Endocrine Abstracts

Introduction: Women with polycystic ovary syndrome (PCOS) are considered to have increased risk of cardiovascular disease (CVD), even though the syndrome encompasses hugely varying phenotypes. Research into CVD prevention demonstrated a variety of biochemical and ultrasound (US) markers predicting risk in the general population, but those are sparsely utilised for PCOS, in part due to the patients’ therapeutic goals.

Aim: To evaluate if PCOS type or BMI are better predictors of cardiovascular risk, by comparing them to biochemical and US markers.

Material and Methods: We recruited 138 women with PCOS in the reproductive age from the Endocrinology Unit in 2009. We subdivided them by Rotterdam criteria into 4 types (A, n = 74; B, n = 22; C, n = 11; D, n = 31), and by BMI into normal weight (18.5–24.9 kg/m², n = 45), overweight (25–29.9 kg/m², n = 42) and obese (>30 kg/m², n = 51). Biochemical analyses measured: OGTT and fasting glycemia, fasting insulin, total cholesterol, LDL, HDL, triglycerides. Derived parameters: HOMA2 insulin resistance index, free testosterone index (Vermeulen formula, fTv). Carotid intima media thickness (cIMT), endocardial fat thickness (EFT) and brachial flow mediated dilation (FMD) were measured using B-mode US.

Results: We did not find any difference in the analysed variables among the four PCOS phenotypes. Conversely, by dividing patients in BMI categories we found increasingly higher values of systolic blood pressure (P = 2 × 10^–11), cIMT (P = 2 × 10^–8), EFT (P = 3.7 × 10^–10), triglycerides (P = 10^–4), HOMA2 (P = 10^–12) and fTv (P = 0.001), and lower values of HDL (P = 3 × 10^–6) and FMD (P = 0.004), going from normal to obese BMI categories. There was no statistical difference in the prevalence of different PCOS phenotypes based on BMI subgrouping (P = 0.633), whereas there was a higher prevalence of diabetes in the obese BMI group with respect to overweight or normal weight groups (31.4 vs 9.8 vs 2.3%, P = 0.0002).

Conclusion: In our group of PCOS women in the reproductive age, BMI was shown to be a better predictor of cardiovascular risk compared to PCOS phenotype categorisation.