Endothelial function and its relationship to leptin, homocysteine, and insulin resistance in lean and overweight eumenorrheic women and PCOS patients: a pilot study

Objective: To verify if patients with polycystic ovarian syndrome (PCOS), have an increased cardiovascular fisk compared with healthy controls. Design: Prospective case-control study. Setting: University-based practice. Patient(s): Twenty eumenorrheic controls (ten lean [,group A] and ten overweight [group BJ) and 24 PCOS women (14 lean [group C] and ten overweight [group D]). Intervention(s): Cardiovascular risk markers and hormonal parameters were assessed. Main Outcome Measure(s): Androgens, fasting glucose, insulin, leptin, fibrinogen, homocysteine, endothelin-1 and flow-mediated dilatation of the brachial artery were measured to investigate their relationship to weight and to PCOS. Result(s): The brachial artery diameter and the pulsatility index, after the reactive hyperemia, showed in group A the most intense vasodilatation compared with the other groups. Homocysteine levels did not differ among the groups. Endothelin-1 was significantly higher in group A compared with groups B and D. Leptin was significantly lower in groups A and C compared with groups B and D. Insulin resistance was higher in groups B and D. Group A had significantly higher glucose-insulin ratio compared with all of the other groups; group C had significantly higher glucose-insulin ratio only compared with group D. Conclusion(s): Weight and PCOS are two independent variables affecting the endothelial function. (Fertil Steril (R) 2009;91:2537-44. (c) 2009 by American Society for Reproductive Medicine.)