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Submitted on July 27, 2004
Accepted on April 27, 2005
Monash University Department of Medicine, Dandenong Hospital, Melbourne, Victoria, Australia
* To whom correspondence should be addressed. E-mail: helena.teede{at}southernhealth.org.au.
Context: Polycystic ovary syndrome (PCOS) is associated with insulin resistance (IR) and the metabolic syndrome, however the cardiovascular (CV) manifestations of PCOS remain unclear.
Objective: The objective of this study was to examine the relationships between IR, metabolic parameters, androgens and markers of early CV disease in PCOS.
Design: Observational study examining non-invasive markers of early CV disease in women with PCOS including structural (carotid intimal media thickness [IMT]) and functional measures (arterial function with pulse wave velocity [PWV] and endothelial function with brachial arterial flow mediated vasodilation [FMD]). Metabolic parameters included insulin and glucose during an oral glucose tolerance test, lipid and androgen levels.
Setting: Participants were recruited from the general community
Patients: 80 overweight women with PCOS who were non smokers and not on the oral contraceptive or other medications known to affect IR
Results: Stepwise regression analysis showed that after adjustment for age and BMI, IMT was significantly correlated with BP load (P = 0.03) and inversely with DHEAS (P = 0.01). After correction for androgen status, IMT was correlated with fasting glucose and area under curve (AUC) insulin. FMD inversely related to lipids (P = 0.02), while PWV was related to BP (P < 0.001), AUC insulin (P = 0.04) and AUC glucose (P = 0.035).
Conclusion: In overweight women with PCOS, insulin resistance and BP interacted negatively with arterial structural and functional measures. DHEA-S correlated inversely with arterial structure, suggesting possible cardioprotective effects of endogenous DHEA-S in women with PCOS. Further research is needed to clarify these findings.
Vascular disease and androgens in PCOS
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