Taskin Mine Islimye, Bulbul Erdogan, Adali Ertan, Hismiogulları Adnan Adil, Inceboz Umit
Department of Obstetrics and Gynecology, Balıkesir University School of Medicine, Balikesir, Turkey.
Department of Radiology, Balıkesir University School of Medicine, Balikesir, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2015 Jun;189:19-23. doi: 10.1016/j.ejogrb.2015.03.006. Epub 2015 Mar 9.
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies, affecting 5-8% of reproductive-age women. It is associated with insulin resistance, central obesity, type 2 diabetes mellitus, dyslipidemia, and cardiovascular diseases. The current study was undertaken to evaluate serum copeptin and obestatin levels, carotid artery intima-media thickness, and brachial artery flow mediated dilatation in obese and nonobese women with PCOS and age-matched healthy controls and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters and cardiovascular risk factors.
In the study population, we analyzed 60 patients with PCOS and 30 age-matched healthy women as controls. The patients with PCOS were divided into two groups based on body mass index (BMI): obese group (BMI>30kg/m(2), n=30) or nonobese group (BMI<30kg/m(2), n=30). History was obtained and a physical examination, peripheral venous blood sampling, and carotid and brachial artery ultrasonography were performed. Serum copeptin and obestatin levels, total testosterone, C-reactive protein (CRP), glucose, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, homeostasis model assessment for insulin resistance (HOMA-IR), carotid artery intima-media thickness (CIMT), and brachial artery flow-mediated vasodilation (FMD) were determined and compared among the groups.
Women with PCOS, especially obese ones, had higher triglycerides, HOMA-IR, total testosterone, CRP, systolic and diastolic blood pressure, and waist-to-hip ratio (WHR), and lower HDL. Serum obestatin levels were significantly lower in the obese PCOS group than they were in the nonobese and control groups (p<0.001). Serum copeptin levels were significantly higher in the obese PCOS group than they were in the nonobese PCOS and control groups (p<0.001). CIMT values were similar among the groups (p>0.05). Brachial artery FMD was lower in the PCOS groups than it was in the control group (p<0.001). Obestatin and FMD values were negatively correlated with cardiovascular risk factors, whereas copeptin was positively correlated. A significant positive correlation was found between copeptin, BMI, WHR, hirsutism score, total testosterone, and HOMA-IR. There was no correlation between CIMT, copeptin, obestatin, and FMD. A positive correlation was seen between CIMT, BMI, triglycerides, and HOMA-IR.
Copeptin and obestatin may provide useful information regarding future cardiovascular risk in PCOS patients as copeptin was positively correlated and obestatin was negatively correlated with cardiovascular risk factors.
多囊卵巢综合征（PCOS）是最常见的内分泌疾病之一，影响5%-8%的育龄妇女。它与胰岛素抵抗、中心性肥胖、2型糖尿病、血脂异常和心血管疾病相关。本研究旨在评估肥胖和非肥胖PCOS女性及年龄匹配的健康对照者的血清 copeptin 和肥胖抑制素水平、颈动脉内膜中层厚度以及肱动脉血流介导的扩张，并研究它们之间以及与临床、代谢、激素参数和心血管危险因素的关系。
在研究人群中，我们分析了60例PCOS患者和30例年龄匹配的健康女性作为对照。PCOS患者根据体重指数（BMI）分为两组：肥胖组（BMI>30kg/m²，n=30）或非肥胖组（BMI<30kg/m²，n=30）。获取病史并进行体格检查、外周静脉血采样以及颈动脉和肱动脉超声检查。测定并比较各组的血清copeptin和肥胖抑制素水平、总睾酮、C反应蛋白（CRP）、血糖、总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、胰岛素抵抗稳态模型评估（HOMA-IR）、颈动脉内膜中层厚度（CIMT）和肱动脉血流介导的血管舒张（FMD）。
PCOS女性，尤其是肥胖者，甘油三酯、HOMA-IR、总睾酮、CRP、收缩压和舒张压以及腰臀比（WHR）较高，HDL较低。肥胖PCOS组的血清肥胖抑制素水平显著低于非肥胖组和对照组（p<0.001）。肥胖PCOS组的血清copeptin水平显著高于非肥胖PCOS组和对照组（p<0.001）。各组间CIMT值相似（p>0.05）。PCOS组的肱动脉FMD低于对照组（p<0.001）。肥胖抑制素和FMD值与心血管危险因素呈负相关，而copeptin呈正相关。copeptin与BMI、WHR、多毛症评分、总睾酮和HOMA-IR之间存在显著正相关。CIMT、copeptin、肥胖抑制素和FMD之间无相关性。CIMT与BMI、甘油三酯和HOMA-IR之间呈正相关。
copeptin和肥胖抑制素可能为PCOS患者未来的心血管风险提供有用信息，因为copeptin与心血管危险因素呈正相关，而肥胖抑制素呈负相关。
