Yildirim Erkan, Karabulut Onur, Yuksel Uygar Cagdas, Celik Murat, Bugan Baris, Gokoglan Yalcin, Ulubay Mustafa, Gungor Mutlu, Koklu Mustafa
Gulhane Research and Training Hospital, Ankara.
Cardiol J. 2017;24(4):364-373. doi: 10.5603/CJ.a2017.0032. Epub 2017 Mar 29.
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder among reproductive-aged women. It is known to be associated with cardiovascular diseases. The aim of this study was to determine and compare the echocardiographic data of patients according to the phenotypes of PCOS.
This study included 113 patients with PCOS and 52 controls. Patients were classified into four potential PCOS phenotypes. Laboratory analyses and echocardiographic measurements were performed. Left ventricular mass was calculated by using Devereux formula and was indexed to body surface area.
Phenotype-1 PCOS patients had significantly higher homeostasis model assessment - insu-lin resistance (HOMA-IR) (p = 0.023), free testosterone (p < 0.001), LDL cholesterol levels (p < 0.001) and free androgen index (p < 0.001) compared with the control group. There were significant differences between groups regarding the septal thickness, posterior wall thickness, Left ventricular ejection frac-tion, E/A ratio and left ventricular mass index (for all, p < 0.05). PCOS patients with phenotype 1 and 2 had significantly higher left ventricular mass index than the control group (p < 0.001). In univariate and multivariate analyses, PCOS phenotype, modified Ferriman-Gallwey Score and estradiol were found as variables, which independently could affect the left ventricular mass index.
This study showed that women in their twenties who specifically fulfilled criteria for PCOS phenotype-1 according to the Rotterdam criteria, had higher left ventricular mass index and decreased E/A ratio, which might be suggestive of early stage diastolic dysfunction. (Cariol J 2017; 24, 4: 364-373).
多囊卵巢综合征(PCOS)是育龄期女性中的一种异质性内分泌疾病。已知其与心血管疾病有关。本研究的目的是根据PCOS的表型确定并比较患者的超声心动图数据。
本研究纳入了113例PCOS患者和52例对照。患者被分为四种潜在的PCOS表型。进行了实验室分析和超声心动图测量。使用Devereux公式计算左心室质量,并将其与体表面积进行指数化。
与对照组相比,表型1的PCOS患者的稳态模型评估-胰岛素抵抗(HOMA-IR)显著更高(p = 0.023)、游离睾酮(p < 0.001)、低密度脂蛋白胆固醇水平(p < 0.001)和游离雄激素指数(p < 0.001)。各组之间在室间隔厚度、后壁厚度、左心室射血分数、E/A比值和左心室质量指数方面存在显著差异(所有p < 0.05)。表型1和2的PCOS患者的左心室质量指数显著高于对照组(p < 0.001)。在单变量和多变量分析中,发现PCOS表型、改良的Ferriman-Gallwey评分和雌二醇是独立影响左心室质量指数的变量。
本研究表明,根据鹿特丹标准明确符合PCOS表型1标准的二十多岁女性,其左心室质量指数较高且E/A比值降低,这可能提示早期舒张功能障碍。(《心血管杂志》2017年;24卷,第4期:364 - 373页)