Endothelial function in young women with polycystic ovary syndrome (PCOS): Implications of body mass index (BMI) and insulin resistance

Endothelial dysfunction in hyperandrogenic polycystic ovary syndrome is not explained by either obesity or ectopic fat deposition

“…However, we are confident that HOMA-IR data are sufficiently sensitive for present purposes as our findings are consistent with several previous studies that have compared IR in PCOS and control women, of a similar BMI, using HOMA-IR [35,[43][44][45]. Our careful inclusion of PCOS women with a normal glucose tolerance test may have filtered out the more insulin resistant patients; hence there were no baseline differences between the two groups in fasting glucose levels or HOMA-IR.…”

“…All women with PCOS in the current study were clinically hyperandrogenic; however, neither testosterone nor FAI correlated with FMD. El-Kannishy et al [35] previously observed a negative correlation between brachial artery FMD and testosterone in women with PCOS. Furthermore, Paradisi et al [36] suggested that endothelial dysfunction in women with PCOS is, at least in part, associated with elevated androgens.…”

“…In the present study, women with PCOS were recruited based on the 'classical' NIH [15]/AES [38] criteria for which hyperandrogenaemia is a prerequisite feature, unlike the Rotterdam criteria [39] for which hyperandrogenism is not a fundamental requirement. Previous studies exploring the possibility that hyperandrogenism is an important pathological feature of PCOS have all used specific biochemical parameters including elevated testosterone [35] and FAI [13] as markers of hyperandrogenism. While it is plausible that androgens could impose a direct impact on the vessel wall, this remains unconfirmed, and the impact of androgens on vascular reactivity in women with PCOS warrants further investigation.…”

Endothelial function measured using flow‐mediated dilation in polycystic ovary syndrome: a meta‐analysis of the observational studies

“…13 Even when women with PCOS were compared with age and BMImatched controls, Soares et al 14 found no significant difference in FMD, a finding that is consistent with previous studies. 15,16 In contrast, Meyer et al 17 and El-Kannishy et al, 18 demonstrated differences in early functional markers of arterial disease, including FMD, in women with PCOS compared to a matched control group. This disparity in the extant literature may be related to different methods employed to assess FMD, the considerable variability between subjects, with different definitions of diagnosis, disease duration, disease severities and comorbidities or to poorly matched control groups.…”

Detection of Type 2 Diabetes Mellitus in Serum from Women with Polycystic Ovarian Syndrome

“…The factors associated with glucose in tolerance in PCOS, age, BMI, Waist/ hip ratios, and family history of diabetes, were identical to those in other population. An underlying genetic defect conferring insulin resistance and perhaps B-cell dysfunction interacts with environmental factors worsening insulin resistance [20,21]. Studies on the molecular mechanisms of insulin resistance in PCOS suggests that the peripheral insulin resistance in these patients may be due to a post-binding defect in insulin receptor-mediated signal transduction, specifically, a dysregulation of insulin receptor phosphorylation and consequently decreased tyrosine kinase activity of the receptor, inhibition of normal signaling and a significant decrease in insulin responsiveness.…”