IJCS | Volume 32, Nº1, January/ February 2019

DOI: 10.5935/2359-4802.20180067 3 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(1)3-9 Mailing Address: Ana Rosa Cunha Rua Sérgio de Camargo, 123/306 - bl: 2. Postal Code: 22775-052, Jacarepaguá, RJ - Brazil. E-mail: anarosacunha@gmail.com , anarosacunha@yahoo.com.br Endothelial Dysfunction and Pulse Wave Reflection in Women with Polycystic Ovarian Syndrome Marcelo Burlá, 1 Ana Rosa Cunha, 1 R onaldo Gismondi, 2 Wille Oigman, 1 Mario Fritsch Neves, 1 Fernanda Medeiros 1 Universidade Federal do Estado do Rio de Janeiro - UNIRIO, 1 Rio de Janeiro, RJ - Brazil Universidade Federal Fluminense, 2 Niterói, RJ - Brazil Manuscript received August 24, 2017; revised manuscript December 18, 2017; accepted March 03, 2018. Abstract Background: Patients with polycystic ovarian syndrome (PCOS) have an increased prevalence of metabolic syndrome and traditional atherosclerotic risk factors, such as dyslipidemia, diabetes and hypertension. Endothelial function and vascular stiffness are surrogate markers of early atherosclerosis, able to predict cardiovascular events. Objective: To compare endothelial function and pulse wave reflection betweenwomenwith PCOS and healthy controls. Methods: Observational and cross-sectional study that included women with PCOS, age between 18 and 40 years-old and body mass index between 25.0 and 35.0 kg/m 2 , and healthy controls. Rotterdan criteria was used to diagnose PCOS. Subjects underwent clinical and anthropometric evaluation, laboratory and hormonal assays and imaging tests to measure pulse wave velocity (PWV), augmentation index (AIx) and brachial artery flow-mediated vasodilation (FMD). Kolmogorov-Smirnov test showed normal distribution of most parameters. Unpaired Student t-test was used with significance level established at p < 0.05. Results: A total of 52 patients were included, 29 (56%) in PCOS group and 23 (44%) in control group. Clinical and laboratory parameters were similar between the groups. Women with PCOS had lower FMD (8.8 ± 1.0 vs 12.8 ± 1.2%, p = 0.021); PWV and AIx were similar between the groups (7.5 ± 0.2 vs 7.5 ± 0.3 m/s, p = 0.671 and 21.0 ± 1 vs. 20 ± 2%, p = 0.716, respectively). In the PCOS group, women with higher testosterone levels had higher AIx (25 ± 2 vs. 17 ± 3%, p = 0.045). Conclusions: PCOS women had endothelial dysfunction and those with higher testosterone levels had higher pulse wave reflection as compared with controls. (Int J Cardiovasc Sci. 2019;32(1)3-9) Keywords: Endothelium, Vascular; Vascular,Stiffness; Metabolic Syndrome; Polycistic Ovary Syndrome; Insulin Resistance; Testosterone. Introduction Polycystic ovary syndrome (PCOS) is one of the most common metabolic disorders in women, with an estimated prevalence of 5 to 15%. 1 The cardinal features of the syndrome encompass hyperandrogenism, ovulatory dysfunction, and/or polycystic ovaries on ultrasound. Obesity, insulin resistance and metabolic syndrome are closely related to PCOS. A recent meta-analysis observed a higher risk of metabolic syndrome inwomenwith PCOS (OR 2.88, 95%CI 2.40-3.45), as well as glucose intolerance and diabetes mellitus (DM). 2 The occurrence of metabolic disorders is also elevated in non-obese PCOS patients, suggesting that the presence of the syndrome per se may favor the development of metabolic comorbidities. 3 In addition, women with PCOS have an increased prevalence of traditional atherosclerotic risk factors, such as dyslipidemia, DM and hypertension. 3,4 The present study aims to evaluate if parameters indicative of early atherosclerosis are also observed in patients with PCOS.