Is plasminogen activator inhibitor-1 a cardiovascular risk factor in young women with polycystic ovary syndrome?

Abstract

This study aimed to evaluate plasminogen activator inhibitor-1 (PAI-1) activity in PCOS. Thirty women with PCOS - 15 normal-weight and 15 obese - and 30 healthy women matched as a group for age and body mass index (BMI) were recruited. The homeostasis model assessment (HOMA) score was significantly elevated in obese compared with normal-weight women, in both PCOS women and controls. HOMA score was significantly higher in both PCOS groups relative to controls. After further adjustment for BMI, PAI-1 activity (IU/ml +/- SD) was significantly higher in the PCOS groups compared with controls. A significant positive correlation was found between HOMA score and BMI in PCOS and control groups. Serum PAI-1 activity was significantly related to BMI and HOMA score. When considering two BMI subgroups, there was no significant difference in the relationship between serum PAI-1 activity and HOMA score in both the control and PCOS groups. No other significant relationship was found between serum PAI-1 activity and any other hormonal or metabolic parameter. In conclusion, women with PCOS have significantly elevated PAI-1 activity independent of obesity, and it is speculated that elevated PAI-1 activity may be a factor in the increased cardiovascular morbidity seen in PCOS.

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

“…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]. Therefore, our findings do not support a role for IR in the increase of PAI-1 levels in overweight/obese patients with PCOS.…”

“…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].…”

“…Given the increased prevalence of IR in women with PCOS and the association between circulating PAI-1 levels and IR, several studies assessed plasma PAI-1 levels in PCOS [10][11][12][13][14][15][16]. Most, but not all, reported elevated plasma PAI-1 levels in women with PCOS [10][11][12][13][14][15][16].…”

“…Most, but not all, reported elevated plasma PAI-1 levels in women with PCOS [10][11][12][13][14][15][16]. However, existing studies are relatively small and none of them compared plasma PAI-1 levels between the different phenotypes of the syndrome level of the widest diameter around the buttocks.…”

“…Patients with the additional PCOS phenotypes introduced by the 2003 criteria had hyperandrogenemia and polycystic ovaries without oligo-or anovulation [phenotype 3 ("ovulatory" PCOS)] or had oligo-or anovulation and polycystic ovaries, without biochemical hyperandrogenemia or clinical manifestations of hyperandrogenemia [phenotype 4 ("mild" PCOS)]. [10][11][12][13][14][15][16]. Accordingly, the aim of the present study was to evaluate plasma PAI-1 levels in a large cohort of women with PCOS and to assess these levels in women with different levels of adiposity and different phenotypes of PCOS.…”