Hum. Reprod. Advance Access originally published online on November 16, 2007
Human Reproduction 2008 23(1):153-159; doi:10.1093/humrep/dem356
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Visceral fat is associated with cardiovascular risk in women with polycystic ovary syndrome
1 Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Naples 80131, Italy 2 Department of Obstetrics and Gynecology, University ‘Magna Graecia’ of Catanzaro, Catanzaro 88100, Italy 3 Department of Internal Medicine, Hepatology, and Gastroenterology, Second University of Naples, Naples 80131, Italy 4 Department of Clinical and Experimental Medicine, Gastroenterology Unit, University ‘Federico II’ of Naples, Naples 80131, Italy 5 Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, Italy 6 Institute of Internal Medicine and Metabolic Disease, ‘Federico II' University of Naples, Naples 80131, Italy 7 Methods and Teaching of Sportive Activity, Faculty of Exercise Sciences, ‘Parthenope' University of Naples, Naples 80133, Italy 8 Endocrinology, Faculty of Exercise Sciences, ‘Parthenope’ University of Naples, Naples 80133, Italy
9 To whom correspondence should be addressed. E-mail: francescoorio{at}virgilio.it
BACKGROUND: Women with polycystic ovary syndrome (PCOS) have been reported to have subclinical cardiovascular disease (CVD) and increased abdominal fat. The aim of this study was to evaluate the relationship between visceral fat (VF) and early markers of CVD in PCOS women.
METHODS: Two hundred overweight PCOS women [(mean ± SD) age 24.6 ± 3.2 years, body mass index (BMI) 28.5 ± 2.8 kg/m2] and 100 healthy age- and BMI-matched volunteer controls entered this cross-sectional study. In all subjects, the amount of VF was measured by ultrasonography. Anthropometric measurements [BMI and waist circumference (WC)], complete hormonal and metabolic pattern, carotid intima-media thickness (IMT), brachial arterial flow-mediated dilation (FMD) and inflammatory biomarkers [C-reactive protein (CRP), fibrinogen, white blood cells count and plasminogen activated inhibitor-1] were also obtained from all subjects. A stepwise linear regression model was used in PCOS patients to verify if IMT or FMD as dependent variables are affected by other independent variables.
RESULTS: VF amount was significantly (P < 0.001) higher in PCOS subjects than in healthy controls [31.4 ± 7.3 versus 28.0 ± 6.1 (mean±SD) mm, respectively] and directly related to insulin resistance: HOMA (r = 0.918, P < 0.001) and AUCINS (r = 0.879, P < 0.001), and to WC (r = 0.658; P < 0.001). In PCOS, the two linear regression analyses showed that IMT is positively affected by VF and CRP, whereas FMD is positively affected by IMT and negatively by VF and CRP.
CONCLUSIONS: VF amount is associated with subclinical CVD in PCOS patients.
Key words: PCOS/visceral fat/cardiovascular risk/hyperandrogenism/insulin resistance
Submitted on May 4, 2007; resubmitted on September 4, 2007; accepted on October 8, 2007.