Arterial stiffness measured by cardio-ankle vascular index is greater in non-obese young women with polycystic ovarian syndrome.
cardiovascular disease
ovarian function/menstrual disorders
polycystic ovary syndrome/hyperandrogenism
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
18
05
2020
revised:
25
08
2020
accepted:
16
10
2020
pubmed:
5
11
2020
medline:
22
6
2021
entrez:
4
11
2020
Statut:
ppublish
Résumé
The association of metabolic abnormalities and polycystic ovarian syndrome (PCOS) has been documented, but few studies have focused on cardiovascular risk in these women. The aim of this study was to compare arterial stiffness by using the cardio-ankle vascular index (CAVI) in PCOS women with controls, and to evaluate whether any clinical or laboratory variables had independent associations with it. A group of 160 women, matched for age and body mass index were recruited. Diagnosis of PCOS was made according to the Rotterdam criteria. Arterial stiffness using CAVI was evaluated in non-obese young woman, with and without PCOS. In the PCOS group (n = 80), 60 cases (75%) had findings of hyperandrogenism, 59 (73.8%) had ovulatory dysfunction, and 70 (87.5%) had an ultrasonographic appearance of polycystic ovaries. Women with PCOS had significantly higher mean CAVI values when compared to subjects without PCOS (5.78 ± 0.64 vs 5.28 ± 0.77, P < 0.001). Multiple regression analysis revealed that androgen excess was associated with increased arterial stiffness, independent of ovulatory dysfunction, polycystic ovaries, body mass index and age. This data suggests that vascular compliance is decreased in young women with PCOS. Androgen excess is independently associated with increased arterial stiffness.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
521-528Informations de copyright
© 2020 Japan Society of Obstetrics and Gynecology.
Références
Azziz R, Carmina E, Chen Z et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016; 2: 1-18.
Rashad NM, Abd El-Fatah AH, Lashin ME-B, Abomandour HG, Allam RM. Impact of vitamin D supplementation on cardio-metabolic status and androgen profile in women with polycystic ovary syndrome: Placebo-controlled clinical trial. Middle East Fertil Soc J. 2019; 24: 5.
Sprung VS, Atkinson G, Cuthbertson DJ et al. Endothelial function measured using flow-mediated dilation in polycystic ovary syndrome: A meta-analysis of the observational studies. Clin Endocrinol (Oxf). 2013 Mar; 78: 438-446.
Meyer ML, Malek AM, Wild RA, Korytkowski MT, Talbott EO. Carotid artery intima-media thickness in polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update. 2012 Mar 1; 18: 112-126.
Christian RC, Dumesic DA, Behrenbeck T, Oberg AL, Sheedy PF, Fitzpatrick LA. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003; 88: 2562-2568.
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: A systematic review and meta-analysis. J Am Coll Cardiol. 2010; 55: 1318-1327.
Mattace-Raso FUS, van der Cammen TJM, Hofman A et al. Arterial stiffness and risk of coronary heart disease and stroke: The Rotterdam study. Circulation. 2006; 113: 657-663.
Mitchell GF, Hwang S-J, Vasan RS et al. Arterial stiffness and cardiovascular events: The Framingham heart study. Circulation. 2010; 121: 505-511.
Hayashi K, Yamamoto T, Takahara A, Shirai K. Clinical assessment of arterial stiffness with cardio-ankle vascular index: Theory and applications. Journal of Hypertension. 2015; 33: 1742-1757.
Shirai K, Hiruta N, Song M et al. Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: Theory, evidence and perspectives. J Atheroscler Thromb. 2011; 18: 924-938.
Matsushita K, Ding N, Kim ED et al. Cardio-ankle vascular index and cardiovascular disease: Systematic review and meta-analysis of prospective and cross-sectional studies. The Journal of Clinical Hypertension. 2019; 21: 16-24.
Rotterdam ESHRE. ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004; 19: 41-47.
Yildiz BO, Bolour S, Woods K, Moore A, Azziz R. Visually scoring hirsutism. Hum Reprod Update. 2010; 16: 51-64.
Kim J, Choi S-Y, Park B et al. Arterial stiffness measured by cardio-ankle vascular index in Korean women with polycystic ovary syndrome. J Obstet Gynaecol. 2019; 39: 681-686.
Gunning MN, Fauser BCJM. Are women with polycystic ovary syndrome at increased cardiovascular disease risk later in life? Climacteric. 2017; 20: 222-227.
Lakhani Kalpana SAM, Paul H. Impaired carotid viscoelastic properties in women with polycystic ovaries. Circulation. 2002; 106: 81-85.
Kelly CJG, Speirs A, Gould GW, Petrie JR, Lyall H, Connell JMC. Altered vascular function in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2002; 87: 742-746.
Meyer C, McGrath BP, Teede HJ. Overweight women with polycystic ovary syndrome have evidence of subclinical cardiovascular disease. J Clin Endocrinol Metab. 2005; 90: 5711-5716.
