Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Endocrinology, Metabolism and Internal Diseases Ward, Heliodor Swiecicki University Hospital, Poznan, Poland.
Endocrine. 2021 Jun;72(3):882-892. doi: 10.1007/s12020-021-02648-7. Epub 2021 Feb 22.
Women with polycystic ovary syndrome (PCOS) present with or without biochemical hyperandrogenism (HAPCOS or non-HAPCOS, respectively). Cardiometabolic and hormonal abnormalities have been reported in women with PCOS, particularly those with hypertension. However, no direct comparison between normotensive (blood pressure <140/90 mmHg) patients with HAPCOS and non-HAPCOS has been made. This study compared different cardiovascular (CV), anthropometric, metabolic and hormonal features between normotensive patients with HAPCOS and non-HAPCOS and healthy women.
We consecutively recruited 249 normotensive patients with PCOS and 85 healthy eumenorrheic women to a case-control observational study. Based on blood androgen concentration, patients with PCOS were divided into HAPCOS (n = 69) or non-HAPCOS (n = 180) groups.
Although within normal ranges, patients with HAPCOS had significantly (p < 0.05) higher peripheral and central systolic blood pressure and pulse pressure, C-reactive protein, low-density lipoprotein cholesterol, triglycerides, glucose, and insulin than subjects with non-HAPCOS, and healthy women. They also had lower N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) concentration. In contrast, their body mass index (BMI) was higher of over 4 kg/m than patients with non-HAPCOS and nearly 6 kg/m than in healthy participants. Except for BMI, statistical differences in the cardiometabolic profile were of little clinical relevance.
Young normotensive women with HAPCOS have a worse cardiometabolic profile but lower NT-proBNP concentration than patients with non-HAPCOS. Features of this profile in both PCOS groups are within ranges typical for healthy women. Increased BMI is the only clinically relevant feature differentiating hyperandrogenic from non-hyperandrogenic patients with PCOS, and healthy women.
患有多囊卵巢综合征(PCOS)的女性表现为有或无生化高雄激素血症(HAPCOS 或非 HAPCOS)。已有研究报道 PCOS 女性存在心脏代谢和激素异常,尤其是高血压患者。然而,目前尚无与 HAPCOS 和非 HAPCOS 的血压正常(血压<140/90mmHg)PCOS 患者进行直接比较的研究。本研究比较了血压正常的 HAPCOS 和非 HAPCOS PCOS 患者与健康女性之间不同的心血管(CV)、人体测量、代谢和激素特征。
我们连续招募了 249 名血压正常的 PCOS 患者和 85 名健康月经正常的女性进行病例对照观察性研究。根据血雄激素浓度,将 PCOS 患者分为 HAPCOS(n=69)或非 HAPCOS(n=180)组。
尽管在正常范围内,HAPCOS 患者外周和中心收缩压和脉压、C 反应蛋白、低密度脂蛋白胆固醇、甘油三酯、血糖和胰岛素明显升高(p<0.05),而 N 端脑钠肽前体(NT-proBNP)浓度明显低于非 HAPCOS 患者和健康女性。此外,HAPCOS 患者的体重指数(BMI)高于非 HAPCOS 患者超过 4kg/m2,接近健康参与者的 6kg/m2。除 BMI 外,心脏代谢特征的统计学差异无临床意义。
年轻血压正常的 HAPCOS 女性具有更差的心脏代谢特征,但 NT-proBNP 浓度低于非 HAPCOS 患者。这两个 PCOS 组的特征都在健康女性的典型范围内。BMI 增加是区分 HAPCOS 和非 HAPCOS PCOS 患者与健康女性的唯一具有临床意义的特征。