Endothelial function in young women with polycystic ovary syndrome (PCOS): Implications of body mass index (BMI) and insulin resistance

Background: Evidence regarding endothelial function in both obese and nonobese women with PCOS is contradictory. It is unknown whether obese women with PCOS carry an increased risk related to body mass index (BMI). Aim: To identify endothelial function and investigate its relationship to body mass index and insulin resistance in young women with PCOS. Subjects and methods: Twenty-two obese women with PCOS (BMI 35.2 +/- 3.2) as well as fourteen lean women (BMI 22.8 +/- 2.1) with PCOS were included in the study. Fasting serum insulin, blood glucose were estimated and HOMA and Quicki index were calculated. All patients were subjected to ultrasound recording of brachial artery diameter at rest and after reactive hyperemia (FMD) for assessment of endothelial function. Ten age matched healthy females with normal BMI were chosen as a control group. Results: There were higher basal insulin levels with lower Quicki index and higher HOMA index in women with PCOS than normal group, but the differences were significant only between obese PCOS subgroup and control. On the other hand, FMD was significantly and equally decreased in both groups of women with PCOS, compared with control subjects (3.7 +/- 3.2% in the nonobese subgroup and 3.5 +/- 2.8% in the obese one vs. 10.6 +/- 4.1% in control subjects, P, 0.001). FMD was not correlated with BMI nor insulin resistance indices. Conclusions: Endothelial dysfunction is already present in young women with PCOS. In this patient group, it cannot be attributed to insulin resistance or obesity. (C) 2009 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.