Cardiovascular risk factors in polycystic ovary syndrome; the relationship of dyslipidemia and obesity

Year 2021, , 526 - 531, 05.09.2021

Şefik Gökçe , Dilşad Herkiloğlu

https://doi.org/10.32322/jhsm.901791

Abstract

Aim: The abnormal endocrinological picture that occurs in polycystic ovary syndrome (PCOS) has been shown to affect many systems and can lead to a wide variety of complications. In our study, it was aimed to examine hormone levels, obesity, serum lipid levels and hematological parameters in adult women with PCOS.
Material and Methods: The present study included 62 patients diagnosed with PCOS and 45 healthy women. Demographic data and laboratory results of all women were collected them from hospital automation system records and were analyzed.
Results: The mean body mass index (BMI) (p=0.041), total cholesterol (p=0.038), triglyceride (p=0.022) and very low density lipoprotein (VLDL) cholesterol (p=0.003) levels in the patient group were significantly higher than the control group. In the patient group, anti-Müllerian hormon (AMH) (p<0.001), total testosterone (p<0.001) and free testosterone (p<0.001) were significantly higher than the control group, and follicle-stimulating hormon (FSH) was significantly lower (p<0.001).
The rate of women (57.6%) with BMI value ≥25 kg/m2 in the patient group was significantly higher than the control group (35.6%) (p=0.026). In addition, having a BMI value of ≥25 kg/m2 had 2.47-fold (odds ratio; 1.11-5.48) higher risk for PCOS development.
Conclusion: In our study, it was concluded that obesity plays a role in the development of PCOS, that the level of AMH in PCOS patients increases significantly enough to gain a diagnostic value, that a significant dyslipidemia develops in PCOS, and this might be a risk for the development of cardiovascular disease in the future.

Keywords

Polycystic ovarian syndrome (PCOS), anti-Mullerian hormone, body mass index, dyslipidemia, cholesterol.

