Aziz Mubeena, Sidelmann Johannes J, Faber Jens, Wissing Marie-Louise M, Naver Klara V, Mikkelsen Anne-Lis, Nilas Lisbeth, Skouby Sven O
Department of Gynecology and Obstetrics, Faculty of Health and Medical Sciences, Copenhagen University, Herlev University Hospital, Herlev, Denmark.
Unit for Thrombosis Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
Acta Obstet Gynecol Scand. 2015 Oct;94(10):1082-9. doi: 10.1111/aogs.12706. Epub 2015 Jul 18.
Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance. The objective of this cross-sectional study was to investigate the impact of insulin resistance and body mass index (BMI) on inflammatory and hemostatic variables associated with long-term risk of cardiovascular disease in women with PCOS.
149 premenopausal women with PCOS were recruited consecutively from April 2010 to February 2012 at three Danish University Hospitals. The study was conducted at the Department of Gynecology and Obstetrics, Herlev University Hospital, Denmark. PCOS was diagnosed in accordance with the Rotterdam criteria and the women were classified into four phenotypes according to BMI and insulin resistance measured by the homeostasis model assessment of insulin resistance index. Body composition was determined by dual-energy X-ray absorptiometry. Main outcome measures were the biomarkers C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and von Willebrand factor antigen.
Normal weight insulin-resistant PCOS women were characterized by abdominal obesity and elevated levels of plasma PAI-1. Overweight/obese insulin-resistant PCOS women had increased levels of both PAI-1 and CRP. Of the three Rotterdam criteria, only hyperandrogenemia was significantly associated with the hemostatic risk marker of long-term cardiovascular disease risk.
Surrogate risk markers for cardiovascular disease are elevated in women with PCOS, especially insulin-resistant and overweight/obese women.
多囊卵巢综合征（PCOS）与肥胖和胰岛素抵抗相关。这项横断面研究的目的是调查胰岛素抵抗和体重指数（BMI）对PCOS女性心血管疾病长期风险相关的炎症和止血变量的影响。
2010年4月至2012年2月期间，在丹麦的三家大学医院连续招募了149名绝经前PCOS女性。该研究在丹麦Herlev大学医院妇产科进行。PCOS根据鹿特丹标准进行诊断，根据通过胰岛素抵抗指数的稳态模型评估测量的BMI和胰岛素抵抗将女性分为四种表型。通过双能X线吸收法测定身体成分。主要观察指标是生物标志物C反应蛋白（CRP）、纤溶酶原激活物抑制剂-1（PAI-1）和血管性血友病因子抗原。
体重正常但胰岛素抵抗的PCOS女性的特征是腹部肥胖和血浆PAI-1水平升高。超重/肥胖且胰岛素抵抗的PCOS女性的PAI-1和CRP水平均升高。在鹿特丹的三项标准中，只有高雄激素血症与长期心血管疾病风险的止血风险标志物显著相关。
PCOS女性心血管疾病的替代风险标志物升高，尤其是胰岛素抵抗和超重/肥胖女性。
