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Serum Aldosterone Concentration and Cardiovascular Risk in Women with Polycystic Ovarian Syndrome

Department of Molecular and Clinical Endocrinology and Oncology (T.C., L.T., A.C., G.L., F.O.), and Department of Clinical and Experimental Medicine (F.M.), University "Federico II," 80131 Naples, Italy; Department of Obstetrics and Gynecology (S.P.), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; MeriGen Laboratory of Molecular Biology (S.D.B., D.L.), 80131 Naples, Italy; and Department of Clinical Medicine (F.G., C.V.), Cardiovascular and Immunological Science, Cardiac Rehabilitation Unit, University "Federico II," 80131 Naples, Italy

Address all correspondence and requests for reprints to: Francesco Orio, M.D., Ph.D., Department of Molecular and Clinical Endocrinology and Oncology, University "Federico II" of Naples, Via S. Pansini 5, 80131 Naples, Italy. E-mail: francescoorio{at}virgilio.it.

Context: Polycystic ovary syndrome (PCOS) is associated with early impairment of vascular structure and a low-grade chronic inflammation. Aldosterone is a well-recognized cardiovascular risk (CVR) factor and is related to inflammatory processes.

Objective: Our objective was to investigate serum aldosterone levels in PCOS and correlate them to some CVR factors and early atherosclerotic markers.

Design and Setting: A prospective baseline-controlled clinical study was conducted at the University "Federico II" of Naples School of Medicine (Naples, Italy).

Patients: Fifty PCOS women age- and body mass index-matched with 50 healthy women were enrolled.

Mean Outcome Measures: Anthropometric, hormonal, and metabolic patterns, including plasma aldosterone, renin, and C-reactive protein, were measured in each subject. Intima-media thickness was also evaluated in each patient and control.

Results: Aldosterone levels were significantly increased (P < 0.001) in PCOS compared with healthy women (10.5 ± 3.2 vs. 5.7 ± 2.5 ng/dl). In PCOS, a significant (P < 0.001) direct correlation between plasma aldosterone and homeostasis model assessment, C-reactive protein, intima-media thickness, and mean blood pressure was found. On the other hand, high-density lipoprotein cholesterol and potassium were inversely (P < 0.001) related to serum aldosterone. Multiple linear regression analysis showed that the area under the curve for insulin and homeostasis model assessment was linearly related to aldosterone in PCOS.

Conclusion: PCOS women show an insulin resistance related increase in serum aldosterone levels.

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