Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Department of Clinical Biochemistry, University of Kashmir, Srinagar, Jammu and Kashmir, India.
Fertil Steril. 2020 Jun;113(6):1299-1307.e2. doi: 10.1016/j.fertnstert.2020.02.001.
To quantitate left ventricular mass index (LVMI) and correlate it with inflammation, insulin resistance (IR) and serum androgen levels among nonobese normotensive women with polycystic ovary syndrome (PCOS).
Cross-sectional study SETTING: Tertiary care institute in North India PATIENTS: A total of 260 drug-naive women qualifying the Rotterdam 2003 criteria for diagnosis of PCOS and 250 apparently healthy women matched for age and body mass index (BMI).
Clinical, biochemical, hormonal, and inflammatory marker assessment was followed by estimation of LVM and LVMI by 2-dimensional echocardiography.
LVM and LVMI in nonobese, normotensive women with PCOS and its correlation with subinflammation, IR, and androgen excess.
Mean ages (28.08 ± 4.18 vs. 29.44 ± 6.33 years) and BMI (24.43 ± 4.15 vs. 23.92 ± 4.21 kg/m) of cases vs. controls were comparable, as was blood pressure and plasma glucose (1 hour after oral glucose tolerance test [OGTT]). Women with PCOS had fewer menstrual cycles per year and higher Ferriman-Gallwey scores, plasma insulin, homeostasis model assessment of IR, total testosterone, plasma glucose (fasting and 2 hours after OGTT), serum high-sensitive C-reactive protein, tumor necrosis factor-α, and interleukin-6 than did the controls (P<.001). Significant differences were observed in LVM (101.50 ± 30.19 vs. 89.35 ± 27.57 g) and LVMI (63.60 ± 16.67 vs. 56.32 ± 10.84 g/m) between women with PCOS and the controls (P<.001). Multivariate analysis revealed that proinflammatory markers and IR rather than hyperandrogenism correlated with LVMI.
We conclude that normotensive nonobese women with PCOS were more likely to have elevated mean LVMI than were healthy controls and it was positively correlated with proinflammatory markers and IR but not with androgen excess. Well-designed long-term follow-up studies with a larger cohort of subjects with comprehensive cardiovascular risk assessment are warranted to conclusively answer the question.
定量左心室质量指数（LVMI），并分析其与非肥胖型、血压正常的多囊卵巢综合征（PCOS）女性中的炎症、胰岛素抵抗（IR）和血清雄激素水平的相关性。
横断面研究
印度北部的一所三级保健机构
共纳入 260 名符合 2003 年鹿特丹标准的未经药物治疗的 PCOS 患者和 250 名年龄和体重指数（BMI）相匹配的健康女性。
临床、生化、激素和炎症标志物评估后，采用二维超声心动图估计 LVM 和 LVMI。
非肥胖型、血压正常的 PCOS 女性的 LVM 和 LVMI，及其与亚炎症、IR 和雄激素过多的相关性。
病例组和对照组的平均年龄（28.08 ± 4.18 岁比 29.44 ± 6.33 岁）和 BMI（24.43 ± 4.15 千克/平方米比 23.92 ± 4.21 千克/平方米）相当，血压和口服葡萄糖耐量试验（OGTT）后 1 小时的血糖也相当。与对照组相比，PCOS 女性每年的月经周期较少，Ferriman-Gallwey 评分、血浆胰岛素、稳态模型评估的 IR、总睾酮、空腹和 OGTT 后 2 小时血糖、血清高敏 C 反应蛋白、肿瘤坏死因子-α和白细胞介素-6 更高（P<.001）。与对照组相比，PCOS 患者的 LVM（101.50 ± 30.19 克比 89.35 ± 27.57 克）和 LVMI（63.60 ± 16.67 克/平方米比 56.32 ± 10.84 克/平方米）差异显著（P<.001）。多元分析显示，促炎标志物和 IR 而不是高雄激素血症与 LVMI 相关。
我们的结论是，与健康对照组相比，血压正常的非肥胖型 PCOS 女性的平均 LVMI 更有可能升高，且与促炎标志物和 IR 呈正相关，而与雄激素过多无关。需要进行设计良好的长期随访研究，纳入更多对象，并进行全面的心血管风险评估，以明确回答这个问题。
