title: Influence of spironolactone treatment on endothelial function in non-obese women with polycystic ovary syndrome.
abstract: OBJECTIVE
  Accumulating evidence connects polycystic ovary syndrome (PCOS) with increased risk of cardiovascular disease. Endothelial dysfunction is present in PCOS and represents an early, reversible marker of cardiovascular damage. As androgens and renin-angiotensin-aldosterone system are implicated in the atherogenesis process of PCOS, we tested the hypothesis that treatment with spironolactone, an androgen and mineralocorticoid receptor blocking drug, might reverse endothelial dysfunction in PCOS.
  
  
  METHODS
  A total of 30 non-obese PCOS patients, compared with 20 body mass index matched control subjects, were evaluated. PCOS patients were given spironolactone 100 mg daily in 21-day long intervals followed by a 7-day pause, for 6 months.
  
  
  METHODS
  Flow-mediated dilatation (FMD), glyceryl trinitrate-induced dilatation, free testosterone, androstenedione, DHEA-sulfate, total, low-density lipoprotein (LDL)-, high-density lipoprotein-cholesterol, and triglycerides were determined at baseline and after 6 months.
  
  
  RESULTS
  Results are expressed as median (25-75th percentile). At baseline, FMD was significantly lower in PCOS patients than in controls: 6.0 (0.0-11.7) vs 10.2 (6.8-15.9) %, P=0.018. This difference disappeared after 6 months of spironolactone treatment, as FMD in PCOS patients significantly increased to 8.3 (5.7-10.3) %, P=0.034, and was no longer different from controls. In PCOS patients, serum androgen levels did not change during treatment, while total and LDL-cholesterol decreased significantly from 4.8 (4.1-5.1) mmol/l to 4.4 (3.9-4.8) mmol/l and from 2.5 (2.1-3.1) to 2.2. (2.1-2.5) mmol/l, P<0.05 and P<0.05 respectively.
  
  
  CONCLUSIONS
  Treatment with spironolactone normalized endothelial function and improved cholesterol levels in non-obese PCOS patients.
authors.affiliation: Division of Endocrinology, Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, Zaloska 7, 1000 Ljubljana, Slovenia. katica.bajuk@gmail.com
authors.forename: Katica Bajuk
authors.initials: KB
authors.lastname: Studen
authors.forename: Miran
authors.initials: M
authors.lastname: Sebestjen
authors.forename: Marija
authors.initials: M
authors.lastname: Pfeifer
authors.forename: Janez
authors.initials: J
authors.lastname: Prezelj
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D000726:Androgen Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000728:Androgens / Q000097:blood; D000735:Androstenedione / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D042783:Endothelial Cells / Q000187:drug effects*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood; D013148:Spironolactone / Q000494:pharmacology* / Q000627:therapeutic use; D013739:Testosterone / Q000097:blood; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D000728:Androgens; D008055:Lipids; D008077:Lipoproteins, LDL; D014280:Triglycerides; D013148:Spironolactone; D013739:Testosterone; D000735:Androstenedione; D000450:Aldosterone; D019314:Dehydroepiandrosterone Sulfate; D012083:Renin; D011188:Potassium