title: A comparison of cardiovascular risk indices in patients with polycystic ovary syndrome with and without coexisting nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Women with polycystic ovary syndrome (PCOS) have an adverse cardiovascular risk profile and an increased prevalence of nonalcoholic fatty liver disease (NAFLD), which is also associated with an adverse cardiovascular risk profile.
  
  
  OBJECTIVE
  To compare the cardiovascular risk profile of women with PCOS alone and women with PCOS and NAFLD.
  
  
  METHODS
  Twenty-five oligoanovulatory women with PCOS were screened for NAFLD (including liver biopsy if appropriate) and had their cardiovascular risk factors measured which included the inflammatory marker C-reactive protein (CRP), endothelial function {measured using endoPAT 2000 and serum markers [intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin and P-selectin]}, clot structure and function [maximum absorbance (MA) and lysis potential (LT)].
  
  
  RESULTS
  Twelve patients had confirmed PCOS without evidence of NAFLD, and 13 patients had confirmed PCOS with evidence of NAFLD. The PCOS and NAFLD group were heavier (BMI 43·9 ± 2·2 kg/m(2) ) compared with the PCOS alone group (BMI 37·6 ± 1·4 kg/m(2) P = 0·03). There was no difference in CRP (7·57 ± 0·95 vs 6·59 ± 1·87 mm P = 0·62) or endothelial function (RH-PAT 1·96 ± 0·1 vs 1·74 ± 0·16 P = 0·25), ICAM-1 (221 ± 48 vs 250 ± 60 ng/ml P = 0·19), VCAM-1 (2124 ± 78 vs 2314 ± 91 ng/ml P = 0·13), E-selectin (33·9 ± 3·3 vs 39·5 ± 15·5 ng/ml P = 0·31) and P-selectin (101·0 ± 6·6 vs 95·9 ± 10·2 ng/ml P = 0·69). There was no difference in clot formation or lysis.
  
  
  CONCLUSIONS
  The patients with PCOS and NAFLD were heavier compared with patients with PCOS alone. Despite this, we were unable to demonstrate differences in inflammatory markers, endothelial function or clot structure and function, suggesting that severity of steatosis is not the most important determinant of cardiovascular risk in PCOS.
authors.affiliation: Department of Diabetes and Endocrinology, University of Hull, Hull, UK.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Dawson
authors.forename: Thozhukat
authors.initials: T
authors.lastname: Sathyapalan
authors.forename: Jacqueline A J
authors.initials: JA
authors.lastname: Smithson
authors.forename: Rebecca V
authors.initials: RV
authors.lastname: Vince
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Coady
authors.forename: Ramzi
authors.initials: R
authors.lastname: Ajjan
authors.forename: Eric S
authors.initials: ES
authors.lastname: Kilpatrick
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Atkin
mesh_terms: D000328:Adult; D001706:Biopsy; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications; D002319:Cardiovascular System; D019040:E-Selectin / Q000378:metabolism; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D007333:Insulin Resistance; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000150:complications; D019007:P-Selectin / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications; D012307:Risk Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism; D055815:Young Adult
chemical_list: D019040:E-Selectin; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein