title: Endocan is a predictor of increased cardiovascular risk in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  Endocan is a proteoglycan secreted mainly from endothelial cells. It has been implicated that there is a link between endocan and endothelial dysfunction. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disease associated with increased risk of cardiovascular events. The aims of this study were to ascertain whether circulating endocan levels are altered in women with PCOS, and whether there is an association between endocan and carotid intima media thickness (cIMT).
  
  
  METHODS
  This cross-sectional study included 80 women with PCOS and 80 age- and BMI-matched controls without PCOS. Circulating endocan levels were measured using ELISA. Metabolic, hormonal parameters and cIMT were determined. 2-h oral glucose tolerance test (2-h OGTT) was performed on all women.
  
  
  RESULTS
  Circulating endocan levels were significantly elevated in women with PCOS compared with controls (5.99 ± 2.37 vs. 3.66 ± 1.79 ng/ml, P < 0.001). Endocan levels positively correlated with BMI, homeostasis model assessment of insulin resistance (HOMA-IR), free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP), and cIMT in both PCOS and control groups. Endocan levels did not correlate with fasting blood glucose, 2-h OGTT, A1Cand lipid parameters. Multiple linear regression analysis revealed that endocan is an independent predictor for cIMT (β = 0.128, 95% CI = 0.118-0.138, P = 0.011).
  
  
  CONCLUSIONS
  Circulating endocan levels are significantly higher in women with PCOS and endocan is independently associated with cIMT. Elevated endocan levels can be a predictor of increased cardiovascular risk in PCOS subjects.
authors.affiliation: a Department of Obstetrics and Gynecology , Izmir University School of Medicine, Medical Park Hospital , Izmir , Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Bicer
authors.affiliation: b Department of Family Physician , Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Guler
authors.affiliation: c Department of Internal Medicine , Division of Endocrinology and Metabolism, Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Gokcen
authors.initials: G
authors.lastname: Unal Kocabas
authors.affiliation: d Department of Radiology , Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Imamoglu
authors.affiliation: e Department of Obstetrics and Gynecology , Private Gynecology Clinic , Izmir , Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Baloglu
authors.affiliation: f Department of Internal Medicine , Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Bilgir
authors.affiliation: f Department of Internal Medicine , Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Arif
authors.initials: A
authors.lastname: Yuksel
authors.affiliation: g Department of Biochemistry and Clinical Biochemistry , Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Giray
authors.initials: G
authors.lastname: Bozkaya
authors.affiliation: c Department of Internal Medicine , Division of Endocrinology and Metabolism, Izmir Bozyaka Training and Research Hospital , Izmir , Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Calan
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009363:Neoplasm Proteins / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D011509:Proteoglycans / Q000097:blood*; D055815:Young Adult
chemical_list: C101134:ESM1 protein, human; D009363:Neoplasm Proteins; D011509:Proteoglycans
keywords: Carotid intima media thickness; endocan; insulin resistance; polycystic ovary syndrome