Soares Gustavo Mafaldo, Vieira Carolina Sales, Martins Wellington Paula, Franceschini Sílvio Antônio, dos Reis Rosana Maria, Silva de Sá Marcos Felipe, Ferriani Rui Alberto
Department of Gynaecology and Obstetrics at the University of São Paulo, Ribeirão Preto School of Medicine, Ribeirão Preto, Brazil.
Clin Endocrinol (Oxf). 2009 Sep;71(3):406-11. doi: 10.1111/j.1365-2265.2008.03506.x. Epub 2008 Dec 15.
Polycystic ovary syndrome (PCOS) is associated with adverse metabolic effects. Some cardiovascular disease (CVD) risk markers are increased in women with PCOS. However, early markers of atherosclerosis are also associated with obesity and insulin resistance, which are related to PCOS. These markers may result either directly from PCOS or indirectly as a consequence of the comorbidities associated with the syndrome.
To assess the presence of early CVD markers in young, nonobese women with PCOS.
Forty women with PCOS and 50 healthy women with regular menstrual cycles, matched for age and body mass index (BMI).
The following CVD markers were assessed by ultrasonography: common carotid artery (CCA) stiffness index (beta), distensibility and intima-media thickness (IMT), and brachial artery flow-mediated dilatation (FMD). Inflammatory markers, including interleukin (IL)-6, tumour necrosis factor (TNF)-alpha, homocysteine, C-reactive protein (CRP), glycaemia, lipid profile and insulin, were also assessed.
CCA beta was higher in PCOS than in control women (3.72 +/- 0.96 vs. 3.36 +/- 0.96, P = 0.04) and CCA distensibility was lower (0.31 +/- 0.08 vs. 0.35 +/- 0.09 mmHg(-1), P = 0.02). Waist circumference, total testosterone and the Free Androgen Index (FAI) were higher in PCOS patients than in controls (78.2 +/- 10.0 vs. 71.5 +/- 7.2 cm, P = 0.001; 88.1 +/- 32.4 vs. 57.1 +/- 21.2 ng/dl, P < 0.01; 12.7 +/- 15.7%vs. 4.7 +/- 2.3%, P < 0.01, respectively), while SHBG was reduced (37.9 +/- 19.1 vs. 47.8 +/- 18.3 nmol/l, P = 0.01). The remaining variables did not differ between the groups.
Young women with PCOS exhibit changes in vascular elasticity even in the absence of classical risk factors for CVD, such as hypertension and obesity.
多囊卵巢综合征（PCOS）与不良代谢效应相关。一些心血管疾病（CVD）风险标志物在PCOS女性中升高。然而，动脉粥样硬化的早期标志物也与肥胖和胰岛素抵抗相关，而这两者与PCOS有关。这些标志物可能直接源于PCOS，也可能间接作为该综合征相关合并症的结果。
评估年轻、非肥胖PCOS女性中早期CVD标志物的存在情况。
40例PCOS女性和50例月经周期规律的健康女性，年龄和体重指数（BMI）相匹配。
通过超声检查评估以下CVD标志物：颈总动脉（CCA）硬度指数（β）、扩张性和内膜中层厚度（IMT），以及肱动脉血流介导的扩张（FMD）。还评估了炎症标志物，包括白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α、同型半胱氨酸、C反应蛋白（CRP）、血糖、血脂谱和胰岛素。
PCOS患者的CCAβ高于对照组女性（3.72±0.96对3.36±0.96，P = 0.04），CCA扩张性较低（0.31±0.08对0.35±0.09 mmHg⁻¹，P = 0.02）。PCOS患者的腰围、总睾酮和游离雄激素指数（FAI）高于对照组（78.2±10.0对71.5±7.2 cm，P = 0.001；88.1±32.4对57.1±21.2 ng/dl，P < 0.01；12.7±15.7%对4.7±2.3%，P < 0.01），而性激素结合球蛋白（SHBG）降低（37.9±19.1对47.8±18.3 nmol/l，P = 0.01）。其余变量在两组之间无差异。
即使没有CVD的经典危险因素，如高血压和肥胖，年轻PCOS女性也存在血管弹性变化。
