Journal
VASCULAR MEDICINE
Volume 22, Issue 2, Pages 85-95Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1358863X16682107
Keywords
carotid intima-media thickness; cholesterol; obesity; pediatrics; polycystic ovarian syndrome; risk factors
Categories
Funding
- KJN: NCRR [K23 RR020038-01]
- NIH/NCRR Colorado CTSI Co-Pilot Grant [TL1 RR025778]
- NIH/NIDDK [1R56DK088971-01, JDRF-5-2008-291, ADA 7-11-CD-08]
- MCG: AHA [13CRP 14120015]
- Thrasher Pediatric Research Foundation Mentored Pilot Grant
- Pediatric Endocrinology Society Fellowship
- Endocrine Society Fellowship in Women's Health
- NIDDK [T32 DK063687]
- BIRCWH [K12HD057022]
- Adult CTRC NIH Grant [M01-RR00051]
- Pediatric CTRC NIH Grant [5MO1-RR00069]
- NIH/NCRR Colorado CTSI Grant [UL1 RR025780]
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Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24 +/- 1.86 mg/kg/min vs 9.10 +/- 2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima-media thickness (cIMT) (0.49 +/- 0.07 mm vs 0.44 +/- 0.06; p=0.038), beta stiffness index (5.1 +/- 1.3 U vs 4.4 +/- 0.9; p=0.037), and reduced arterial compliance (1.95 +/- 0.47 mm(2)/mmHg x 10(-1) vs 2.13 +/- 0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68 +/- 28 mu mol/mL vs 41 +/- 10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are 'normal'. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development.
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