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Balık AÖ, Vural F, Alpogan O, Özoğul M, Dönmez EE. The effects of testosterone on transgender males on carotid intima-media thickness and serum inflammatory markers compared within patients with polycystic ovary syndrome. Gynecol Endocrinol 2022; 38:771-775. [PMID: 35989584 DOI: 10.1080/09513590.2022.2112942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Objective: To evaluate the effects of testosterone on carotid intima-media thickness (CIMT) and serum inflammatory markers compared within transgender males (TGM-Former called female-to-male) and polycystic ovary syndrome (PCOS).Methods: The prospective observational study included 30 TGM, 30 patients with PCOS, and 30 healthy women. Groups were compared for CIMT and hematologic inflammatory markers white blood cell (WBC), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV).Results: The CIMT of the TGM group was 0.48 ± 0.09 mm was significantly higher than PCOS (0.41 ± 0.09 mm, p = .005) and the control group (0.38 ± 0.7 mm, p = .001). The mean NLR, LMR, and MPV values were similar (p > .05). TGM had higher WBC levels compared to control women (p = .029). TGM had significantly lower PLR compared to PCOS and the control group (p = .001). CIMT were related to age (r = .390, p = .04) and body mass index (BMI) (r = .392, p = .03) in TGM.Conclusion: Increased CIMT in TGM individuals is not associated with inflammation; it seems to be a deleterious effect of exogenous testosterone exposure. Since increased CIMT may be a sign of serious cardiovascular problems developing in the future, it is suggested that it will be beneficial for these individuals should undergo clinical and radiological evaluation at regular intervals.
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Affiliation(s)
- Ayşe Özlem Balık
- Department of Radiology, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Fisun Vural
- Department of Obstetrics and Gynecology, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Okşan Alpogan
- Department of Ophtalmology, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Murat Özoğul
- Department of Radiology, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Emin Erhan Dönmez
- Department of Obstetrics and Gynecology, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
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Sun D, Wu Y, Ding M, Zhu F. Comprehensive Meta-Analysis of Functional and Structural Markers of Subclinical Atherosclerosis in Women with Polycystic Ovary Syndrome. Angiology 2022; 73:622-634. [PMID: 35258380 DOI: 10.1177/00033197211072598] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The relationship between polycystic ovary syndrome (PCOS) and subclinical atherosclerosis remains unclear. We performed a comprehensive systematic review and meta-analysis to evaluate the effect of PCOS on functional and structural markers of subclinical atherosclerosis as measured by carotid intima-media thickness (cIMT), flow-mediated vasodilation (FMD), nitroglycerin-mediated vasodilation (NMD), pulse wave velocity (PWV), and coronary artery calcium (CAC). Standard mean differences (SMDs) or odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated. Ninety-six articles involving 5550 PCOS patients and 5974 controls were included. Compared with controls, PCOS patients showed significantly thicker cIMT (SMD (95% CI) = .587 (.398, .776), P < .001), lower FMD (SMD (95% CI) = -.649 (-.946, -.353), P < .001) and NMD (SMD (95% CI) = -.502 (-.686, -.317), P < .001), as well as higher PWV (SMD (95% CI) = .382 (.019, .746), P = .039), and increased CAC incidence (OR (95% CI) = 2.204 (1.687, 2.879), P < .001). When analyzing subgroups by age and body mass index (BMI), results were still significant (P < .05) except for PWV in the BMI subgroup. There was no significant result on sensitivity analysis, and Begg' test or Egger's test. PCOS contributes to subclinical atherosclerosis, resulting in functional and structural changes in cIMT, FMD and NMD, PWV, and CAC incidence.
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Affiliation(s)
- Dandan Sun
- Department of Cardiovascular Ultrasound, 159408The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, China
| | - Yupeng Wu
- Department of Neurosurgery, 159408The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, China
| | - Mingyan Ding
- Department of Cardiovascular Ultrasound, 159408The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, China
| | - Fang Zhu
- Department of Cardiovascular Ultrasound, 159408The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, China
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Garoufi A, Pagoni A, Papadaki M, Marmarinos A, Karapostolakis G, Michala L, Soldatou A. Cardiovascular Risk Factors and Subclinical Atherosclerosis in Greek Adolescents with Polycystic Ovary Syndrome: Its Relationship with Body Mass Index. CHILDREN 2021; 9:children9010004. [PMID: 35053629 PMCID: PMC8773958 DOI: 10.3390/children9010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and subclinical atherosclerosis through measurements of carotid intima–media thickness (cIMT). The relationships of the above markers with increased body mass index and abdominal obesity were investigated. Twenty-three adolescents (72%) were overweight (OW) or obese (OB). The OW/OB group had significantly higher insulin, HOMA-IR, high-sensitive C-reactive protein (hsCRP), visceral adiposity index (VAI), and lipid accumulation product (LAP) levels; and lower glucose-per-insulin ratios and HDL-C levels compared to the healthy weight group. The cIMT and small dense low-density lipoprotein cholesterol (sdLDL-C) levels did not differ between the two groups. Similarly, cIMT and sdLDL-C levels did not differ between PCOS-adolescents and healthy controls. CIMT was positively correlated with systolic blood pressure and waist circumference per height ratio. In conclusion, OW/OB PCOS-adolescents have a cluster of adverse factors predisposing them to atherosclerotic cardiovascular disease. Therefore, early cardiovascular risk assessment, as well as timely and targeted interventions, are necessary for prevention.
