Predictors of Endothelial Dysfunction in Young Women With Polycystic Ovary Syndrome

Kravariti, Maria; Naka, Katerina K.; Kalantaridou, Sophia Ν.; Kazakos, Nikolaos; Katsouras, Christos S.; Makrigiannakis, Antonis; Paraskevaidis, Evangelos; Chrousos, George P.; Tsatsoulis, Agathocles; Michalis, Lampros K.

doi:10.1097/01.ogx.0000206323.83912.31

Cited by 52 publications

(91 citation statements)

References 7 publications

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“…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.…”

Section: Discussioncontrasting

confidence: 70%

“…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].…”

Section: Introductionmentioning

confidence: 98%

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

Ilie¹,

Pepene²,

Marian³

et al. 2010

Open Medicine

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AbstractThe study investigated the presence of early vascular damage and chronic inflammation, and their relationships with hormonal and metabolic parameters in 45 young women with PCOS in comparison with thirty-two healthy age-matched controls. Hormonal and metabolic profiles, high sensitivity C-reactive protein (hsCRP), tumoral necrosis factor-alpha (TNF-α), endothelin-1 (ET-1), brachial flow-mediated vasodilation (FMD) and carotid intima-media thickness (CIMT) were determined in both groups. Compared with the controls, women with PCOS had significantly lower FMD and respectively higher ET-1 levels (p=0.001). No differences were observed between the groups in terms of CIMT or inflammatory markers. In the PCOS group, ET-1 levels were significantly correlated with only testosterone concentrations (r = 0.31, p = 0.037), whereas the hsCRP levels were independently predicted only by body mass index (BMI). Within the total group, the PCOS status was the sole significant predictor of ET-1 levels and the only independent predictor of FMD. In conclusion, there is evidence of endothelial dysfunction associated with increased levels of androgen hormones in young women with PCOS. The combination of endothelial dysfunction and coexistent obesity promoting inflammation contributes to the progression of atherogenesis in PCOS. The PCOS status should be regarded as a predictor marker of cardiovascular risk, along with well-known cardiovascular risk factors.

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Section: Discussioncontrasting

confidence: 70%

Section: Introductionmentioning

confidence: 98%

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

Ilie¹,

Pepene²,

Marian³

et al. 2010

Open Medicine

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“…This theory is supported by studies showing impaired endothelial function in postmenopausal women with low testosterone levels 110 and increased carotid atherosclerosis and endothelial dysfunction in polycystic ovary syndrome women with supraphysiological testosterone levels. 111,112 Results from experimental studies show a similar pattern. Bruck et al 113 showed an increase in plaque size after testosterone treatment in female rabbits on an atherogenic diet.…”

Section: Atherosclerosismentioning

confidence: 63%

Testosterone, SHBG and cardiovascular health in postmenopausal women

Brand

Schouw

2010

Int J Impot Res

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Cardiovascular disease (CVD) affects men and women differently with women having a lower incidence and later onset of disease. Research has recently refocused interest on the cardiovascular role of androgens. The purpose of this review is to summarize the evidence available on the association between testosterone and cardiovascular health in postmenopausal women. Published studies relating testosterone and sex hormone-binding globulin (SHBG) to CVD and its risk factors were reviewed. Studies included in this review suggest that increased androgenicity, characterized by high testosterone and low SHBG levels, is associated with an adverse CVD risk factor profile in postmenopausal women. However, evidence for an association with cardiovascular events is lacking and it is uncertain whether the observed associations with endogenous testosterone have clinical implications regarding the use of postmenopausal testosterone therapy. Large-scale, longitudinal studies relating testosterone and SHBG levels to cardiovascular risk factors and endpoints are needed to determine the temporal relationship between androgenicity and cardiovascular risk and to ascertain the long-term efficacy and safety of testosterone therapy in postmenopausal women.

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“…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).…”

Section: Markers Of Cardiovascular Risk In Pcosmentioning

confidence: 98%

Long-term consequences of polycystic ovary syndrome on cardiovascular risk

Rizzo

Berneis²,

Spinas³

et al. 2009

Fertility and Sterility

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2 CAPSULEPostmenopausal women with PCOS have increased cerebro-vascular events and cardiovascular morbidity. Our best long-term strategy is information, acknowledging women with PCOS of their risk for metabolic and cardiovascular diseases. 3 ABSTRACTMost available data suggest that the prevalence of cardiovascular diseases in women with polycystic ovary syndrome (PCOS) is smaller than what expected on the basis of the risk calculation during fertile age; therefore, we need many more studies on their long term cardiovascular consequences although evidence is accumulating that women with PCOS at postmenopausal age have an increase in cerebro-vascular events and in cardiovascular morbidity. These events are partially related to the persisting hyperandrogenism but are mostly correlated to the excessive body weight (mainly to the visceral obesity); this suggests that our best long term strategy is the information, acknowledging women with PCOS of their high risk for metabolic and cardiovascular diseases.

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Predictors of Endothelial Dysfunction in Young Women With Polycystic Ovary Syndrome

Cited by 52 publications

References 7 publications

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

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

Testosterone, SHBG and cardiovascular health in postmenopausal women

Long-term consequences of polycystic ovary syndrome on cardiovascular risk

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