title: Endothelial function measured using flow-mediated dilation in polycystic ovary syndrome: a meta-analysis of the observational studies.
abstract: OBJECTIVE
  Women with polycystic ovary syndrome (PCOS) demonstrate an increased prevalence of cardiovascular disease (CVD) risk factors. Previous researchers have compared flow-mediated dilation (FMD), an early marker of CVD, in women with and without PCOS. Evidence for a PCOS-mediated reduction in FMD remains equivocal, potentially because of study differences in cohort-matching and measurement approaches. The aims of this systematic review and meta-analysis were to examine to what extent FMD is impaired in PCOS and to explore the influence of potential moderators of FMD reduction, such as age and BMI.
  
  
  METHODS
  A systematic review and meta-analysis of published observational studies comparing FMD in PCOS with control women.
  
  
  METHODS
  Twenty-one published studies were included (PCOS, n = 908; controls, n = 566). A subanalysis, using tighter inclusion criteria, involved seven studies (PCOS, n = 402; control, n = 251).
  
  
  METHODS
  Mean differences in FMD between PCOS and controls were synthesized. The subanalysis was delimited to the inclusion of age and BMI-matched controls. These factors were then explored as moderators using meta-regression.
  
  
  RESULTS
  The pooled mean FMD was 3.4% (95% CI=1.9, 4.9) lower in PCOS compared with control women, with substantial heterogeneity between studies. In the subanalysis, the PCOS-mediated reduction in FMD was 4.1% (95% CI=2.7, 5.5). Heterogeneity remained substantial (I(2) =81%). Subsequent meta-regression indicated that the magnitude of FMD difference was not influenced by BMI (P = 0.17) nor age (P = 0.38).
  
  
  CONCLUSIONS
  This systematic research synthesis indicates that endothelial function is compromised in PCOS women, even if they are young and nonobese.
authors: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
authors: Victoria S
authors: VS
authors: Sprung
authors: Greg
authors: G
authors: Atkinson
authors: Daniel J
authors: DJ
authors: Cuthbertson
authors: Christopher J A
authors: CJ
authors: Pugh
authors: Nabil
authors: N
authors: Aziz
authors: Daniel J
authors: DJ
authors: Green
authors: N Timothy
authors: NT
authors: Cable
authors: Helen
authors: H
authors: Jones
mesh_terms: D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology*; D014664:Vasodilation / Q000502:physiology*