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Affiliation(s)
- Anastasia Garoufi
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
| | - Athanasia Pagoni
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
| | - Maria Papadaki
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry—Molecular Diagnostic, 2nd Department of Pediatrics, Medical School, NKUA, “P. & A. Kyriakou” Children’s Hospital, 11527 Athens, Greece;
| | - Georgios Karapostolakis
- Radiology Department, 401 Military General Hospital of Athens (MGHA), 138 Mesogeion Av., 11525 Athens, Greece;
| | - Lina Michala
- First Department of Obstetrics and Gynaecology, Medical School, Alexandra General Hospital, National and Kapodistrian University of Athens (NKUA), 80 Vassilissis Sofias Av., 11528 Athens, Greece;
| | - Alexandra Soldatou
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
- Correspondence:
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Jabbour R, Ott J, Eppel W, Frigo P. Carotid intima-media thickness in polycystic ovary syndrome and its association with hormone and lipid profiles. PLoS One 2020; 15:e0232299. [PMID: 32330202 PMCID: PMC7182264 DOI: 10.1371/journal.pone.0232299] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/11/2020] [Indexed: 12/12/2022] Open
Abstract
Objective Polycystic ovary syndrome (PCOS) has been associated with an increased risk of metabolic disturbances and cardiovascular disease. Intima-media thickness of the common carotid artery (CIMT) represents a valid surrogate marker of early systemic atherosclerosis. This study aimed to investigate if CIMT is increased in PCOS patients compared to healthy controls and if there is an association with hormone and metabolic profiles. Methods In this prospective cross-sectional study, past medical history, anthropometrical measurements and hormonal, lipidemic and glycemic parameters were obtained in 41 PCOS patients and 43 age-matched healthy controls of similar body mass index (BMI) and frequency of smokers. B-mode ultrasound enabled CIMT measurement at the far wall of the left and right common carotid artery. Results Patients with PCOS showed significantly increased CIMT values compared to healthy controls (0.49±0.04mm vs. 0.37±0.04mm respectively, P<0.001). They featured a generally increased cardiovascular risk profile. Correlation analysis showed a positive association between CIMT and the adverse metabolic risk profile. The diagnosis of PCOS was the strongest predictor of CIMT, even after multiple adjustments for BMI, age and smoking status (β = 0.797, P<0.001, R2 = 0.73). A model among oligomenorrhoic patients revealed a relationship between CIMT and the suspected duration of disease (β = 0.373, P = 0.021, R2 = 0.14). Conclusions PCOS patients are likely to feature signs of premature systemic atherosclerosis at a young age. Early exposure to adverse cardiovascular risk factors may possibly have long-term consequences on the vascular system. An early vessel screening might thus already be beneficial in these patients at a younger age.
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Affiliation(s)
- Rhea Jabbour
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Johannes Ott
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Eppel
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Peter Frigo
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
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Association of the HSD11B1rs12086634(T/G) gene polymorphism and IL6 serum level with the risk of polycystic ovary syndrome. Meta Gene 2020. [DOI: 10.1016/j.mgene.2019.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Polycystic ovary syndrome and cardiometabolic risk: Opportunities for cardiovascular disease prevention. Trends Cardiovasc Med 2019; 30:399-404. [PMID: 31519403 DOI: 10.1016/j.tcm.2019.08.010] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/18/2019] [Accepted: 08/29/2019] [Indexed: 12/21/2022]
Abstract
Although polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women, its etiology is not entirely understood. Clinical symptoms of PCOS include acne, amenorrhea or oligomenorrhea, hirsutism, infertility, and mood disorders, which tend to be the primary focus of clinical management. However, the impact of PCOS on future cardiovascular disease (CVD) risk should not be overlooked, and opportunities to implement CVD prevention strategies in these women should be given high priority. The pathogenesis of PCOS commonly involves insulin resistance which leads to several cardiometabolic abnormalities (e.g., dyslipidemia, hypertension, glucose intolerance, diabetes, and metabolic syndrome), thereby putting women at an increased risk for CVD. Prior studies have found that subclinical CVD markers such as coronary artery calcium scores, C-reactive protein, carotid intima-media thickness, and endothelial dysfunction are more likely to be increased in women with PCOS. While the associations between PCOS and cardiometabolic abnormalities have been well established, whether PCOS is associated with subclinical and clinical CVD, independently of these CVD risk factors, is not entirely clear. Lifestyle interventions and weight management may mitigate some of these future CVD risks and should be encouraged. This review summarizes the literature on PCOS and CVD risk factors and provides recommendations that would aid clinicians in the management of these risk factors.
