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Platelet Dysfunction in Lean Women with Polycystic Ovary Syndrome and Association with Insulin Sensitivity

Departments of Endocrinology (D.D., G.O., C.Y.) and Hematology (F.B.), Ege University Faculty of Medicine, Uckuyular/Izmir, Turkey 35350; and Department of Endocrinology (E.G.), Adnan Menderes University Faculty of Medicine, Aydin, Turkey 09110

Address all correspondence and requests for reprints to: Didem Dereli M.D., Oyak Sitesi 2/8, Sokak No. 2/13, Uckuyular/Izmir, Turkey 35350. E-mail: dtdereli{at}superonline.com.

Platelet dysfunction and its association with insulin resistance and/or hyperandrogenemia were evaluated in 50 women with polycystic ovary syndrome (PCOS), 50 women with nonclassic congenital adrenal hyperplasia (NC-CAH), and 30 women in the control group. Agonist-induced platelet aggregation was measured. Women with PCOS had significantly higher levels of platelet aggregations induced by ADP (77.4 ± 3.3 vs. 67.3 ± 2.8), collagen (79.7 ± 1.8 vs. 69.1 ± 3.9), and epinephrine (84.7 ± 2.6 vs. 67.8 ± 3.8), compared with controls. However platelet aggregations of women with NC-CAH because of ADP (68.2 ± 4.22), collagen (69.5 ± 5.4), or epinephrine (68.6 ± 4.3) were similar to those in the control group. There were negative correlations between aggregations induced by agonists and the insulin sensitivity in women with PCOS. These correlations also appeared significant after androgen levels with covariance analysis were excluded. These covariance analyses were performed because serum androgen levels might affect platelet function. Any significant correlations were not found between androgen levels and agonist-induced platelet aggregation in women with NC-CAH. We conclude that platelet dysfunction may be an important reason for the possible cardiovascular heart diseases in women with PCOS.

Abbreviations: 17-OHP, 17-OH progesterone; BMI, body mass index; CV, coefficient of variation; DHEAS, dehydroepiandrosterone sulfate; FT, free testosterone; HOMA, homeostasis model assessment; IR, insulin resistance; NC-CAH, nonclassic congenital adrenal hyperplasia; PCOS, polycystic ovary syndrome; PRP, platelet-rich plasma.

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