Brinkworth G D, Noakes M, Moran L J, Norman R, Clifton P M
CSIRO-Human Nutrition, Adelaide, South Australia, Australia.
BJOG. 2006 Nov;113(11):1308-14. doi: 10.1111/j.1471-0528.2006.01090.x.
There remains a large degree of disagreement about the association of polycystic ovary syndrome (PCOS) with impaired endothelial dysfunction and cardiovascular disease (CVD) risk. The purpose of this study was to determine whether overweight and obese women with PCOS have impaired endothelial function compared with weight-matched controls without PCOS and whether endothelial function is associated with cardiovascular risk markers and hormonal parameters.
Cross-sectional analysis.
An outpatient trial at the Commonwealth Scientific Industrial Research Organisation Clinical Research Unit.
Overweight and obese women with PCOS (n= 12) and weight-matched controls without PCOS (n= 10).
Endothelial function, cardiovascular risk markers and hormonal parameters were assessed in the patients.
Endothelial function was assessed by flow-mediated dilatation (FMD) of the brachial artery using high-resolution ultrasound. Lipid profile, fasting insulin level, glucose level, insulin resistance, C-reactive protein level, folate level, Vitamin B(12) level and hormonal parameters.
Women with PCOS had significantly higher testosterone levels (P < 0.001) and free androgen index (P= 0.006) compared with the controls without PCOS. Both groups were normoinsulinaemic, and there were no significant differences in any of the markers of CVD between women with and without PCOS. Furthermore, FMD was similar in both groups (PCOS 6.1 +/- 1.2% versus control 5.6 +/- 1.0%, P= 0.77).
Compared with a group of weight-matched women with similar metabolic profiles, normoinsulinemic, overweight and obese women with PCOS did not show any greater impairment in endothelial function assessed by FMD. A normoinsulinemic phenotype of PCOS with low metabolic risk factors may reduce the risk of endothelial dysfunction in overweight and obese women with this syndrome. Further studies are required that directly compare FMD in normoinsulinemic and hyperinsulinaemic women with PCOS.
关于多囊卵巢综合征（PCOS）与内皮功能障碍及心血管疾病（CVD）风险之间的关联，仍存在很大程度的分歧。本研究的目的是确定与体重匹配的无PCOS对照组相比，超重和肥胖的PCOS女性是否存在内皮功能受损，以及内皮功能是否与心血管风险标志物和激素参数相关。
横断面分析。
英联邦科学与工业研究组织临床研究单位的门诊试验。
超重和肥胖的PCOS女性（n = 12）以及体重匹配的无PCOS对照组（n = 10）。
对患者进行内皮功能、心血管风险标志物和激素参数评估。
使用高分辨率超声通过肱动脉的血流介导的扩张（FMD）评估内皮功能。血脂谱、空腹胰岛素水平、血糖水平、胰岛素抵抗、C反应蛋白水平、叶酸水平、维生素B12水平和激素参数。
与无PCOS的对照组相比，PCOS女性的睾酮水平（P < 0.001）和游离雄激素指数（P = 0.006）显著更高。两组均为正常胰岛素血症，有PCOS和无PCOS的女性在任何CVD标志物方面均无显著差异。此外，两组的FMD相似（PCOS组为6.1±1.2%，对照组为5.6±1.0%，P = 0.77）。
与一组具有相似代谢特征、正常胰岛素血症的体重匹配女性相比，超重和肥胖的正常胰岛素血症PCOS女性通过FMD评估的内皮功能未显示出更大损害。具有低代谢风险因素的PCOS正常胰岛素血症表型可能会降低超重和肥胖的该综合征女性发生内皮功能障碍的风险。需要进一步研究直接比较正常胰岛素血症和高胰岛素血症PCOS女性的FMD。
