Vascular dysfunction and metabolic parameters in polycystic ovary syndrome.
BACKGROUND
Polycystic ovary syndrome (PCOS) is associated with insulin resistance (IR) and the metabolic syndrome; however, the cardiovascular (CV) manifestations of PCOS remain unclear.


OBJECTIVE
The objective of this study was to examine the relationships between IR, metabolic parameters, androgens, and markers of early CV disease in PCOS.


METHODS
We conducted an observational study examining noninvasive markers of early CV disease in women with PCOS including structural [carotid intimal media thickness (IMT)] and functional measures (arterial function with pulse wave velocity and endothelial function with brachial arterial flow-mediated vasodilation). Metabolic parameters included insulin and glucose during an oral glucose tolerance test and lipid and androgen levels.


METHODS
Participants were recruited from the general community.


METHODS
Eighty overweight women with PCOS who were nonsmokers and not on oral contraceptives or other medications known to affect IR participated in the study.


RESULTS
Stepwise regression analysis showed that after adjustment for age and body mass index, IMT was significantly correlated with blood pressure (BP) load (P = 0.03) and inversely with dehydroepiandrosterone sulfate (DHEAS) (P = 0.01). After correction for androgen status, IMT was correlated with fasting glucose and area under curve (AUC) insulin. Flow-mediated vasodilation was inversely related to lipids (P = 0.02), whereas pulse wave velocity was related to BP (P < 0.001), AUC insulin (P = 0.04), and AUC glucose (P = 0.035).


CONCLUSIONS
In overweight women with PCOS, insulin resistance and BP interacted negatively with arterial structural and functional measures. DHEAS correlated inversely with arterial structure, suggesting possible cardioprotective effects of endogenous DHEAS in women with PCOS. Additional research is needed to clarify these findings.
Meyer
C
C
Monash University Department of Medicine, Dandenong Hospital, Melbourne, Victoria, Australia.
McGrath
B P
BP
Cameron
J
J
Kotsopoulos
D
D
Teede
H J
HJ
D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000378:metabolism; D018660:Blood Pressure Monitoring, Ambulatory; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000378:metabolism*; D011673:Pulsatile Flow; D012044:Regression Analysis; D014463:Ultrasonography; D014664:Vasodilation
D000728:Androgens