Abstract
: It is believed that microvascular dysfunction plays a major role in the development of insulin resistance (IR). Performing nailfold capillaroscopy witÂh evaluation of microvascular parameters in women with polycystic ovary syndrome (PCOS) would undoubtedly be helpful for the investigation of novel pathophysiological mechanisms in IR occurrence. The aim of the present study was to compare the values of microvascular parameters between PCOS patients and clinically healthy women and to assess its relationship with clinical and metabolic parameters in the PCOS women. Our study included 21 PCOS patients and 22 clinically healthy women (controls). Nailfold capillaroscopy was conducted and the following parameters were assessed: arterial limb diameter (d art), venous limb diameter (d ven), top diameter of loops (top d), length of loops, d art/d ven ratio, d ven/d art ratio, number of capillary loops (n cap), number of abnormal loops (% abn cap) and a presence of perivascular diapedesis. Weight, height, fasting plasma glucose (FPG), immunoreactive insulin (IRI), lipid parameters, total testosterone, systolic (SBP) and diastolic blood pressure (DBP) were measured in the PCOS women. Body mass index (BMI) and homeostasis model of insulin resistance index (HOMA-IR) were calculated. We found significantly higher values of age, BMI and % abn cap in the women with PCOS as compared to the controls. Interestingly, % abn cap showed a negative correlation with age. Furthermore, an inverse association between top d and the values of SBP and DBP was established. We determined a positive correlation between the presence of perivascular diapedesis and the values of FPG, HOMA-IR and testosterone. As a conclusion, the higher % abn cap in the PCOS women might be an early pathophysiological sign of microvascular dysfunction. The positive correlation between perivascular diapedesis and the degree of IR, hyperglycemia, and hyperandrogenemia shows the existence of a chronic low-grade inflammatory process in PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a condition that represents a specific prototype of metabolic syndrome (MS) among women at reproductive age
Patients with polycystic ovary syndrome (PCOS) are characterized by typical clinical features of hyperandrogenemia and their metabolic status often includes android type of obesity, glucose tolerance disturbances, atherogenic dyslipidemia, and hypertension
Several studies have shown that PCOS women have a greater risk of developing type 2 diabetes mellitus (TDM2) as well as a low-grade chronic inflammatory process leading to endothelial dysfunction and coagulation and/or fibrinolysis abnormalities (Teede et al, 2010; Koleva et al, 2016)
Summary
Polycystic ovary syndrome (PCOS) is a condition that represents a specific prototype of metabolic syndrome (MS) among women at reproductive age. Patients with PCOS are characterized by typical clinical features of hyperandrogenemia and their metabolic status often includes android type of obesity, glucose tolerance disturbances, atherogenic dyslipidemia, and hypertension. The main functions of the microcirculation are: 1) to accomplish the exchange of nutrients, oxygen, and hormones between plasma and tissue fluid; 2) to minimize the fluctuations in the hydrostatic pressure at the level of capillaries; 3) to adjust the peripheral vascular resistance, respectively the blood pressure (Muris et al, 2013). It has been found that microvascular dysfunction might cause disrupted glucose tissue utilization (Clark et al, 2003; Serne et al, 2001; Wallis et al, 2002) and peripheral vascular resistance (Antonios et al, 1999), resulting in the development of IR and arterial hypertension (AH)
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