Factors Associated With Increased Carotid Intima-Media Thickness and Being Nondipper in Nonobese and Normotensive Young Patients Affected by PCOS

Ercan, Ebru Akgül; Ertek, Sibel; İş, Gürkan; Caglar, Oya; Öztaş, Efser; Cicero, Arrigo F G; Alhan, Aslıhan; Çehreli, Şengül; Töre, Hasan Fehmi; Erdoğan, Gürbüz

doi:10.1177/0003319711400183

Cited by 7 publications

(3 citation statements)

References 45 publications

(50 reference statements)

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“…Our observations are in agreement with previous findings in adolescents with PCOS [53][54][55][56]. High IMT values in PCOS were reported in women in early adulthood (associated with decreased sex hormone-binding globulin) [57] and adulthood [58][59][60][61][62][63][64][65] in obese women [50,66,67] and patients with juvenile rheumatoid arthritis [68]. Our study participants were adolescent and young adult women with PCOS and proper controls matched for BMI, so as to overcome the strong confounding associations of age and BMI with arterial thickness in PCOS [68].…”

Section: Commentsupporting

confidence: 93%

Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study

et al. 2022

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Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which clinical, sonographic, and endophenotypic features have been underinvestigated or inconclusive, especially in the early stages of the disease (adolescence/young adulthood). Objective: This prospective pilot study focused on the differences of multiple physiological functions between Greek adolescent/young adult females suffering from PCOS and age- and body mass index (BMI)- matched healthy controls. Study design: Nineteen PCOS patients and eighteen healthy controls (aged 13 to 23 years) were studied for: (i) biochemical and hormonal dysfunction by measuring circulating glucose, insulin, and androgen levels; (ii) arterial stiffness with pulse wave analysis (PWA) by Sphygmocord; (iii) intima-media thickness (IMT) by ultrasound; (iv) heart rate variability (HRV) by Task Force Monitor; and (v) QT, QRS, QT, P, QRSD by electrocardiogram (ECG). Statistical analysis included Hedge’s g correction for small samples bias, and the results are shown using the Hedge’s g effect size and 95% CI, in line with precision medicine prerequisites. Results: Significant differences in pulse wave velocity (PWV) (g = 0.964 [0.296, 1.632]), subendocardial viability ratio (SEVR) carotid (g = −0.679 [−1.329, −0.030]), pulse pressure (PP) carotid (g = 0.942 [0.275, 1.608]), systolic pressure (SP) carotid (g = 0.785 [0.129, 1.440]), free-testosterone (g = 0.677 [0.042, 0.312]), and Delta4-androstenedione (g = 0.735 [0.097, 0.373]) were observed between PCOS patients and controls. No differences were detected in the remaining endocrine and PWA or ECG biomarkers. Conclusions: Our multidisciplinary approach showed early onset of vascular dysfunction, predisposition to hypertension, thermoregulation delays, and metabolic syndrome changes in adolescent/young adult PCOS.

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Section: Commentsupporting

confidence: 93%

Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study

et al. 2022

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“…Insulin resistance and hyperinsulinism have been known as pathogenetic mechanisms for the last 15 years, present in 50-70% of these women, whereas MetS prevalence is higher than in age and weight-matched controls [85]. Even in the absence of obesity or MetS, these patients may have insulin resistance and increased cardiovascular risk [86]. High insulin levels affect the hypothalamus-pituitary-ovarian function, as well as glucose utilization in peripheral tissues [87].…”

Section: Metformin In Polycystic Ovary Syndromementioning

confidence: 99%

Mini-Special Issue paper Management of diabetic patients with hypoglycemic agents Metformin and its clinical use: new insights for an old drug in clinical practice

Cicero¹,

Tartagni²,

Ertek³

2012

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Metformin is generally recommended as first-line treatment in type 2 diabetes, especially in overweight patients, but in recent years new indications for its use have emerged. Metformin has been found to be safe and efficacious both as monotherapy and in combination with all oral antidiabetic agents and insulins. If metformin use during pregnancy and the lactation period is supported by few data, it could be indicated for women with polycystic ovary syndrome, since it could diminish circulating androgens and insulin resistance, thus ameliorating the ovulation rate. Metformin seems to reduce cancer risk, which appears to be increased in diabetics, and is a promising agent for oncoprevention and chemotherapy combinations. Moreover, metformin could find a place in the treatment of non-alcoholic fatty liver disease. Lactic acidosis could be decreased by avoiding metformin use in patients with hypovolemia, sepsis, renal impairment, hypoxic respiratory diseases and heart failure, in the preoperative period and before intravenous injection of contrast media.

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“…33 –35 Third, a recent study reported that arterial stiffness, a novel risk factor for future CVD, 36 was more common in PCOS participants in their 20s. 37 Fourth, carotid intima–media thickness was higher in women with PCOS 38 and in women over 45 years with a history of PCOS. 39 In the same study, no clue for clinical atherosclerosis could be detected in women with PCOS aged between 30 and 44 years.…”

Section: Discussionmentioning

confidence: 94%

Abdominal Obesity is Associated With a Lower Ankle–Brachial Index in Women With Polycystic Ovary Syndrome

et al. 2012

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Polycystic ovary syndrome (PCOS) was linked to increased lifetime risk of cardiovascular disease. A low ankle-brachial index (ABI) is associated with accelerated atherosclerosis. The ABI value and the associated conditions in women with PCOS were searched in the present study. The ABI was measured using a handheld Doppler device and calculated using both standard and modified definitions. Women with PCOS (n = 103, mean age = 24.9 ± 5.9 years) had a mean ABI of 1.10 ± 0.10. A low ABI (≤0.9) was 2.9% and 14.6% using the standard and modified definitions, respectively. Mean ABI correlated negatively to body weight, BMI, waist circumference, waist-to-hip ratio, and hematocrit. Logistic regression analysis revealed higher waist-to-hip ratio as independently associated with a lower ABI. Frequency of ABI ≤0.9 in PCOS was lower than the general population. However, increased waist-to-hip ratio was a predictor of a lower ABI value.

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Factors Associated With Increased Carotid Intima-Media Thickness and Being Nondipper in Nonobese and Normotensive Young Patients Affected by PCOS

Cited by 7 publications

References 45 publications

Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study

Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study

Mini-Special Issue paper Management of diabetic patients with hypoglycemic agents Metformin and its clinical use: new insights for an old drug in clinical practice

Abdominal Obesity is Associated With a Lower Ankle–Brachial Index in Women With Polycystic Ovary Syndrome

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