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多囊卵巢综合征女性亚临床心血管疾病的预测因素:血脂异常与动脉血压的相互关系

Predictors of subclinical cardiovascular disease in women with polycystic ovary syndrome: interrelationship of dyslipidemia and arterial blood pressure.

作者信息

Macut Djuro, Bačević Marina, Božić-Antić Ivana, Bjekić-Macut Jelica, Čivčić Milorad, Erceg Snježana, Vojnović Milutinović Danijela, Stanojlović Olivera, Andrić Zoran, Kastratović-Kotlica Biljana, Šukilović Tijana

机构信息

Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

General Hospital Pančevo, 26000 Pančevo, Serbia.

出版信息

Int J Endocrinol. 2015;2015:812610. doi: 10.1155/2015/812610. Epub 2015 Mar 24.

Abstract

Background. Women with polycystic ovary syndrome (PCOS) could develop subclinical atherosclerosis during life. Purpose. To analyze cardiovascular risk (CVR) factors and their relation to clinical markers of cardiovascular disease (CVD) in respect to their age. Material and Methods. One hundred women with PCOS (26.32 ± 5.26 years, BMI: 24.98 ± 6.38 kg/m(2)) were compared to 50 respective controls. In all subjects, total cholesterol (TC), HDL-C, LDL-C, triglycerides, TC/HDL-C and TG/HDL-C ratios, glucose, insulin and HOMA index, waist-to-hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP, resp.), and carotid intima-media thickness (CIMT) were analyzed in respect to their age and level of androgens. Results. PCOS over 30 years had higher WHR (P = 0.008), SBP (P < 0.001), DBP (P < 0.001), TC (P = 0.028), HDL-C (P = 0.028), LDL-C (P = 0.045), triglycerides (P < 0.001), TC/HDL-C (P < 0.001), and triglycerides/HDL-C (P < 0.001) and had more prevalent hypertension and pronounced CIMT on common carotid arteries even after adjustment for BMI (P = 0.005 and 0.036, resp.). TC/HDL-C and TG/HDL-C were higher in PCOS with the highest quintile of FAI in comparison to those with lower FAI (P = 0.045 and 0.034, resp.). Conclusions. PCOS women older than 30 years irrespective of BMI have the potential for early atherosclerosis mirrored through the elevated lipids/lipid ratios and through changes in blood pressure.

摘要

背景。多囊卵巢综合征(PCOS)女性在一生中可能会发展为亚临床动脉粥样硬化。目的。分析心血管风险(CVR)因素及其与心血管疾病(CVD)临床标志物在年龄方面的关系。材料与方法。将100名PCOS女性(年龄26.32±5.26岁,体重指数:24.98±6.38kg/m²)与50名相应对照进行比较。对所有受试者,分析其年龄、雄激素水平与总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯、TC/HDL-C和TG/HDL-C比值、血糖、胰岛素和HOMA指数、腰臀比(WHR)、收缩压和舒张压(分别为SBP和DBP)以及颈动脉内膜中层厚度(CIMT)之间的关系。结果。30岁以上的PCOS女性WHR更高(P=0.008)、SBP更高(P<0.001)、DBP更高(P<0.001)、TC更高(P=0.028)、HDL-C更高(P=0.028)、LDL-C更高(P=0.045)、甘油三酯更高(P<0.001)、TC/HDL-C更高(P<0.001)以及甘油三酯/HDL-C更高(P<0.001),即使在调整体重指数后,高血压患病率更高,颈总动脉CIMT更明显(分别为P=0.005和0.036)。与游离雄激素指数(FAI)较低的PCOS女性相比,FAI最高五分位数的PCOS女性TC/HDL-C和TG/HDL-C更高(分别为P=0.045和0.034)。结论。30岁以上的PCOS女性,无论体重指数如何,都有早期动脉粥样硬化的可能性,这通过血脂/血脂比值升高和血压变化得以体现。

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