Project Number

Yok

References

• McCartney CR, Marshall JC. Clinical Practice. Polycystic Ovary Syndrome N Engl J Med 2016; 375: 54-4.
• Meier RK. Polycystic Ovary Syndrome. Nurs Clin North Am 2018; 53: 407-20.
• Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome Endocrinol Metab Clin North Am 2014; 43: 123-47.
• Rothenberg SS, Beverley R, Barnard E, Baradaran-Shoraka M, Sanfilippo JS. Polycystic ovary syndrome in adolescents. Best Pract Res Clin Obstet Gynaecol 2018; 48: 103-14.
• Li L, Feng Q, Ye M, He Y, Yao A, Shi K. Metabolic effect of obesity on polycystic ovary syndrome in adolescents: a meta-analysis. J Obstet Gynaecol 2017; 37: 1036-47.
• Bani Mohammad M, Majdi Seghinsara A. Polycystic ovary syndrome (PCOS), diagnostic criteria, and AMH. Asian Pac J Cancer Prev 2017; 18: 17-21.
• Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91: 941-5.
• Wild RA, Rizzo M, Clifton S, Carmina E. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril 2011; 95: 1073-9.
• Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Front Biosci (Elite Ed) 2014; 6: 104-19.
• Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: etiology, pathogenesis and diagnosis. Nat Rev Endocrinol 2011; 7: 219-231.
• Łebkowska A, Kowalska I. Anti-Müllerian hormone and polycystic ovary syndrome. Endokrynol Pol 2017; 68: 74-8.
• Bani Mohammad M, Majdi Seghinsara A. Polycystic ovary syndrome (PCOS), diagnostic criteria, and AMH. Asian Pac J Cancer Prev 2017; 18: 17-21.
• Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91: 941-5.
• Feldman RA, O’Neill K, Butts SF, Dokras A. Antimüllerian hormone levels and cardiometabolic risk in young women with polycystic ovary syndrome. Fertil Steril 2017; 107: 276-81.
• Tata B, Mimouni NEH, Barbotin AL, et al. Elevated prenatal anti-Müllerian hormone reprograms the fetus and induces polycystic ovary syndrome in adulthood. Nat Med 2018; 24: 834-6.
• Karakas SE. New biomarkers for diagnosis and management of polycystic ovary syndrome. Clin Chim Acta 2017; 471: 248-53.
• Bhide P, Dilgil M, Gudi A, Shah A, Akwaa C, Homburg R. Each small antral follicle in ovaries of women with polycystic ovary syndrome produces more antiMullerian hormone than its counterpart in a normal ovary: an observational cross-sectional study. Fertil Steril 2015; 103: 537–41.
• Homburg R, Ray A, Bhide P, et al. The relationship of serum anti-Mullerian hormone with polycystic ovarian morphology and polycystic ovary syndrome: a prospective cohort study. Hum Reprod 2013: 28: 1077–83.
• Sahmay S, Atakul N, Aydogan B, Aydin Y, Imamoglu M, Seyisoglu H. Elevated serum levels of anti-Mullerian hormone can be introduced as a new diagnostic marker for polycystic ovary syndrome. Acta Obstet Gynecol Scand 2013; 92: 1369–74.
• Saikumar P, Selvi VK, Prabhu K, Venkatesh P, Krishna P. Anti Mullerian hormone: a potential marker for recruited non growing follicle of ovarian pool in women with polycystic ovarian syndrome. J Clin Diagn Res 2013; 7: 1866–9.
• Agapova SE, Cameo T, Sopher AB, Oberfield SE. Diagnosis and challenges of polycystic ovary syndrome in adolescence. Semin Reprod Med 2014; 32: 194–201.
• Elchuri SV, Patterson BC, Brown MR, Buchanan I, Mertens AC, Meacham LR. Anti-Mullerian hormone levels in American girls by age and race/ethnicity. J Pediatr Endocrinol Metab 2015; 28; 189–93.
• Koninger A, Koch L, Edimiris P, et al. Anti-Mullerian hormone: an indicator for the severity of polycystic ovarian syndrome. Arch Gynecol Obstet 2014; 290: 1023–30.
• Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 2009; 296: 238–43.
• Schiffner J, Roos J, Broomhead D, et al. Relationship between anti-Müllerian hormone and antral follicle count across the menstrual cycle using the Beckman Coulter Access assay in comparison with Gen II manual assay. Clin Chem Lab Med 2017; 55: 1025-33.
• Bentzen JG, Forman JL. Pinborg A, et al. Ovarian reserve parameters: a comparison between users and non-users of hormonal contraception. Reprod BioMed Online 2012; 25: 612–9.
• Kallio S, Puurunen J, Ruokonen A, Vaskivuo T, Piltonen T, Tapanainen JS. AntiMullerian hormone levels decrease in women using combined contraception independently of administration route. Fertil Steril 2013; 99: 1305–10.
• Su HI, Maas K, Sluss PM, Chang RJ, Hall JE, Joffe H. The impact of depot GnRH agonist on AMH levels in healthy reproductive-aged women. J Clin Endocrinol Metab 2013; 98: 1961–6.
• Wissing ML, Mikkelsen AL, Kumar A, et al. Associations of different molecular forms of antimüllerian hormone and biomarkers of polycystic ovary syndrome and normal women. Fertil Steril 2019; 112: 149-55.
• Fleming R, Harborne L, MacLaughlin DT, et al. Metformin reduces serum mullerian-inhibiting substance levels in women with polycystic ovary syndrome after protracted treatment. Fertil Steril 2005; 83: 130-6.
• De Kat AC, Verschuren WM, Eijkemans MJ, Broekmans FJ, van der Schouw YT. Anti-Müllerian hormone trajectories are associated with cardiovascular disease in women: results from the Doetinchem Cohort Study. Circulation 2017; 135: 556-65.
• Bozdag G, Yildiz BO. Interventions for the metabolic dysfunction in polycystic ovary syndrome. Steroids 2013; 78: 777-81.
• Glueck CJ, Goldenberg N. Characteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics. Metabolism 2019; 92: 108-20.
• Caldwell AS, Middleton LJ, Jimenez M, et al. Characterization of reproductive, metabolic, and endocrine features of polycystic ovary syndrome in female hyperandrogenic mouse models. Endocrinology 2014; 155: 3146-59.