IJCS | Volume 32, Nº1, January/ February 2019

5 Table 1 - Clinical and demographic characteristics of patients with polycystic ovarian syndrome (PCOS) (n = 52) Control (n = 29) PCOS (n = 23) p value Age (years) 29 ± 1 28 ± 1 0.399 BMI (kg/m 2 ) 28.6 ± 0.7 28.9 ± 0.7 0.809 Waist circumference (cm) 91 ± 1 95 ± 2 0.156 Systolic BP (mmHg) 116 ± 2 118 ± 2 0.640 Diastolic BP (mmHg) 72 ± 1 73 ± 2 0.633 Insulin (mcU/mL) 14.3 ± 1.7 14.1 ± 1.3 0.934 Glucose (mg/dL) 86 ± 2 87 ± 1 0.671 HOMA–IR 3.1 ± 0.4 3.0 ± 0.3 0.802 HOMA-Beta 241 ± 44 251 ± 34 0.866 Total cholesterol (mg/dL) 188 ± 10 178 ± 7 0.452 LDL-cholesterol (mg/dL) 120 ± 9 104 ± 6 0.150 HDL-cholesterol (mg/dL) 52 ± 3 49 ± 2 0.521 Triglycerides (mg/dL) 104 ± 10 122 ± 14 0.334 Testosterone (ng/dL) 28 ± 5 47 ± 7 0.052 DHEAS (mmol/liter) 190 ± 38 170 ± 21 0.623 BMI: body mass index; BP: blood pressure; HOMA: homeostatic model assessment; LDL: low-density lipoprotein; HDL: high density lipoprotein; DHEAS: dehydroepiandrosterone sulphate. Between-group differences were analyzed using unpaired Student’s t-test, considering a significance level of 5% and a two-tailed probability. Values expressed as mean ± standard error. Burlá et al. Vascular changes in polycystic ovarian syndrome Int J Cardiovasc Sci. 2019;32(1)3-9 Original Article FMDwas calculated as the percentage change of brachial artery diameter from baseline. Pulse wave velocity The same investigator measured the carotid-femoral PWV using a Complior device (Alam Medical, France) after the patients had rested for 10 minutes in supine position in a quiet room with a stable temperature. 8 All measurements were performed between 8 a.m. and 11 a.m. During the measurements, speaking or sleeping was not allowed, and no meal, caffeine or smoking was allowed within 3h before measurement. Pulse waveforms were obtained transcutaneously from the right common carotid artery and femoral artery. Aortic PWV was calculated by dividing the distance traveled (DT) by the transit time (TT). TT was obtained by measuring the time difference between the arrival of the pulse wave at the femoral and at carotid arteries. DT was measured using a tape measure and estimated as 80% of the distance between carotid and femoral arteries. Carotid-femoral PWV was calculated as DT in meters divided by TT in seconds (PWV = DT/TT). The mean of two measurements was calculated and when the difference between them was more than 0.5 m/s, a third measurement was obtained. All PWV values were adjusted by mean arterial pressure (MAP) to obtain normalized PWV (PWV norm) as 100 x (PWV/MAP). Central hemodynamic parameters Applanation tonometry was performed with the SphygmoCor system (Atcor Medical, Sydney, Australia) with the patient in the sitting position, resting the arm on a rigid surface, and a sensor in the radial artery. 20 Central aortic pressure was calculated from the radial pulse wave analysis with the use of a validated transfer function. Wave reflection parameters, such as augmentation pressure (AP) and augmentation index (AIx), were also obtained by this method. Statistical analysis Continuous variables were expressed as mean ± standard error and categorical variables were described as absolute numbers and/or percentages. Kolmogorov- Smirnov test showed normal distribution of the variables. Differences between the two study groupswere evaluated with unpaired Student’s t-tests for continuous variables. All tests were performed considering a significance level of 5% and a two-tailed probability. Based on a recent study, 12 assuming a 5% level of significance and 85% power, we estimated 18 patients in each group to detect 4% difference in FMD between the groups and 4% standard deviation.12 Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 18.0 for Windows (SPSS, Chicago, IL). Results Fifty-two patients were included, 29 (56%) in PCOS group and 23 (44%) in control group. The demographics and clinical characteristics of study patients are presented in Table 1. Clinical and laboratorial parameters were similar between the groups. No cases of acne, alopecia,