Unit for Thrombosis Research, Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Esbjerg, Denmark.
Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark.
Acta Obstet Gynecol Scand. 2020 Aug;99(8):1078-1084. doi: 10.1111/aogs.13825. Epub 2020 Mar 3.
Polycystic ovary syndrome (PCOS) is characterized by increased central fat mass (CFM), hyper-inflammation, and hemostatic alterations; the risk of cardiovascular disease may also be increased. Reduced fibrin lysability is a risk factor for cardiovascular disease. The present study assessed fibrin lysability in women with PCOS and controls of similar age and body mass index.
Ninety women with PCOS and 35 controls of comparable age and body mass index were included. Hemostatic markers (fibrin lysability, fibrinogen, coagulation factor XIII, plasminogen, plasminogen activator inhibitor 1 [PAI-1], plasmin inhibitor, thrombin activatable fibrinolysis inhibitor (TAFI), D-dimer), C-reactive protein (CRP), body mass index, waist-to-hip ratio, CFM determined by Dual-energy X-ray absorptiometry scan, and sex hormones (testosterone estradiol, and sex hormone binding globulin) were determined.
TAFI and CRP were higher in women with PCOS, than controls. In women with PCOS, fibrin lysability correlated with CFM, waist-to-hip ratio, CRP, fibrinogen, and all hemostatic variables (P ≤ .004) except TAFI and D-dimer. CFM correlated with fibrinogen, CRP, coagulation factor XIII, waist-to-hip ratio, plasminogen, PAI-1, plasmin inhibitor, and TAFI (P < .02). In controls, fibrin lysability correlated with CFM, fibrinogen, coagulation factor XIII, and plasmin inhibitor (P ≤ .02). CFM correlated with PAI-1, plasmin inhibitor, coagulation factor XIII, fibrinogen, and CRP (P ≤ .05). Stepwise regression analysis revealed that fibrin lysability was associated with CFM, fibrinogen and CRP in women with PCOS (r = .46, P ≤ .001), but only with CFM in controls (r = .28, P < .001).
Fibrin lysability was comparable in women with PCOS and controls. Fibrin lysability was associated with CFM and hyper-inflammation in women with PCOS, but only with CFM in controls. These findings suggest that obese women with PCOS and augmented inflammation could have an increased risk of cardiovascular disease.
多囊卵巢综合征(PCOS)的特征是中央脂肪量(CFM)增加、过度炎症和止血改变;心血管疾病的风险也可能增加。纤维蛋白溶酶原活性降低是心血管疾病的一个危险因素。本研究评估了 PCOS 患者和年龄、体重指数相似的对照组的纤维蛋白溶酶原活性。
纳入 90 名 PCOS 患者和 35 名年龄和体重指数相似的对照组。测定止血标志物(纤维蛋白溶酶原活性、纤维蛋白原、凝血因子 XIII、纤溶酶原、纤溶酶原激活物抑制剂 1[PAI-1]、纤溶酶抑制剂、凝血酶激活的纤维蛋白溶解抑制剂[TAFI]、D-二聚体)、C 反应蛋白(CRP)、体重指数、腰臀比、通过双能 X 射线吸收法测定的 CFM 以及性激素(睾酮、雌二醇和性激素结合球蛋白)。
与对照组相比,PCOS 患者的 TAFI 和 CRP 水平更高。在 PCOS 患者中,纤维蛋白溶酶原活性与 CFM、腰臀比、CRP、纤维蛋白原和所有止血变量(P≤.004)相关,除了 TAFI 和 D-二聚体。CFM 与纤维蛋白原、CRP、凝血因子 XIII、腰臀比、纤溶酶原、PAI-1、纤溶酶抑制剂和 TAFI 相关(P<.02)。在对照组中,纤维蛋白溶酶原活性与 CFM、纤维蛋白原、凝血因子 XIII 和纤溶酶抑制剂相关(P≤.02)。CFM 与 PAI-1、纤溶酶抑制剂、凝血因子 XIII、纤维蛋白原和 CRP 相关(P≤.05)。逐步回归分析显示,纤维蛋白溶酶原活性与 PCOS 患者的 CFM、纤维蛋白原和 CRP 相关(r=0.46,P≤.001),但仅与对照组的 CFM 相关(r=0.28,P<.001)。
PCOS 患者和对照组的纤维蛋白溶酶原活性相当。在 PCOS 患者中,纤维蛋白溶酶原活性与 CFM 和过度炎症相关,而在对照组中仅与 CFM 相关。这些发现表明,肥胖的 PCOS 患者和炎症增加可能会增加心血管疾病的风险。