Increased arterial stiffness in nonobese women with polycystic ovary syndrome (PCOS) without comorbidities: one more characteristic inherent to the syndrome?

Abstract

Polycystic ovary syndrome (PCOS) is associated with adverse metabolic effects. Some cardiovascular disease (CVD) risk markers are increased in women with PCOS. However, early markers of atherosclerosis are also associated with obesity and insulin resistance, which are related to PCOS. These markers may result either directly from PCOS or indirectly as a consequence of the comorbidities associated with the syndrome. To assess the presence of early CVD markers in young, nonobese women with PCOS. Forty women with PCOS and 50 healthy women with regular menstrual cycles, matched for age and body mass index (BMI). The following CVD markers were assessed by ultrasonography: common carotid artery (CCA) stiffness index (beta), distensibility and intima-media thickness (IMT), and brachial artery flow-mediated dilatation (FMD). Inflammatory markers, including interleukin (IL)-6, tumour necrosis factor (TNF)-alpha, homocysteine, C-reactive protein (CRP), glycaemia, lipid profile and insulin, were also assessed. CCA beta was higher in PCOS than in control women (3.72 +/- 0.96 vs. 3.36 +/- 0.96, P = 0.04) and CCA distensibility was lower (0.31 +/- 0.08 vs. 0.35 +/- 0.09 mmHg(-1), P = 0.02). Waist circumference, total testosterone and the Free Androgen Index (FAI) were higher in PCOS patients than in controls (78.2 +/- 10.0 vs. 71.5 +/- 7.2 cm, P = 0.001; 88.1 +/- 32.4 vs. 57.1 +/- 21.2 ng/dl, P < 0.01; 12.7 +/- 15.7%vs. 4.7 +/- 2.3%, P < 0.01, respectively), while SHBG was reduced (37.9 +/- 19.1 vs. 47.8 +/- 18.3 nmol/l, P = 0.01). The remaining variables did not differ between the groups. Young women with PCOS exhibit changes in vascular elasticity even in the absence of classical risk factors for CVD, such as hypertension and obesity.