Sasaki A, Emi Y, Matsuda M. Sharula null, Kamada Y, Chekir C, et al. increased arterial stiffness in mildly-hypertensive women with polycystic ovary syndrome. J Obstet Gynaecol Res. 2011; 37: 402-411.
Ketel IJ, Stehouwer CD, Henry RM et al. Greater arterial stiffness in polycystic ovary syndrome (PCOS) is an obesity - but not a PCOS-associated phenomenon. J Clin Endocrinol Metab. 2010; 95: 4566-4575.
Rees E, Coulson R, Dunstan F et al. Central arterial stiffness and diastolic dysfunction are associated with insulin resistance and abdominal obesity in young women but polycystic ovary syndrome does not confer additional risk. Hum Reprod. 2014; 29: 2041-2049.
Soares GM, Vieira CS, Martins WP, Franceschini SA. dos reis RM, Silva de Sá MF, et al. increased arterial stiffness in nonobese women with polycystic ovary syndrome (PCOS) without comorbidities: One more characteristic inherent to the syndrome? Clin Endocrinol (Oxf). 2009; 71: 406-411.
Kaya MG, Gunebakmaz O, Zencir C et al. An assessment of the elastic properties of the aorta in nonobese women with polycystic ovary syndrome. Fertility and Sterility. 2010; 94: 2402-2405.
Alpañés M, Fernández-Durán E, Escobar-Morreale HF. Androgens and polycystic ovary syndrome. Expert Rev Endocrinol Metab. 2012; 7: 91-102.
González F, Rote NS, Minium J, Kirwan JP. Evidence of proatherogenic inflammation in polycystic ovary syndrome. Metabolism. 2009; 58: 954-962.
Christakou CD, Diamanti-Kandarakis E. Role of androgen excess on metabolic aberrations and cardiovascular risk in women with polycystic ovary syndrome. Womens Health (Lond). 2008; 4: 583-594.
Yildirir A, Aybar F, Kabakci G, Yarali H, Oto A. Heart rate variability in young women with polycystic ovary syndrome. Ann Noninvasive Electrocardiol. 2006; 11: 306-312.
Perciaccante A, Fiorentini A, Valente R, Tubani L. Polycystic ovary syndrome: Androgens, autonomic nervous system, and hypertension. Hypertension 2007; 50: e7; author reply e8.
Orshal JM, Khalil RA. Gender, sex hormones, and vascular tone. Am J Physiol Regul Integr Comp Physiol. 2004; 286: R233-R249.
Hillebrand U, Hausberg M, Lang D et al. How steroid hormones act on the endothelium - insights by atomic force microscopy. Pflugers Arch. 2008; 456: 51-60.
Natoli Alaina K, Medley Tanya L, Ahimastos Anna A et al. Sex steroids modulate human aortic smooth muscle cell matrix protein deposition and matrix metalloproteinase expression. Hypertension. 2005; 46: 1129-1134.
Laughlin GA, Goodell V, Barrett-Connor E. Extremes of endogenous testosterone are associated with increased risk of incident coronary events in older women. J Clin Endocrinol Metab. 2010; 95: 740-747.
Macut D, Antić IB, Bjekić-Macut J. Cardiovascular risk factors and events in women with androgen excess. J Endocrinol Invest. 2015 Mar; 38: 295-301.
Creatsa M, Armeni E, Stamatelopoulos K et al. Circulating androgen levels are associated with subclinical atherosclerosis and arterial stiffness in healthy recently menopausal women. Metab Clin Exp. 2012; 61: 193-201.
Lambrinoudaki I, Georgiopoulos GA, Athanasouli F et al. Free androgen index as a determinant of arterial stiffness in menopause: A mediation analysis. Menopause. 2017; 24: 635-644.
Subramanya V, Ambale-Venkatesh B, Ohyama Y et al. Relation of sex hormone levels with prevalent and 10-year change in aortic Distensibility assessed by MRI: The multi-ethnic study of atherosclerosis. Am J Hypertens. 2018; 31: 774-783.
Luque-Ramírez M, Mendieta-Azcona C, Alvarez-Blasco F, Escobar-Morreale HF. Androgen excess is associated with the increased carotid intima-media thickness observed in young women with polycystic ovary syndrome. Hum Reprod. 2007; 22: 3197-3203.
Yilmaz SA, Kebapcilar A, Koplay M et al. Association of clinical androgen excess with radial artery intima media thickness in women with polycystic ovary syndrome. Gynecol Endocrinol. 2015; 31: 477-482.
Vieira CS, Martins WP, Fernandes JBF et al. The effects of 2 mg chlormadinone acetate/30 mcg ethinylestradiol, alone or combined with spironolactone, on cardiovascular risk markers in women with polycystic ovary syndrome. Contraception. 2012; 86: 268-275.