Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) patients present with or without biochemical hyperandrogenism (HAPCOS or non-HAPCOS, respectively). Although cardiometabolic and hormonal abnormalities have been reported in women with PCOS, particularly those with hypertension, direct comparisons between normotensive (blood pressure (BP) <140/90 mmHg) patients with HAPCOS and non-HAPCOS are scarce. Data on N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) in PCOS are inconclusive.

Methods/design: We compared various cardiovascular (CV), anthropometric, metabolic, and hormonal features of normotensive PCOS patients and healthy women. This case-control observational study involved 249 normotensive PCOS and 85 healthy eumenorrheic women. Based on blood androgen concentrations, PCOS patients were divided into HAPCOS (n=69) or non-HAPCOS (n=180) groups. NT-proBNP was measured using Cobas 6000 Analyzer with electrochemiluminescence sandwich immunoassays (Roche Diagnostics GmbH, Germany).

Results: HAPCOS patients had significantly (P<0.05) lower NT-proBNP concentration than non-HAPCOS women (34.57 vs. 39.77 pg/ml;P=0.021) and controls (41.58 pg/ml;P=0.01). NT-proBNP levels were comparable between non-HAPCOS and controls. HAPCOS patients had also significantly higher peripheral and central systolic BP and pulse pressure (PP), C-reactive protein, low-density lipoprotein cholesterol, triglycerides, glucose, and insulin than non-HAPCOS and healthy women. Still, these results were within normal ranges. However, body mass index (BMI) of HAPCOS subjects was over 4 kg/m² higher than in non-HAPCOS patients and nearly 6 kg/m² higher than in controls. Except for BMI, statistical differences in the cardiometabolic profile were of little clinical relevance. Higher amounts of adipose tissue in HAPCOS patients may be an explanation for the coexistence of higher BP and lower NT-proBNP concentration. A negative correlation between parameters of biochemical hyperandrogenism (free testosterone, dehydroepiandrosterone sulfate, androstenedione, dihydrotestosterone), and NT-proBNP was observed, suggesting a role of androgens in influencing NT-proBNP levels. It is likely that a combination of several abnormalities in HAPCOS women, like: excess fat tissue, hyperandrogenism, hyperinsulinemia, and insulin resistance, may be responsible for the relatively lower NT-proBNP levels and higher systolic BP and PP among this patient population.

Conclusions: Normotensive women with HAPCOS have a worse cardiometabolic profile but a lower NT-proBNP concentration than non-HAPCOS patients. Features of this profile in both PCOS groups are within normal ranges typical for healthy women. Increased BMI may be the only clinically relevant parameter differentiating hyperandrogenic from non-hyperandrogenic PCOS patients and healthy women.