Flow-mediated dilatation in overweight and obese women with polycystic ovary syndrome

Objective: There remains a large degree of disagreement about the association of polycystic ovary syndrome (PCOS) with impaired endothelial dysfunction and cardiovascular disease (CVD) risk. The purpose of this study was to determine whether overweight and obese women with PCOS have impaired endothelial function compared with weight-matched controls without PCOS and whether endothelial function is associated with cardiovascular risk markers and hormonal parameters. Design: Cross-sectional analysis. Setting: An outpatient trial at the Commonwealth Scientific Industrial Research Organisation Clinical Research Unit. Population: Overweight and obese women with PCOS (n = 12) and weight-matched controls without PCOS (n = 10). Methods: Endothelial function, cardiovascular risk markers and hormonal parameters were assessed in the patients. Main outcome measures: Endothelial function was assessed by flow-mediated dilatation (FMD) of the brachial artery using high-resolution ultrasound. Lipid profile, fasting insulin level, glucose level, insulin resistance, C-reactive protein level, folate level, Vitamin B₁₂ level and hormonal parameters. Results: Women with PCOS had significantly higher testosterone levels (P < 0.001) and free androgen index (P = 0.006) compared with the controls without PCOS. Both groups were normoinsulinaemic, and there were no significant differences in any of the markers of CVD between women with and without PCOS. Furthermore, FMD was similar in both groups (PCOS 6.1 ± 1.2% versus control 5.6 ± 1.0%, P = 0.77). Conclusions: Compared with a group of weight-matched women with similar metabolic profiles, normoinsulinemic, overweight and obese women with PCOS did not show any greater impairment in endothelial function assessed by FMD. A normoinsulinemic phenotype of PCOS with low metabolic risk factors may reduce the risk of endothelial dysfunction in overweight and obese women with this syndrome. Further studies are required that directly compare FMD in normoinsulinemic and hyperinsulinaemic women with PCOS.