Visceral fat amount as predictor for subclinical cardiovascular disease in women with polycystic ovary syndrome

Teresa Cascella; Stefano Palomba; Sio Ilario De; Francesco Manguso; Laura Vuolo; Francesco Giallauria; Alessandra Grieco; Gaetano Lombardi; Annamaria Colao; Domenico Tafuri; Francesco Orio

OC11.6

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Endocrine Abstracts (2007) 14 OC11.6

ECE2007 Oral Communications Reproductive endocrinology II (7 abstracts)

Visceral fat amount as predictor for subclinical cardiovascular disease in women with polycystic ovary syndrome

Teresa Cascella ¹ , Stefano Palomba ² , Ilario De Sio ³ , Francesco Manguso ⁴ , Laura Vuolo ¹ , Francesco Giallauria ⁵ , Alessandra Grieco ¹ , Gaetano Lombardi ¹ , Annamaria Colao ¹ , Domenico Tafuri ⁶ & Francesco Orio ⁷

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¹Department of Molecular & Clinical Endocrinology and Oncology, “Federico II” University of Naples, Naples, Italy; ²Department of Obstetrics and Gynecology, University “Magna Graecia” of Catanzaro, Catanzaro, Italy; ³Department of Internal Medicine, Hepatology, and Gastroenterology, Second University of Naples, Naples, Italy; ⁴Gastroenterology Unit, “Cardarelli” Hospital, Naples;, Naples, Italy, ⁵Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, Institute of Internal Medicine and Metabolic Disease, “Federico II” University of Naples, Naples, Italy; ⁶Teaching and Methods of Sportive Activity, “Parthenope” University of Naples, Naples, Italy; ⁷Endocrinology, Faculty of Motor Science, “Parthenope” University of Naples and Department of Molecular & Clinical Endocrinology and Oncology, “Federico II” University of Naples, Naples, Italy.

Introduction and aim: Polycystic Ovary Syndrome (PCOS) is a common disorder associated with a wide range of endocrine and metabolic abnormalities. Obesity is present in about 45–50% of PCOS women. Increased cardiovascular risk factors and evidence of subclinical cardiovascular disease (CVD) have been reported in PCOS. The aim of the present study was to evaluate whether visceral fat amount may be considered as predictor for early CVD in PCOS women.

Patients and methods: The procedures used were in accordance with the guidelines of the Helsinki Declaration on human experimentation. The study was approved by the local Ethical Committee. Two-hundred PCOS women and 100 healthy age- and body mass index-matched women were enrolled in this prospective baseline-controlled clinical study. Non-invasive markers of early CVD [carotid intima-media thickness (IMT), brachial arterial flow-mediated dilation (FMD)] and visceral fat amount [using abdominal ultrasonography] were evaluated. Inflammatory biomarkers [C-reactive protein (CRP), fibrinogen, white blood cells (WBC) count, plasminogen activated inhibitor (PAI)-1], hormonal and metabolic parameters were also investigated.

Results: Subjects with PCOS had significantly (P<0.001) higher visceral fat compared to healthy women [31.4+7.3 vs. 28.0+6.1, mm+SD), respectively] which were directly related to HOMA (r=0.918, P<0.001), AUC_INS (r=0.879, P<0.001) and WC (r=0.358; P<0.001). Stepwise linear regression model showed that visceral fat amount was an independent predictor of IMT, FMD and CRP.

Conclusions: The early impairment of endothelial structure and function, the increase of low-grade chronic inflammation and insulin resistance in women with PCOS are associated with increased central fat excess. Visceral fat amount could be an important predictor of subclinical CVD in PCOS.