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Hum. Reprod. Advance Access published online on October 11, 2007
Human Reproduction, doi:10.1093/humrep/dem324
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Androgen excess is associated with the increased carotid intima-media thickness observed in young women with polycystic ovary syndrome

Manuel Luque-Ramírez1,3, Covadonga Mendieta-Azcona2, Francisco Álvarez-Blasco1 and Héctor F. Escobar-Morreale1,4

1 Department of Endocrinology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Carretera de Colmenar Viejo Km 9,1. E-28034 Madrid, Spain 2 Department of Vascular Surgery, Hospital Universitario La Paz, Madrid, Spain 3 Present address: Department of Endocrinology, Hospital Universitario de la Princesa, Madrid, Spain

4 Correspondence address. Tel/Fax: +34-91-336-9029; E-mail: hescobarm.hrc{at}salud.madrid.org

BACKGROUND: We evaluated carotid intima-media thickness (CIMT) as an early marker of atherosclerosis, as well as its main determinants among androgen excess, obesity and insulin resistance, in patients with polycystic ovary syndrome (PCOS).

METHODS: We selected 40 PCOS patients and 20 non-hyperandrogenic women who were similar in terms of age and grade of obesity. Complete clinical, metabolic and hormonal profiles and left common CIMT measurements were obtained.

RESULTS: Patients with PCOS presented with increased mean CIMT values when compared with controls (F = 8.575; P = 0.005), and this was independent of obesity. Five PCOS patients but no controls had increased CIMT values. CIMT correlated directly with serum total and free testosterone, androstenedione and dehydroepiandrosterone-sulfate levels and mean 24-h heart rate (HR), and inversely with the insulin sensitivity index (ISI), but no correlation was observed with the body mass index (BMI). Multiple stepwise linear regression models showed that in PCOS patients, the main determinants of CIMT were serum total testosterone or androstenedione concentrations, with no influence of ISI or the mean 24-h HR.

CONCLUSIONS: Compared with control women, PCOS patients present with an increased CIMT, independent of obesity and related directly to androgen excess; this suggests that hyperandrogenism is associated with atherosclerosis and cardiovascular risk in these women.

Key words: hyperandrogenism/androgen excess/obesity/insulin resistance/atherosclerosis

Submitted on June 7, 2007; resubmitted on August 7, 2007; accepted on September 11, 2007.


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