Cardiovascular, anthropometric, metabolic and hormonal profiling of normotensive women with polycystic ovary syndrome with and without biochemical hyperandrogenism

Małgorzata Kałużna,Katarzyna Ziemnicka,Jolanta Kaczmarek,Katarzyna Wachowiak-Ochmańska,Przemysław Guzik,Tomasz Krauze,Marek Ruchała,Adam Janicki,Andrzej Wykrętowicz

doi:10.1007/s12020-021-02648-7

Małgorzata Kałużna, Katarzyna Ziemnicka + Show 7 more

Open Access

https://doi.org/10.1007/s12020-021-02648-7

Copy DOI

Abstract

PurposeWomen with polycystic ovary syndrome (PCOS) present with or without biochemical hyperandrogenism (HAPCOS or non-HAPCOS, respectively). Cardiometabolic and hormonal abnormalities have been reported in women with PCOS, particularly those with hypertension. However, no direct comparison between normotensive (blood pressure <140/90 mmHg) patients with HAPCOS and non-HAPCOS has been made. This study compared different cardiovascular (CV), anthropometric, metabolic and hormonal features between normotensive patients with HAPCOS and non-HAPCOS and healthy women.MethodsWe consecutively recruited 249 normotensive patients with PCOS and 85 healthy eumenorrheic women to a case-control observational study. Based on blood androgen concentration, patients with PCOS were divided into HAPCOS (n = 69) or non-HAPCOS (n = 180) groups.ResultsAlthough within normal ranges, patients with HAPCOS had significantly (p < 0.05) higher peripheral and central systolic blood pressure and pulse pressure, C-reactive protein, low-density lipoprotein cholesterol, triglycerides, glucose, and insulin than subjects with non-HAPCOS, and healthy women. They also had lower N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) concentration. In contrast, their body mass index (BMI) was higher of over 4 kg/m2 than patients with non-HAPCOS and nearly 6 kg/m2 than in healthy participants. Except for BMI, statistical differences in the cardiometabolic profile were of little clinical relevance.ConclusionsYoung normotensive women with HAPCOS have a worse cardiometabolic profile but lower NT-proBNP concentration than patients with non-HAPCOS. Features of this profile in both PCOS groups are within ranges typical for healthy women. Increased BMI is the only clinically relevant feature differentiating hyperandrogenic from non-hyperandrogenic patients with PCOS, and healthy women.

Highlights

The polycystic ovary syndrome (PCOS) is an endocrinological disease found in 12–21% of reproductive-aged women with clinical symptoms of oligo/amenorrhea, oligo/anovulatory cycles, hirsutism or male pattern balding, infertility, various psychological symptoms such as depression, anxiety, or psychosexual dysfunction [1]
The concentrations of TT, SHBG, dehydroepiandrosterone sulfate (DHEAS), 17-OHP and DHT were comparable in patients with non-HAPCOS vs healthy controls
Concentrations of SHBG, highdensity lipoprotein concentration (HDL), and NT-proBNP were lower in individuals with HAPCOS

Summary

Introduction

The polycystic ovary syndrome (PCOS) is an endocrinological disease found in 12–21% of reproductive-aged women with clinical symptoms of oligo/amenorrhea, oligo/anovulatory cycles, hirsutism or male pattern balding, infertility, various psychological symptoms such as depression, anxiety, or psychosexual dysfunction [1]. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is an inactive form of the B-type natriuretic peptide. It is secreted by cardiomyocytes in response to increased volume and/or pressure overload, producing myocardial wall stretching. For this reason, it has been used in the diagnosis and monitoring the progress of acute and chronic heart failure. NT-proBNP is increased in patients with hypertension and ischemic heart disease. The measurement of NT-proBNP is considered a biochemical marker of the CV function [11, 12]

Objectives

Methods

Results

Discussion

Conclusion