Endothelial function and its relationship to leptin, homocysteine, and insulin resistance in lean and overweight eumenorrheic women and PCOS patients: a pilot study

ObjectiveTo verify if patients with polycystic ovarian syndrome (PCOS), have an increased cardiovascular risk compared with healthy controls.DesignProspective case-control study.SettingUniversity-based practice.Patient(s)Twenty eumenorrheic controls (ten lean [group A] and ten overweight [group B]) and 24 PCOS women (14 lean [group C] and ten overweight [group D]).Intervention(s)Cardiovascular risk markers and hormonal parameters were assessed.Main Outcome Measure(s)Androgens, fasting glucose, insulin, leptin, fibrinogen, homocysteine, endothelin-1 and flow-mediated dilatation of the brachial artery were measured to investigate their relationship to weight and to PCOS.Result(s)The brachial artery diameter and the pulsatility index, after the reactive hyperemia, showed in group A the most intense vasodilatation compared with the other groups. Homocysteine levels did not differ among the groups. Endothelin-1 was significantly higher in group A compared with groups B and D. Leptin was significantly lower in groups A and C compared with groups B and D. Insulin resistance was higher in groups B and D. Group A had significantly higher glucose-insulin ratio compared with all of the other groups; group C had significantly higher glucose-insulin ratio only compared with group D.Conclusion(s)Weight and PCOS are two independent variables affecting the endothelial function.