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Submitted on December 3, 2004
Accepted on February 18, 2005
Department of Clinical Biochemistry Medical School, Athens University, Athens, Greece Department of Endocrinology, Diabetes and Metabolism, Red Cross Hospital, Athens, Greece Department of Radiology, Red Cross Hospital, Athens, Greece Laboratory of Pharmacology Medical School, Democritus University of Thrace, Greece
* To whom correspondence should be addressed. E-mail: mahi vr{at}hotmail.com.
Polycystic ovary syndrome (PCOS), a common endocrinopathy of women of reproductive age, is associated with the early appearance of multiple risk factors for cardiovascular disease (CVD), such as abdominal obesity, dyslipidemia and diabetes mellitus. However, premature atherosclerosis of the carotid artery has not yet been demonstrated in young women with PCOS. Measurement of carotid intima-media thickness (IMT) is considered an easy and reliable index of subclinical atherosclerosis, which is predictive of subsequent myocardial infarction and stroke. To evaluate the cardiovascular risk of PCOS and the participation of the hyperandrogenemic and metabolic pattern, we measured carotid IMT by B-mode ultrasound as well as hormonal and several cardiovascular disease-associated parameters in 75 young women with PCOS and 55 healthy, age and body mass index (BMI)-matched women. The PCOS women had significantly increased carotid IMT (0.58 mm vs. 0.47 mm P < 0.001) and abdominal adiposity, higher levels of androgens, insulin, homeostasis model assessment score of insulin sensitivity (HOMA), total and LDL-cholesterol and significantly lower levels of sex hormone binding globulin (SHBG) and HDL-cholesterol.
In the studied population (n = 130), PCOS status, age, BMI and parental history of coronary heart disease (CHD) were strong positive predictors of carotid IMT, while dehydroepiandrosterone sulfate (DHEAS) was a strong negative predictor. In PCOS patients lower 
4-androstenedione (4A) and HDL-cholesterol levels were additionally strong positive predictors of carotid IMT, whereas in control women only total cholesterol was the additional positive predictor of carotid IMT.
In conclusion, young women with PCOS have an early increase of cardiovascular risk factors and greater carotid IMT, both of which may be responsible for subclinical atherosclerosis. The hyperandrogenemic phenotype of the syndrome may attenuate the consequences of the dysmetabolic phenotype on the vascular wall.
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