SAN DIEGO — Young women with polycystic ovary syndrome have evidence of endothelial dysfunction and low-grade, chronic inflammatory markers characteristic of much older patients, researchers reported at the annual meeting of the Endocrine Society.
Evanthia Diamanti-Kandarakis, M.D., and associates at Laiko Hospital of the University of Athens compared endothelial function and inflammatory cytokines in 25 women with PCOS and 20 age-matched controls with similar body mass index (BMI) measurements and waist-hip ratios. The women were in their mid to late 20s and had BMIs of about 26–29 kg/m
Endothelial function was determined by flow-mediated dilatation of the brachial artery on ultrasound, plus endothelin-1 (ET-1) plasma levels. Numerous cytokines were measured in blood to assess arterial inflammation.
Subjects with PCOS had significantly lower percentages of flow-mediated dilatation than controls (3.47% vs. 9.26%). Nitrate-induced dilatation, measured to exclude smooth muscle cell injury, was not significantly different in the two groups. Significantly higher levels of ET-1, intracellular adhesion molecules (ICAMs), vascular cell adhesion molecules (VCAMs), and C-reactive protein were found in PCOS subjects, compared with controls. E-selectin levels did not differ between groups.
In PCOS “the lining of the arteries is affected and at the same time, the molecules are sticking to each other and to the vessel wall, leading to a compromised circulation as would be seen in a woman much older” than these subjects, Dr. Diamanti-Kandarakis said at a press conference at the meeting.
As expected, testosterone levels were significantly elevated in women with PCOS.
Asked to advise clinicians on how to use the information, she pointed out that a multiple regression analysis determined that the best predictors of endothelial damage in PCOS subjects were elevated levels of testosterone and CRP. Young PCOS patients with high levels of both should be closely followed for cardiovascular consequences of the syndrome.
“We cannot assume that all women with PCOS have [endothelial dysfunction]. There are different subtypes of the disease,” Dr. Diamanti-Kandarakis said.