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Obstetrics & Gynecology 2008;111:385-395
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Vascular Risk in Young Women With Polycystic Ovary and Polycystic Ovary Syndrome

Cesare Battaglia, MD, PhD, Fulvia Mancini, MD1, Arianna Cianciosi, MD1, Paolo Busacchi, MD1, Fabio Facchinetti, MD2, Giulio Reggiani Marchesini, MD3, Rebecca Marzocchi, MD3 and Domenico de Aloysio, MD1

From the Departments of 1Obstetrics and Gynecology, University of Bologna, Bologna; 2Obstetrics and Gynecology, University of Modena-Reggio Emilia, Modena; and 3Endocrinology, University of Bologna, Bologna, Italy.

OBJECTIVE: To estimate if young polycystic ovary syndrome (PCOS) patients have subclinical risks of vascular disease compared with eumenorrheic polycystic ovary (PCO) women and healthy controls.

METHODS: Twenty-eight PCOS patients, 17 eumenorrheic PCO women, and 15 healthy eumenorrheic volunteers underwent medical examination; blood measurement of nitrites/nitrates, biochemical and hormonal parameters; uteroovarian ultrasonographic analysis and color Doppler evaluation of uterine, stromal ovarian, and ophthalmic arteries; brachial artery flow–mediated vasodilatation; 24-hour ambulatory blood pressure monitoring. An oral glucose tolerance test was performed to analyze glucose, insulin, and C-peptide.

RESULTS: Doppler analysis revealed a significantly higher uterine pulsatility index in the PCOS group compared with controls. The lowest vascular resistances in the ovaries were found in PCOS and PCO compared with controls. The ophthalmic artery back pressure was significantly higher in women with PCOS than in controls. The brachial artery diameter, at baseline, was similar in all the participants. After the reactive hyperemia, a greater vasodilatation was observed in controls and PCO patients in comparison with PCOS women. Total cholesterol, triglycerides, and the atherogenic plasma index were significantly higher in PCOS than PCO and controls. Leukocytes and homocysteine were slightly higher in PCOS. The nitrites/nitrates plasma levels were lower in PCOS and PCO patients compared with controls. The insulin and C-peptide plasma values were higher in PCOS patients than controls. In PCOS patients the different estimates of insulin sensitivity and pancreatic β-cell function were higher compared with PCO and controls.

CONCLUSION: Polycystic ovary syndrome is a condition associated with an increased vascular risk.

LEVEL OF EVIDENCE: II




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