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Kumar AN, Naidu JN, Satyanarayana U, Ramalingam K, Anitha M. Metabolic and Endocrine Characteristics of Indian Women with Polycystic Ovary Syndrome. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:22-8. [PMID: 27123196 PMCID: PMC4845525 DOI: 10.22074/ijfs.2016.4764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 12/31/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrinological disorders among women of reproductive age and the leading cause of female infertility. This study intends to evaluate the lipid profile, hormonal levels [free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), insulin, luteinizing hormone (LH), follicle stimulating hormone (FSH), and prolactin] in PCOS women from Nellore and its surrounding districts of Andhra Pradesh, India. MATERIALS AND METHODS This cross-sectional study included 80 newly diagnosed PCOS women and an equal number of age and body mass index (BMI) matched healthy controls. We used the photometry methods to determine serum glucose levels and the lipid profile. An immunoturbidometry method was employed to measure high sensitive C-reactive protein (hsCRP). All hormonal parameters were measured using chemiluminescence immunoassays. Insulin resistance was evaluated using the homeostatic model assessment-insulin resistance (HOMA-IR) method. Statistical analysis was done using SPSS software version 20.0. RESULTS The PCOS patients presented statistically higher levels of total cholesterol (TC), triglycerides (TG) and low density lipoprotein cholesterol (LDL-c, P<0.0001) when compared to those of controls. PCOS patients had elevated fasting glucose, hsCRP, fasting insulin, TSH, LH and prolactin levels (P<0.001). An increased LH/FSH ratio (>1.5) was seen in women with PCOS compared with control women. In addition, we observed a direct correlation between fasting insulin with fasting glucose and HOMA-IR. LH was inversely proportional to BMI. CONCLUSION The present study showed a higher prevalence of insulin resistance, dyslipidemia, and hypothyroidism in PCOS women. Furthermore this study showed increased LH concentrations, a higher LH/FSH ratio, and higher prolactin levels in PCOS women.
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Affiliation(s)
- Amar Nagesh Kumar
- Department of Biochemistry, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - Jupalle Nagaiah Naidu
- Department of Biochemistry, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - Uppala Satyanarayana
- Department of Biochemistry, Dr Pinnamaneni Siddartha Institute of Medical Sciences, Gannavaram, Andhra Pradesh, India
| | - Krishnan Ramalingam
- Department of Biochemistry, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - Medabalmi Anitha
- Department of Obstetrics and Gynecology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
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Meyer ML, Malek AM, Wild RA, Korytkowski MT, Talbott EO. Carotid artery intima-media thickness in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2011; 18:112-26. [PMID: 22108382 DOI: 10.1093/humupd/dmr046] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder associated with cardiovascular disease (CVD) risk factors and metabolic disturbances. This systematic review and meta-analysis was conducted to determine whether carotid intima-media thickness (CIMT), a marker of subclinical atherosclerosis, is higher in women with PCOS compared with women without PCOS. METHODS Primary articles reporting the mean CIMT in women with PCOS and controls were identified using Ovid MEDLINE, EMBASE and PUBMED. We performed a random-effects meta-analysis and created forest plots of the mean difference in CIMT and conducted tests for heterogeneity and publication bias. Studies were grouped by quality, defined by reporting reproducibility of CIMT and averaging both common carotid arteries versus one side for CIMT. RESULTS From the 36 eligible full-text studies, 8 studies were included in the systematic review and 19 studies were included in the meta-analysis (total n= 1123 women with PCOS, n= 923 controls). The summary mean difference in CIMT among women with PCOS compared with controls was 0.072 mm [95% confidence interval (CI) 0.040, 0.105, P < 0.0001] for highest quality studies, 0.084 mm (95% CI 0.042, 0.126, P = 0.0001) for good quality studies, 0.041 (95% CI -0.038, 0.120, P = 0.310) for fair-quality studies and 0.045 (95% CI -0.020, 0.111, P = 0.173) for lower quality studies. CONCLUSIONS Larger studies with a well-defined PCOS population using rigorous methodology may be required to draw a more robust conclusion. However, these results suggest women with PCOS are at a greater risk of premature atherosclerosis, which emphasizes the importance of screening and monitoring CVD risk factors in women with PCOS.
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Affiliation(s)
- Michelle L Meyer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Bank of America Center, Chapel Hill, NC 27514, USA.
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