Insulin resistance causes impaired vasodilation and hypofibrinolysis in young women with polycystic ovary syndrome

Plasma plasminogen activator inhibitor-1 levels in the different phenotypes of the polycystic ovary syndrome

“…In previous studies that included both normal weight and overweight/obese women with PCOS, PAI-1 antigen levels positively correlated with serum T levels and negatively with serum SHBG levels [28,29]. In other studies, PAI-1 levels were higher in obese women with PCOS only when biochemical hyperandrogenemia was present [12] and the difference in PAI-1 levels between overweight/obese women with PCOS and controls disappeared after adjustment for androgen levels [16].…”

“…However, our findings do not suggest that IR modulates PAI-1 levels in normal weight women with PCOS because PAI-1 levels drogenemia in the regulation of PAI-1 levels in PCOS. Given the association between IR and hyperandrogenemia [1], it is possible that the correlation between circulating androgens and PAI-1 levels in previous studies [12,16,28,29] might reflect the higher IR in women with more severe hyperandrogenemia.…”

Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking

“…Although insulin resistance is related with the appearance of endothelial dysfunction in subjects with type 2 diabetes, it has been postulated that variations in the mechanism of insulin resistance in PCOS patients may affect endothelial function differently (46). The insulin resistance of PCOS patients has been proposed to involve a post-receptor defect in the phosphatidylinositol 3-kinase insulin-signaling pathway (47) that may reduce the vasodilatatory action of insulin (48), thereby favoring the vasoconstrictory action through the MAP kinase pathway (49). Yet insulin resistance is not universal in PCOS patients (50) and even in insulinresistant PCOS patients, this defect may be tissuespecific (51,52).…”

Metabolic Aspects of Polycystic Ovary Syndrome

“…The triad obesity, raised triglycerides and, raised insulin levels is the most consistent predictor of impaired fibrinolysis and is often found in PCOS women [15,[100][101][102][103]. Earlier studies on PCOS women suggest both increased and normal levels of PAI-1 activity [15,[100][101][102][103], while studies on tPA-mass in PCOS patients are less ambiguous with increased levels [104][105][106], although at least one study reported unchanged levels [107]. As most studies on fibrinolytic activity in women with PCOS are limited in size it is still unclear if lean women with PCOS have disturbances in the fibrinolytic system.…”