Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland.
Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland.
Endocrine. 2021 May;72(2):400-410. doi: 10.1007/s12020-020-02596-8. Epub 2021 Jan 13.
Insulin resistance is an important factor in the pathogenesis of polycystic ovary syndrome (PCOS), which is associated with higher risk of metabolic syndrome (MetS) and cardiovascular complications. Early atherosclerotic lesions may be diagnosed by ultrasonographic parameters: brachial artery flow-mediated dilation after reactive hyperaemia (FMD) and intima-media thickness of common carotid artery (IMT). The aim of the study was to assess the relation of IMT and FMD with clinical and laboratory parameters reflecting metabolic status in young women with different PCOS phenotypes.
The study included 154 PCOS patients diagnosed with the Rotterdam criteria, divided into four phenotypes, and 113 healthy women. Laboratory analyses, transvaginal ultrasound, and IMT and FMD measurements were conducted. MetS was diagnosed with International Diabetes Federation/American Heart Association (IDF/AHA) consensus criteria.
MetS was more prevalent in PCOS patients than healthy women (14.29 vs. 5.31%; p = 0.019), with highest prevalence in phenotypes I and II (p = 0.039). IMT and FMD did not differ between PCOS patients and the controls, nor between the PCOS phenotypes. PCOS patients with MetS presented lower FMD than other PCOS patients (p = 0.018). In women with PCOS, FMD correlated with glucose and insulin concentrations in the fasting state (R = -0.33, p = 0.002; R = -0.23, p = 0.026) and at 2 h of OGTT (R = -0.29, p = 0.006; R = -0.26, p = 0.014). In patients with phenotype I, correlations were found between IMT and BMI (R = 0.45, p = 0.006) and between FMD and fasting glucose concentrations (R = -0.46, p = 0.011).
Metabolic disturbances and the diagnosis of MetS in patients with PCOS, especially in hyperandrogenic phenotypes, might be associated with alterations in IMT and FMD.
胰岛素抵抗是多囊卵巢综合征（PCOS）发病机制中的一个重要因素，它与代谢综合征（MetS）和心血管并发症的风险增加有关。早期动脉粥样硬化病变可通过超声参数诊断：反应性充血后肱动脉血流介导的扩张（FMD）和颈总动脉内膜中层厚度（IMT）。本研究的目的是评估 IMT 和 FMD 与反映年轻女性代谢状态的临床和实验室参数之间的关系，这些女性患有不同的 PCOS 表型。
该研究纳入了 154 名根据鹿特丹标准诊断为 PCOS 的患者，分为 4 种表型，并纳入了 113 名健康女性。进行了实验室分析、经阴道超声以及 IMT 和 FMD 测量。MetS 按照国际糖尿病联合会/美国心脏协会（IDF/AHA）共识标准进行诊断。
与健康女性相比，PCOS 患者的 MetS 更为常见（14.29%比 5.31%；p=0.019），其中表型 I 和 II 的患病率最高（p=0.039）。PCOS 患者与对照组之间，以及 PCOS 各表型之间的 IMT 和 FMD 无差异。患有 MetS 的 PCOS 患者的 FMD 低于其他 PCOS 患者（p=0.018）。在患有 PCOS 的女性中，FMD 与空腹时（R=-0.33，p=0.002；R=-0.23，p=0.026）和口服葡萄糖耐量试验（OGTT）2 小时时（R=-0.29，p=0.006；R=-0.26，p=0.014）的血糖和胰岛素浓度相关。在表型 I 的患者中，IMT 与 BMI（R=0.45，p=0.006）之间，以及 FMD 与空腹血糖浓度（R=-0.46，p=0.011）之间存在相关性。
PCOS 患者，尤其是高雄激素表型患者的代谢紊乱和 MetS 的诊断可能与 IMT 和 FMD 的改变有关。
