Serum aldosterone concentration and cardiovascular risk in women with polycystic ovarian syndrome

Context: Polycystic ovary syndrome ( PCOS) is associated with early impairment of vascular structure and a low- grade chronic inflammation. Aldosterone is a well- recognized cardiovascular risk ( CVR) factor and is related to inflammatory processes. Objective: Our objective was to investigate serum aldosterone levels in PCOS and correlate them to some CVR factors and early atherosclerotic markers. Design and Setting: A prospective baseline- controlled clinical study was conducted at the University Federico II of Naples School of Medicine ( Naples, Italy). Patients: Fifty PCOS women age- and body mass index- matched with 50 healthy women were enrolled. Mean Outcome Measures: Anthropometric, hormonal, and metabolic patterns, including plasma aldosterone, renin, and C- reactive protein, were measured in each subject. Intima-media thickness was also evaluated in each patient and control. Results: Aldosterone levels were significantly increased ( P < 0.001) in PCOS compared with healthy women ( 10.5 +/- 3.2 vs. 5.7 +/- 2.5 ng/dl). In PCOS, a significant ( P < 0.001) direct correlation between plasma aldosterone and homeostasis model assessment, C- reactive protein, intima- media thickness, and mean blood pressure was found. On the other hand, high- density lipoprotein cholesterol and potassium were inversely ( P < 0.001) related to serum aldosterone. Multiple linear regression analysis showed that the area under the curve for insulin and homeostasis model assessment was linearly related to aldosterone in PCOS. Conclusion: PCOS women show an insulin resistance related increase in serum aldosterone levels.