Lakhani K, Leonard A, Seifalian A M, Hardiman P
Ultrasound Department, North Middlesex Hospital, London.
Hum Reprod. 2005 Nov;20(11):3219-24. doi: 10.1093/humrep/dei199. Epub 2005 Jul 21.
Polycystic ovary syndrome (PCOS) is associated with multiple cardiovascular risk factors and an increased prevalence of arterial dysfunction. However, microvascular dysfunction in PCOS has not been assessed.
Subjects comprised 12 women with PCOS and 12 age-matched controls with normal ovaries. Microvascular function was assessed by observing forearm skin microvascular erythrocyte flux responses, to cumulative iontophoretic doses of 1% (w/v) acetylcholine (ACh) and 1% (w/v) sodium nitroprusside (SNP), using laser Doppler imaging.
Basal microvascular perfusion was comparable in PCOS and controls. The increase in skin microvascular perfusion in response to ACh was however generally blunted in PCOS women (P = 0.018). Peak ACh-induced erythrocyte flux was also less (p < 0.04) in PCOS women (125.1 +/- 21.7, i.e. 5.3-fold basal flux) than in controls (200.8 +/- 28.5, i.e. 8.3-fold basal flux). Analysis of covariance indicated this effect was unrelated to differences in body mass index or serum testosterone but serum insulin may be a weak confounder. No differences were noted between the PCOS and control groups in their response to SNP.
Despite its limited sample size studied, this is the first demonstration that women with PCOS exhibit microvascular endothelial dysfunction, indicated by an inhibited vasodilatory response to ACh.
多囊卵巢综合征（PCOS）与多种心血管危险因素相关，且动脉功能障碍的患病率增加。然而，PCOS患者的微血管功能障碍尚未得到评估。
研究对象包括12名PCOS女性和12名年龄匹配的卵巢正常的对照者。使用激光多普勒成像技术，通过观察前臂皮肤微血管红细胞通量对累积离子电渗剂量的1%（w/v）乙酰胆碱（ACh）和1%（w/v）硝普钠（SNP）的反应，来评估微血管功能。
PCOS患者和对照者的基础微血管灌注相当。然而，PCOS女性对ACh反应引起的皮肤微血管灌注增加通常减弱（P = 0.018）。PCOS女性中，ACh诱导的红细胞通量峰值（125.1±21.7，即基础通量的5.3倍）也低于对照者（200.8±28.5，即基础通量的8.3倍）（p < 0.04）。协方差分析表明，这种效应与体重指数或血清睾酮的差异无关，但血清胰岛素可能是一个较弱的混杂因素。PCOS组和对照组对SNP的反应未观察到差异。
尽管本研究样本量有限，但这是首次证明PCOS女性存在微血管内皮功能障碍，表现为对ACh的血管舒张反应受到抑制。
