Abstract 12078: Obese Girls With PCOS Have Evidence of Vascular Stiffening and Left Ventricular Hypertrophy Which Relate to Insulin Resistance

Abstract

Introduction: Women with polycystic ovarian syndrome (PCOS) have evidence of greater plaque formation and vascular disease by the third decade of life compared to women without PCOS. We previously reported that obese girls with PCOS have a more atherogenic lipoprotein particle size profile compared to controls. It was unknown these youth also already had evidence of cardiac or vascular disease and plaque development. Hypothesis: We hypothesized that adolescent girls with PCOS have evidence of vascular stiffness and plaque formation. Methods: Sedentary, non-diabetic, obese girls with PCOS (OBP; N=38, age 14.9±0.2 years, BMI% 98.1±0.3) and without PCOS (OB; N=14, age 14±0.5 years, BMI% 97.4±0.7) were enrolled. Girls with clinical hypertension, renal disease or structural cardiac abnormalities were excluded. Measures included carotid IMT (CIMT), resting echocardiogram, blood pressure, serum lipid profile, and insulin sensitivity assessed with a hyperinsulinemic euglycemic clamp. Calculated measures included carotid beta- stiffness index and distention. Results: Resting blood pressures were normal for age and similar between groups. OBP had greater carotid vascular stiffness than OB (βstiffness 1.91±0.08U OB vs 2.19±0.09 OBP, p=0.01; Distention 0.23±0.17mm OB vs 0.18±0.01 OBP, P=0.0007), and there was evidence of greater left ventricular posterior wall thickness (0.79±0.03cm OB vs 0.88±0.02 OBP; P=0.02) and intraventricular wall thickness (0.77±0.04cm OB vs 0.86±0.02 OBP; P=0.04). There was no difference in CIMT between OBP and OB (0.45±0.02cm OB vs 0.48±0.01 OBP, P>0.1). However, OBP were also more insulin resistant than OB (glucose infusion rate 18.3±2.3 mg/leankg/min OB vs 10.4±1.6 OBP, P=0.0007), which correlated with left ventricular posterior wall thickness (R=-0.50, P<0.001). Conclusions: Obese normotensive girls with PCOS have vascular stiffening and left ventricular remodeling which relate to insulin resistance. They do not yet have increased CIMT, however, they have insulin resistance and a more atherogenic lipid profile, indicating that the substrate for imtimal-medial thickening and plaque formation is present. Interventions to prevent cardiovascular disease should begin in adolescence.