Abstract
Classic features of polycystic ovary syndrome (PCOS) include derangement of metabolic and cardiovascular health, and vascular dysfunction is commonly reported. These comorbidities indicate impaired blood flow; however, other than limited reports of increased plasma viscosity, surprisingly little is known regarding the physical properties of blood in PCOS. We aimed to investigate whether haemorheology was impaired in women with PCOS. We thus measured a comprehensive haemorheological profile, in a case-control design, of lean women with PCOS and age-matched healthy controls. A clinical examination determined similar cardiovascular risk for the two groups. Whole blood and plasma viscosity was measured using a cone-plate viscometer. The magnitude and rate of red blood cell (RBC) aggregation was determined using a light-transmission aggregometer, and the degree of RBC deformability was measured via laser-diffraction ektacytometry. Plasma viscosity was significantly increased in women with PCOS. Blood viscosity was also increased for PCOS at lower-to-moderate shear rates in both native and standardised haematocrit samples. The magnitude of RBC aggregation–a primary determinant of low-shear blood viscosity–was significantly increased in PCOS at native and 0.4 L·L-1 haematocrit. No difference was detected between PCOS and CON groups for RBC deformability measurements. A novel measure indicating the effectiveness of oxygen transport by RBC (i.e., the haematocrit-to-viscosity ratio; HVR) was decreased at all shear rates in women with PCOS. In a group of young and lean women with PCOS with an unremarkable cardiovascular risk profile based on clinical data, significant haemorheological impairment was observed. The degree of haemorheological derangement observed in the present study reflects that of overt chronic disease, and provides an avenue for future therapeutic intervention in PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder among women of reproductive age [1]
In whole blood samples at native haematocrit, blood viscosity was increased at lower-to-moderate shears for women with PCOS when compared with CON, reaching significance at 75 s-1 (p < 0.001)
Blood viscosity at lower-shear rates was significantly elevated in PCOS (Fig 1A), and this could not be explained due to differences in baseline haematocrit; when blood samples were standardised for haematocrit, differences in lower-shear blood viscosity remained significant (Fig 1B)
Summary
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder among women of reproductive age [1]. Classic features of PCOS include disordered reproductive, metabolic, and psychological health [2], the presentation of these factors vary with age. The progression from normoglycaemia towards impaired glucose tolerance, and from impaired glucose tolerance toward type 2 diabetes, is accelerated in PCOS [4]. Given these factors each represent discrete risk factors for cardiovascular disease, it is not surprising that PCOS promotes vascular dysfunction [5], leading to blood flow impairments that precede overt cardiovascular and metabolic diseases [6]
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