Endocrine Abstracts

Background: Polycystic ovary syndrome (PCOS) is clinically associated with increased risk of CVD. Thrombin generation (TG) is a measure of the thrombotic potential. This can be expressed as endogenous thrombin potential (ETP) representing the total amount of generated active thrombin over the time (nmol/l×min). ETP is considered the most predictive parameter of thrombosis and is associated to both venous and arterial thrombotic disease. Setting: PCOS women prospectively referred to three Danish Gynecological clinics due to infertility, hirsutism and oligo-/amenorrhea.

Materials and methods: One hundred and forty-eight PCOS women diagnosed according to the Rotterdam criteria, mean age 27 years (range 18–40). Measurements: BMI, plasma TG, hsCRP, PAI-1, HOMA-IR, body composition (DXA) and urinary-albumin/creatinin. The calibrated automated thrombogram was used to measure TG.

Results: ETP levels were divided into tertiles:

Total and free testosteron, u-albumin/creatinin did not correlate to ETP. The correlation to total fat mass (TFM) seemed equal to both android and gynoid fat.

ETP did not correlate to number or combinations of the Rotterdam criteria. In a univariate analysis, ETP correlated to the majority of the above-mentioned parameters. In a multivariate analysis including TFM, HOMA-IR, hsCRP, total and LDL-cholesterol, triglycerides, ETP was independently associated with TFM and total cholesterol (β=0.358, P=0.025; β=0.482, P=0.022 respectively).

Conclusion: Increasing ETP is associated with a number of parameters traditionally associated with increased risk of CVD in PCOS. This association seems mainly driven by total FM and cholesterol in PCOS. The Rotterdam criteria were unable to detect this signal of potentially increased risk of thrombosis.