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A comparison of cardiovascular risk indices in patients with polycystic ovary syndrome with and without coexisting nonalcoholic fatty liver disease

Dawson, Alison J.; Sathyapalan, Thozhukat; Smithson, Jacqueline A. J.; Vince, Rebecca V.; Coady, Anne-Marie; Ajjan, Ramzi; Kilpatrick, Eric S.; Atkin, Stephen L.

Authors

Alison J. Dawson

Thozhukat Sathyapalan

Jacqueline A. J. Smithson

Anne-Marie Coady

Ramzi Ajjan

Eric S. Kilpatrick

Stephen L. Atkin



Abstract

Background
Women with polycystic ovary syndrome (PCOS) have an adverse cardiovascular risk profile and an increased prevalence of nonalcoholic fatty liver disease (NAFLD), which is also associated with an adverse cardiovascular risk profile.

Objective
To compare the cardiovascular risk profile of women with PCOS alone and women with PCOS and NAFLD.

Design, Setting and Participants
Twenty‐five oligoanovulatory women with PCOS were screened for NAFLD (including liver biopsy if appropriate) and had their cardiovascular risk factors measured which included the inflammatory marker C‐reactive protein (CRP), endothelial function {measured using endoPAT 2000 and serum markers [intracellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), E‐selectin and P‐selectin]}, clot structure and function [maximum absorbance (MA) and lysis potential (LT)].

Results
Twelve patients had confirmed PCOS without evidence of NAFLD, and 13 patients had confirmed PCOS with evidence of NAFLD. The PCOS and NAFLD group were heavier (BMI 43·9 ± 2·2 kg/m2) compared with the PCOS alone group (BMI 37·6 ± 1·4 kg/m2 P = 0·03). There was no difference in CRP (7·57 ± 0·95 vs 6·59 ± 1·87 mm P = 0·62) or endothelial function (RH‐PAT 1·96 ± 0·1 vs 1·74 ± 0·16 P = 0·25), ICAM‐1 (221 ± 48 vs 250 ± 60 ng/ml P = 0·19), VCAM‐1 (2124 ± 78 vs 2314 ± 91 ng/ml P = 0·13), E‐selectin (33·9 ± 3·3 vs 39·5 ± 15·5 ng/ml P = 0·31) and P‐selectin (101·0 ± 6·6 vs 95·9 ± 10·2 ng/ml P = 0·69). There was no difference in clot formation or lysis.

Conclusion
The patients with PCOS and NAFLD were heavier compared with patients with PCOS alone. Despite this, we were unable to demonstrate differences in inflammatory markers, endothelial function or clot structure and function, suggesting that severity of steatosis is not the most important determinant of cardiovascular risk in PCOS.

Journal Article Type Article
Publication Date 2014-06
Journal Clinical Endocrinology
Print ISSN 0300-0664
Electronic ISSN 1365-2265
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 80
Issue 6
Pages 843-849
APA6 Citation Dawson, A. J., Sathyapalan, T., Smithson, J. A. J., Vince, R. V., Coady, A., Ajjan, R., …Atkin, S. L. (2014). A comparison of cardiovascular risk indices in patients with polycystic ovary syndrome with and without coexisting nonalcoholic fatty liver disease. Clinical Endocrinology, 80(6), 843-849. https://doi.org/10.1111/cen.12258
DOI https://doi.org/10.1111/cen.12258
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1111/cen.12258
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