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Submitted on January 26, 2005
Accepted on June 20, 2005
Department of Endocrinology, University Hospital, Ioannina, Greece (M.K., A.T.); the Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece (K.K.N., N.K., C.S.K., L.K.M.); the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, Ioannina, Greece (S.N.K., E.P.); the Department of Obstetrics and Gynecology, University of Crete, Greece (A.M.); and the Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA (G.P.C.)
* To whom correspondence should be addressed. E-mail: atsatsou{at}cc.uoi.gr.
Context: Women with polycystic ovary syndrome (PCOS) may be at increased risk for cardiovascular disease. Endothelial dysfunction is an early marker of atherosclerosis.
Objectives: (1) To compare endothelial function in young women with PCOS and regularly mensruating control women and (2) to identify the determinants of endothelial function and investigate its relationship with body mass index (BMI) in women with PCOS.
Design: Cross-sectional study.
Setting: Tertiary cardiovascular research center.
Patients: Sixty-two young women with PCOS (mean age, 22.7 yr) and 17 control women, matched as a group for age and BMI. Twenty-three women with PCOS were lean, 21 overweight and 18 obese.
Main Outcome Measures: Endothelium-dependent and -independent vascular function; assessed by measuring flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) in the brachial artery (diameter change during hand hyperemia and following sublingual glyceryl trinitrate administration, respectively).
Results: FMD and NMD were significantly lower in PCOS than in control women (reduced by approximately 50% and 25% respectively, both P < 0.0005). Insulin resistance, total testosterone and total cholesterol were independent predictors of FMD, accounting for 21%, 10% and 9% of the variance, respectively (P < 0.005 for all). A trend of deterioration in FMD from lean to overweight and obese PCOS women was observed, but differences among groups were not statistically significant.
Conclusions: Women with PCOS have significant endothelial dysfunction at an early age (i.e. early 20s), and largely independent of obesity. This suggests that women with PCOS are at increased risk for early-onset cardiovascular disease and may gain particular benefit from measures to improve endothelial function.
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