Department of Internal Medicine, Complesso Integrato Columbus, Catholic University of Rome, Via Moscati, 31, Rome 00168, Italy.
Hum Reprod. 2012 May;27(5):1320-6. doi: 10.1093/humrep/des062. Epub 2012 Mar 12.
Atherosclerosis is a chronic and degenerative disease developing typically in the elderly; nonetheless, a condition of accelerated atherosclerosis can be observed precociously in the presence of some diseases. Endometriosis, a chronic benign gynecological disorder, shows some characteristics, such as oxidative stress, systemic inflammation and a pro-atherogenic lipid profile, which could increase the risk of developing accelerated atherosclerosis. The aim of our study was to evaluate markers of subclinical atherosclerosis in young European women with endometriosis.
This cross-sectional study included 37 women with endometriosis and 31 control subjects. The presence of subclinical atherosclerosis was investigated by ultrasound evaluation of common carotid intima-media thickness (ccIMT) and flow-mediated dilation (FMD); in addition, serum levels of lipids, inflammatory and coagulation parameters, as well as markers of endothelial inflammation and activation, were determined.
Women with endometriosis showed significantly lower values of FMD compared with controls [mean difference: -4.62, 95% confidence interval (CI): -6.52, -2.73; P < 0.001], whereas no significant differences in ccIMT values were found between the two groups. As regards markers of endothelial inflammation and activation, women with endometriosis had significantly higher values of inter-cellular adhesion molecule 1 (P < 0.001), vascular cell adhesion molecule 1 (P < 0.001), E-selectin (P < 0.001), von Willebrand factor (P = 0.004) and ristocetin cofactor (P = 0.001) compared with controls.
Our study suggests that women with endometriosis have more subclinical atherosclerosis, resulting in a higher risk of developing cardiovascular disorders. Moreover, our findings demonstrate that endothelial dysfunction can occur in the absence of structural atherosclerotic changes; its evaluation might be helpful in young women with endometriosis.
动脉粥样硬化是一种常见于老年人的慢性退行性疾病；然而，在某些疾病存在的情况下，也可能会过早地观察到加速动脉粥样硬化的情况。子宫内膜异位症是一种慢性良性妇科疾病，表现出一些特征，如氧化应激、全身炎症和促动脉粥样硬化脂质谱，这可能会增加发生加速动脉粥样硬化的风险。我们的研究目的是评估患有子宫内膜异位症的年轻欧洲女性亚临床动脉粥样硬化的标志物。
本横断面研究纳入了 37 名子宫内膜异位症患者和 31 名对照组患者。通过超声评估颈总动脉内膜-中层厚度（ccIMT）和血流介导的扩张（FMD）来评估亚临床动脉粥样硬化的存在；此外，还测定了血脂、炎症和凝血参数以及内皮炎症和激活标志物的水平。
与对照组相比，子宫内膜异位症患者的 FMD 值显著降低[平均差值：-4.62，95%置信区间（CI）：-6.52，-2.73；P<0.001]，而两组之间的 ccIMT 值无显著差异。至于内皮炎症和激活标志物，子宫内膜异位症患者的细胞间黏附分子 1（P<0.001）、血管细胞黏附分子 1（P<0.001）、E-选择素（P<0.001）、血管性血友病因子（P=0.004）和瑞斯托菌素辅因子（P=0.001）的水平显著高于对照组。
我们的研究表明，患有子宫内膜异位症的女性有更多的亚临床动脉粥样硬化，从而增加了发生心血管疾病的风险。此外，我们的研究结果表明，内皮功能障碍可能在没有结构动脉粥样硬化变化的情况下发生；其评估可能对患有子宫内膜异位症的年轻女性有帮助。
