Endocrine Abstracts

Background: Polycystic ovary syndrome is a long lasting, complex, hormonal condition associated with microvascular endothelial dysfunction and strongly related to CIMT changes at an early age. ED represents an initial reversible step in atherogenesis development, so early clinical identification of ED may play a pivotal in the prevention or reversal of progression to atherosclerosis. Also, CIMT is considered as an early marker of atherosclerosis

Objective: to assess the early vascular changes in Egyptian women with PCOS marked functionally by measurement of endothelial dysfunction using brachial artery flow–mediated dilatation (FMD) andstructurally via CIMT using high resolution Doppler ultrasonography with correlation of such early vascular changes with HOMA-IR index. Also, to assess independent determinants of CIMT in PCOS patients for optimal control of all modifiable CV risk factors and targeted treatment protocols.

Material and Methods: In this study, Seventy Egyptian females were included and they were divided into 50 diagnosed to have PCOS using Rotterdam Criteria (PCOS group) and 20 in control group. Patients were recruited from General Gynecology Clinics and Endocrinology &Metabolic Diseases Outpatient Clinic at Cairo university hospitals during the period from 2019 to 2020. fasting insulin, fasting blood glucose, HbA1C, lipid profile, TSH, free testosterone, HOMA-IR, CIMT and endothelial function were assessed in all patients.

Results: HOMA-IR correlates positively with (BMI, waist circumference, SBP, DBP, TG, T. Cholesterol) and negatively with HDL in PCOS patients. We also found that CIMT was significantly higher in PCOS group (0.06 ± 0.01) than control group (0.05 ± 0.01) with P< 0.001. A more intense vasodilatation was observed in controls than in polycystic ovary syndrome (PCOS) patients (P< 0.001). The diagnosis of PCOS per se is a strong independent predictor of CIMT and endothelial dysfunction.

Conclusion: polycystic ovary syndrome is a condition associated with increased vascular risk as it is associated with microvascular endothelial dysfunction and strongly related to CIMT changes. For optimal control of all modifiable CV risk factors and targeted treatment protocols, we recommend screening of early stages of atherosclerotic diseases in PCOS women which may be possible causes of morbidity and mortality as PCOS is also associated with increased risk of different metabolic complications including HTN, insulin resistance, DM, CV diseases

Keywords: polycystic ovary syndrome;carotid-intima media thickness; endothelial dysfunction;insulin resistance; atherosclerosis.