title: Endothelial dysfunction but not increased carotid intima-media thickness in young European women with endometriosis.
abstract: BACKGROUND
  Atherosclerosis is a chronic and degenerative disease developing typically in the elderly; nonetheless, a condition of accelerated atherosclerosis can be observed precociously in the presence of some diseases. Endometriosis, a chronic benign gynecological disorder, shows some characteristics, such as oxidative stress, systemic inflammation and a pro-atherogenic lipid profile, which could increase the risk of developing accelerated atherosclerosis. The aim of our study was to evaluate markers of subclinical atherosclerosis in young European women with endometriosis.
  
  
  METHODS
  This cross-sectional study included 37 women with endometriosis and 31 control subjects. The presence of subclinical atherosclerosis was investigated by ultrasound evaluation of common carotid intima-media thickness (ccIMT) and flow-mediated dilation (FMD); in addition, serum levels of lipids, inflammatory and coagulation parameters, as well as markers of endothelial inflammation and activation, were determined.
  
  
  RESULTS
  Women with endometriosis showed significantly lower values of FMD compared with controls [mean difference: -4.62, 95% confidence interval (CI): -6.52, -2.73; P < 0.001], whereas no significant differences in ccIMT values were found between the two groups. As regards markers of endothelial inflammation and activation, women with endometriosis had significantly higher values of inter-cellular adhesion molecule 1 (P < 0.001), vascular cell adhesion molecule 1 (P < 0.001), E-selectin (P < 0.001), von Willebrand factor (P = 0.004) and ristocetin cofactor (P = 0.001) compared with controls.
  
  
  CONCLUSIONS
  Our study suggests that women with endometriosis have more subclinical atherosclerosis, resulting in a higher risk of developing cardiovascular disorders. Moreover, our findings demonstrate that endothelial dysfunction can occur in the absence of structural atherosclerotic changes; its evaluation might be helpful in young women with endometriosis.
authors.affiliation: Department of Internal Medicine, Complesso Integrato Columbus, Catholic University of Rome, Via Moscati, 31, Rome 00168, Italy. lu_santoro@libero.it
authors.forename: Luca
authors.initials: L
authors.lastname: Santoro
authors.forename: Ferruccio
authors.initials: F
authors.lastname: D'Onofrio
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Campo
authors.forename: Pietro Manuel
authors.initials: PM
authors.lastname: Ferraro
authors.forename: Paolo
authors.initials: P
authors.lastname: Tondi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Campo
authors.forename: Andrea
authors.initials: A
authors.lastname: Flex
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Angelo
authors.initials: A
authors.lastname: Santoliquido
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D059168:Carotid Intima-Media Thickness; D004715:Endometriosis / Q000150:complications*; D004727:Endothelium / Q000503:physiopathology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008597:Menstrual Cycle; D012039:Regional Blood Flow; D014664:Vasodilation
chemical_list: D015415:Biomarkers