD was similar in both groups (PCOS 6.1 ± 1.2% versus control 5.6 ± 1.0%, P = 0.77).Conclusions Compared with a group of weight-matched women with similar metabolic profiles, normoinsulinemic, overweight and obese women with PCOS did not show any greater impairment in endothelial function assessed by FMD. A normoinsulinemic phenotype of PCOS with low metabolic risk factors may reduce the risk of endothelial dysfunction in overweight and obese women with this syndrome. Further studies are required that directly compare FMD in normoinsulinemic and hyperinsulinaemic women with PCOS.

The polycystic ovary syndrome (pcos) status and cardiovascular risk in young women

“…Consistent with our results, most of the studies, but not all [8,12], demonstrated impaired endothelial function in PCOS using either noninvasive endothelium-dependent (FMD) and-independent (glyceroltrinitrate, GTN) changes in the brachial artery or invasive methodology [4,6,10,11,24] compared with the controls. Among several circulating endothelium-derived vasoactive molecules, ET-1 is considered one of the best indices of abnormal vascular reactivity, playing an important role in the early events of endothelial dysfunction [4].…”

“…Therefore, we might speculate that some genetic abnormalities, such as polymorphisms in AR or other yet unidentified genetic abnormalities aggravated by the higher levels of androgens found in PCOS subjects, may be responsible for impaired endothelial function observed in our test group in comparison with our control group. Several lines of evidence, but not all [8,10,12,27,33], revealed an association between insulin resistance and endothelial dysfunction markers in PCOS women [4,7,9,11,34]. We observed however, significant correlations of FMD with insulin concentrations and HOMA-IR, but only in the entire population studied.…”

“…Up to the present, the results on this topic have been controversial as far as the presence of arterial structural and functional alterations or of chronic inflammation in PCOS are concerned. For example, there are reports which have demonstrated that PCOS is associated with endothelial dysfunction or increased CIMT even from a young age, while other reports have stated the contrary [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Additionally, there are authors who consider PCOS as a pro-inflammatory state due to elevated plasma concentrations of inflammatory mediators of atherogenesis, such as interleukin (IL)-6, IL-18, soluble intercellular adhesion molecule-1 (sICAM-1), sEselectin, high sensitivity C-reactive protein (hsCRP), tumoral necrosis factor-alpha (TNF-α), monocyte chemotactic protein-1 (MCP-1), and plasminogen activator inhibitor-1 (PAI-1) [17][18][19].…”

An Assessment of Flow-Mediated Dilatation in Behçet’s Disease

“…The mean FMDs of the brachial artery of both groups were assessed by a non-invasive method previously used by Brinkworth and et al [16] in their study. Doppler US examinations were performed with a 10 mHz linear array transducer and a Logiq 9 US system (GE Medical Systems, Milwaukee, Wisconsin, USA).…”

Metabolic Aspects of Polycystic Ovary Syndrome

“…In addition, women with PCOS display signs of endothelial dysfunction, which is an early event in the development of atherosclerosis that precedes plaque formation and clinical disease. Endothelial function is evaluated in PCOS patients, mostly by measuring post-ischemic flow mediated dilatation of the brachial artery by high-resolution ultrasonography and by measuring arterial stiffness with pulse wave velocity [83][84][85][86][87][88][89]. Women with PCOS also display signs of sub-clinical atherosclerosis at young age [13, 76-78, 86, 90-92].…”