Assessment of Endothelium-dependent and Independent Vasodilation of Brachial Artery in Polycystic Ovary Syndrome

Abstract

Objective: The endothelium plays an important role in the regulation of vascular tone. Arterial distensibility is a marker of functional and structural wall properties. A decreased distensibility is an important risk factor for cardiovascular disease. Hyperandrogenism may be related to impaired systemic arterial vascular compliance. In this study, using a non-invasive ultrasonography method, we investigated endothelium dependent and endothelium independent vasodilation in the brachial artery of the patients with polycystic ovary syndrome (PCOS). Materials and Methods: Fourteen hyperandrogenemic patients with PCOS and 18 healthy age and BMI matched controls were included in the study. Serum DHEAS, androstenedione, total and free testosterone levels were measured for the diagnosis of hyperandrogenism. Brachial artery diameter was measured at baseline, during post-occlusion reactive hyperaemia (flow-mediated, endothelium dependent dilation), and after 400 µg glyceryl trinitrate sublingually (endothelium-independent dilation). Vasodilation was expressed as the percentage change relative to the baseline diameter. Results: Baseline flow and blood pressure were similar in the patients with PCOS and healthy subjects. Baseline vessel diameter (mm) was not statistically different between the patients with PCOS (3.2±0.3) and control group (3.1±0.4). Endothelium dependent dilation in PCOS patients (7.8±5.4%) was significantly (p<0.05) lower than in control subjects (14.9±7.9%). Endothelium-independent dilation in PCOS patients (10.8±4.2%) was also significantly (p<0.01) lower than in controls subjects (20.3±9.9%). Conclusion: The results of this study suggest that the patients with PCOS have impaired endothelium-dependent and independent vasodilation and it could be determined non-invasive methods. Key words: Polycystic Ovary Syndrome; Hyperandrogenism; Brachial Artery; Vasodilation.

Keywords

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Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+

Öz

Amaç: Endotel vasküler tonusun düzenlenmesinde önemli bir rol oynar. Arteryel esneklik fonksiyonel ve yapısal duvar özelliklerinin bir göstergesidir. Azalmış esneklik kardiyovasküler hastalıklar için önemli bir risk faktörüdür. Hiperandrojenizm sistemik arteryel kompliyans bozukluğu ile ilgili olabilir. Bu çalışmada, non invaziv ultrasonografi yöntemi kullanarak polikistik over sendromlu (PKOS) kadınlarda brakiyal arterde endotel bağımlı ve endotel bağımsız vazodilatasyonu araştırdık. Gereç ve Yöntem: Ondört PKOS'lu hiperandrojenemik kadın ile yaş ve vücut kitle indeksi uyumlu 18 olguluk sağlıklı kontrol grubu çalışmaya alındı. Hiperandrojenizm tanısı için serum DHEAS, androstenedion, total ve serbest testosteron düzeyleri ölçüldü. Brakiyal arter çapı başlangıçta, tıkanık sonrası reaktif hiperemi (akım aracılı, endotel bağımlı dilatasyon) ile dilaltı 400 mikrogram gliseril trinitrat sonrasında (endotel bağımsız dilatasyon) ölçüldü. Vazodilatasyon başlangıç çapına göreceli olarak yüzde değişim olarak ifade edildi. Bulgular: Başlangıç akımı ve kan basıncı PKOS'lu kadınlarda ve sağlıklı kontrollerde benzerdi. Başlangıç damar çapı (mm) PKOS'lu kadınlarla (3,2±0,3) kontrol grubu (3,1±0,4) arasında istatistiksel olarak farklı değildi. Akım aracılı dilatasyon PKOS'lu kadınlarda (%7,8±5,4) kontrol grubuna (%14,9±7,9) göre anlamlı olarak (p<0,05) daha düşüktü. PKOS'lu kadınlardaki (%10,8±4,2) endotel bağımsız dilatasyon da kontrol olgularına (%20,3±9,9) göre belirgin olarak (p<0,01) daha düşüktü. Sonuç: Bu çalışmanın sonuçları, PKOS'lu kadınlarda endotel bağımlı ve bağımsız vazodilatasyon bozukluğu olduğunu ve bunun noninvaziv yöntemlerle belirlenebileceğini ileri sürmektedir. Anahtar Sözcükler: Polikistik Over Sendromu; Hiperandrojenizm; Brakiyal Arter; Damar Genişlemesi.

Anahtar Kelimeler

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Kaynakça

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35. Bu makaleye atıf yapmak için: Baykara M, Gökçe
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