title: Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance. The objective of this cross-sectional study was to investigate the impact of insulin resistance and body mass index (BMI) on inflammatory and hemostatic variables associated with long-term risk of cardiovascular disease in women with PCOS.
  
  
  METHODS
  149 premenopausal women with PCOS were recruited consecutively from April 2010 to February 2012 at three Danish University Hospitals. The study was conducted at the Department of Gynecology and Obstetrics, Herlev University Hospital, Denmark. PCOS was diagnosed in accordance with the Rotterdam criteria and the women were classified into four phenotypes according to BMI and insulin resistance measured by the homeostasis model assessment of insulin resistance index. Body composition was determined by dual-energy X-ray absorptiometry. Main outcome measures were the biomarkers C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and von Willebrand factor antigen.
  
  
  RESULTS
  Normal weight insulin-resistant PCOS women were characterized by abdominal obesity and elevated levels of plasma PAI-1. Overweight/obese insulin-resistant PCOS women had increased levels of both PAI-1 and CRP. Of the three Rotterdam criteria, only hyperandrogenemia was significantly associated with the hemostatic risk marker of long-term cardiovascular disease risk.
  
  
  CONCLUSIONS
  Surrogate risk markers for cardiovascular disease are elevated in women with PCOS, especially insulin-resistant and overweight/obese women.
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Herlev University Hospital, Herlev, Denmark.
authors.forename: Mubeena
authors.initials: M
authors.lastname: Aziz
authors.affiliation: Unit for Thrombosis Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Sidelmann
authors.affiliation: Department of Endocrinology, Faculty of Health and Medical Sciences, Copenhagen University, Herlev University Hospital, Herlev, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Marie-Louise M
authors.initials: ML
authors.lastname: Wissing
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: Klara V
authors.initials: KV
authors.lastname: Naver
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Anne-Lis
authors.initials: AL
authors.lastname: Mikkelsen
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Nilas
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Herlev University Hospital, Herlev, Denmark.
authors.forename: Sven O
authors.initials: SO
authors.lastname: Skouby
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D010641:Phenotype; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D014841:von Willebrand Factor / Q000276:immunology
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D014841:von Willebrand Factor; D002097:C-Reactive Protein
keywords: Polycystic ovary syndrome; cardiovascular disease; chronic low-grade inflammation; endothelial dysfunction; insulin resistance; phenotypes