title: Adolescents with Classical Polycystic Ovary Syndrome Have Alterations in the Surrogate Markers of Cardiovascular Disease but Not in the Endothelial Function. The Possible Benefits of Metformin.
abstract: OBJECTIVE
  To study whether adolescents with the classical form of polycystic ovary syndrome (PCOS) have alterations in metabolic and vascular structure and function. The effect of metformin was evaluated.
  
  
  METHODS
  Controlled study.
  
  
  METHODS
  University outpatient clinic.
  
  
  METHODS
  Eighteen nonobese adolescents with PCOS were enrolled. Seventeen healthy age-matched adolescents were recruited as control subjects.
  
  
  METHODS
  The metabolic profile and the endothelial structure and function were evaluated.
  
  
  METHODS
  Hormonal and lipid profile, blood pressure (BP) measurement, fasting glucose and insulin levels, C-reactive protein (CRP), homocysteine, tissue-type plasminogen activator, plasminogen activator inhibitor-1 (PAI-1), and plasmin-antiplasmin complexes (PAP) were measured. Flow mediated dilation (FMD), central pulse wave velocity (PWV), radial artery pulse wave, and common carotid intima-media thickness (IMT) were also assessed. Girls with PCOS were also studied 6 months after treatment with metformin (850 mg twice per day).
  
  
  RESULTS
  Adolescents with PCOS were insulin resistant and/or hyperinsulinemic and they had higher BP values and levels of CRP and PAI-1 than the control subjects. The levels of tissue-type plasminogen activator and PAP were similar in both groups. FMD, PWV, and IMT were also similar. Metformin significantly (P < .05) reduced insulin, BP, CRP, and PAI-1 levels. The PAP levels significantly (P < .05) increased. Radial artery pulse wave was significantly reduced after metformin treatment. No modifications in FMD, PWV, and IMT were observed.
  
  
  CONCLUSIONS
  Adolescents with classical PCOS have alterations in some surrogate markers of cardiovascular risk and they are ameliorated by metformin. No deterioration of vascular structure and function has been detected, probably because of the short duration of exposure to the disease.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy. Electronic address: ffruzzi@tin.it.
authors.forename: Franca
authors.initials: F
authors.lastname: Fruzzetti
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ghiadoni
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Virdis
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: De Negri
authors.affiliation: Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Perini
authors.affiliation: Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Bucci
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Giannarelli
authors.affiliation: Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
authors.forename: Angiolo
authors.initials: A
authors.lastname: Gadducci
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Taddei
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000188:drug therapy; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D004727:Endothelium; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008687:Metformin / Q000627:therapeutic use*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D063177:Pulse Wave Analysis; D012307:Risk Factors; D010959:Tissue Plasminogen Activator / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D006710:Homocysteine; D002097:C-Reactive Protein; D008687:Metformin; C067262:PLAT protein, human; D010959:Tissue Plasminogen Activator
keywords: Arterial stiffness; Endothelium; Fibrinolysis; Metformin; PCOS