Abstract
Polycystic ovary syndrome (PCOS) has been associated with an increased risk of metabolic disturbances and cardiovascular disease. Intima-media thickness of the common carotid artery (CIMT) represents a valid surrogate marker of early systemic atherosclerosis. This study aimed to investigate if CIMT is increased in PCOS patients compared to healthy controls and if there is an association with hormone and metabolic profiles. In this prospective cross-sectional study, past medical history, anthropometrical measurements and hormonal, lipidemic and glycemic parameters were obtained in 41 PCOS patients and 43 age-matched healthy controls of similar body mass index (BMI) and frequency of smokers. B-mode ultrasound enabled CIMT measurement at the far wall of the left and right common carotid artery. Patients with PCOS showed significantly increased CIMT values compared to healthy controls (0.49±0.04mm vs. 0.37±0.04mm respectively, P<0.001). They featured a generally increased cardiovascular risk profile. Correlation analysis showed a positive association between CIMT and the adverse metabolic risk profile. The diagnosis of PCOS was the strongest predictor of CIMT, even after multiple adjustments for BMI, age and smoking status (β = 0.797, P<0.001, R2 = 0.73). A model among oligomenorrhoic patients revealed a relationship between CIMT and the suspected duration of disease (β = 0.373, P = 0.021, R2 = 0.14). PCOS patients are likely to feature signs of premature systemic atherosclerosis at a young age. Early exposure to adverse cardiovascular risk factors may possibly have long-term consequences on the vascular system. An early vessel screening might thus already be beneficial in these patients at a younger age.
Highlights
Polycystic ovary syndrome (PCOS) represents one of the most common endocrinopathies in women of reproductive age, affecting approximately 4 to 7% of all women [1]
Patients with PCOS showed significantly increased CIMT values compared to healthy controls (0.49±0.04mm vs. 0.37±0.04mm respectively, P
The diagnosis of PCOS was the strongest predictor of CIMT, even after multiple adjustments for body mass index (BMI), age and smoking status (β = 0.797, P
Summary
Polycystic ovary syndrome (PCOS) represents one of the most common endocrinopathies in women of reproductive age, affecting approximately 4 to 7% of all women [1]. Ovulatory dysfunction and polycystic ovarian morphology on ultrasound (PCOM) [2,3]. PCOS seems to be closely associated with a metabolic disorder linked to insulin resistance (IR) [6], as 50–70% of PCOS patients show IR with compensatory hyperinsulinemia [7]. This state is characterized by IR in skeletal muscle, adipose tissue and liver, due to a post-binding defect in insulin receptor signaling caused by increased serine phosphorylation of the insulin receptor and the insulin receptor substrate-1 (IRS-1), but ovarian hypersensitivity to insulin [6,8]. IR being a key component of the pathophysiology of PCOS, treatment options with insulin-sensitizers, such as metformin or inositol isoforms [11], are increasingly being used due to their beneficial effects on metabolic and hormonal parameters
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