Online first
Current issue
Archive
Special Issues
About the Journal
Publication Ethics
Anti-Plagiarism system
Instructions for Authors
Instructions for Reviewers
Editorial Board
Editorial Office
Contact
Reviewers
All Reviewers
2023
2022
2021
2020
2019
2018
2017
2016
General Data Protection Regulation (RODO)
REVIEW PAPER
Cardiovascular system diseases in patients with polycystic ovary syndrome – the role of inflammation process in this pathology and possibility of early diagnosis and prevention
1
Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Szczecin, Poland
Corresponding author
Aleksandra Marciniak
Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Szczecin, Poland
Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Szczecin, Poland
Ann Agric Environ Med. 2016;23(4):537-541
KEYWORDS
ABSTRACT
Polycystic ovary syndrome is a disorder which affects 5–10% of women in reproductive age. PCOS is a cause of hyperandrogenism, menstrual disorders and infertility. The most common clinical symptoms are hirsutism, acne and obesity. Patients often suffer from metabolic disorders: insulin resistance, hyperinsulinemia, dislipidemia, leading to atherosclerosis and others irregularities of the metabolic syndrome. Patients are in the high risk group for cardiovascular diseases (CVD) development because of the metabolic abnormalities. Obesity is observed in 35–60% of women with PCOS. Lean women with PCOS are also exposed to a greater risk of glucose intolerance development and abnormalities in lipid profile than women without PCOS with comparable BMI. Adipocytes are the source of many compounds of the paracrine and endocrine activity. Some of them are also markers and mediators of inflammation. Increased levels of proinflammatory cytokines in blood can promote atherosclerosis and cardiovascular disease. Markers: IL-18, TNF, IL-6 and hs-CRP are often elevated in patients with polycystic ovary syndrome. An increase in inflammatory markers may be an early indicator of the risk of developing insulin resistance and atherosclerosis, and may become a useful prognostic and therapeutic tool for monitoring patients with PCOS: lean and those with overweight and obesity. Assessment of the concentrations of inflammatory markers may become a very useful test in evaluating the risk of developing atherosclerosis and cardiovascular disease, long before their clinical manifestation. It will also allow for the appropriate prophylaxis.
REFERENCES (44)
1.
Dunaif A, Thomas A. Current concepts in the polycystic ovary syndrome. Annu Rev Med. 2001; 52: 401–419.
2.
Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: etiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 2011; 7: 219–231.
3.
The Rotterdam ESHRE/ASRAM-sponsored PCOS Consensus Workshop Group 2004. Revised 2003. Consensus on diagnostic criteria and long-therm. Health risks related to polycystic ovary syndrome. Hum Reprod. 2004; 19: 41–47.
4.
Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010; 95: 2038–2049.
5.
Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril. 2012; 97: 7–12.
6.
Carmina E, Chu MC, Longo RA, Rini GB, Lobo RA Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters. J Clin Endocrinol Metab. 2005; 90: 2545–2549.
7.
DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005; 83: 1454–1460.
8.
Essah PA, Nestler JE, Carmina E. Differences in dyslipidemia between American and Italian women with polycystic ovary syndrome. J Endocrinol Invest. 2008; 31: 35–41.
9.
Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN Prevalence and predictors of metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006; 91: 48–53.
10.
Koltsova EK, Garcia Z, Chodaczek G, Landau M, McArdle S, Scott SR, et al. Dynamic T cell-APC interactions sustain chronic inflammation in atherosclerosis.J Clin Invest. 2012; 122: 3114–3126.
11.
Tosi F, Dorizzi R, Castello R, Maffeis C , Spiazzi G, Zoppini G, et al. Body fat and insulin resistance independently predict increased serum C-reactive protein in hyperandrogenic women with polycystic ovary syndrome. Eur J Endocrinol. 2009; 161: 737–745.
12.
Castell JV, Gómez-Lechón MJ, David M, Andus T, Geiger T, Trullenque R, et al. Interleukin-6 is the major regulator of acute phase protein synthesis in adult human hepatocytes. FEBS Lett. 1989; 242: 237–239.
13.
Venugopal SK, Devaraj S, Jialal I. Effect of C-reactive protein on vascular cells: evidence for a proinflammatory, proatherogenic role. Curr Opin Nephrol Hypertens. 2005; 14: 33–37.
14.
Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation. 2003; 107: 391–397.
15.
Abeywardena MY, Leifert WR, Warnes KE, Varghese JN, Head RJ Review Cardiovascular biology of interleukin-6. Curr Pharm Des. 2009; 15: 1809–1821.
16.
Diamanti-Kandarakis E, Paterakis T, Kandarakis HA. Indices of low-grade inflammation in polycystic ovary syndrome. Ann N Y Acad Sci. 2006; 1092: 175–186.
17.
Saxena P, Prakash A, Nigam A, Mishra A. Polycystic ovary syndrome: Is obesity a sine qua non? A clinical, hormonal, and metabolic assessment in relation to body mass index. Indian J Endocrinol Metab. 2012; 16: 996–999.
18.
Carmina E, Bucchieri S, Esposito A, Del Puente A, Mansueto P, Orio F, et al. Abdominal fat quantity and distribution in women with polycystic ovary syndrome and extent of its relation to insulin resistance. J Clin Endocrinol Metab. 2007; 92: 2500–2505.
19.
Marino JS, Iler J, Dowling AR, Chua S, Bruning JC, Coppari R, at al. Adipocyte dysfunction in a mouse model of polycystic ovary syndrome (PCOS): evidence of adipocyte hypertrophy and tissue-specific inflammation. PLoS One. 2012; 7: e48643.
20.
Halberg N, Khan T, Trujillo ME, Wernstedt-Asterholm I, Attie AD, Sherwani S, et al. Hypoxia-inducible factor 1alpha induces fibrosis and insulin resistance in white adipose tissue. Mol Cell Biol. 2009; 29: 4467–4483.
21.
Austin RL, Rune A, Bouzakri K, Zierath JR, Krook A. siRNA-mediated reduction of inhibitor of nuclear factor-kappaB kinase prevents tumor necrosis factor-alpha-induced insulin resistance in human skeletal muscle. Diabetes. 2008; 57: 2066–2073.
22.
Cai D, Yuan M, Frantz DF, Melendez PA, Hansen L, Lee J, et al. Local and systemic insulin resistance resulting from hepatic activation of IKK-beta and NF-kappaB. Nat Med. 2005; 11: 183–190.
23.
Sprague AH, Khalil RA. Review Inflammatory cytokines in vascular dysfunction and vascular disease. Biochem Pharmacol. 2009; 78: 539–552.
24.
Chen MJ, Chen HF, Chen SU, Ho HN, Yang YS, Yang WS. The relationship between follistatin and chronic low-grade inflammation in women with polycystic ovary syndrome. Fertil Steril. 2009; 92: 2041–2044.
25.
Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab. 2001; 86: 2453–2455.
26.
Escobar-Morreale HF, Luque-Ramírez M, González F. Review circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril. 2011; 95: 1048–1058.
27.
Diamanti-Kandarakis E, Alexandraki K, Piperi C, Protogerou A, Katsikis I, Paterakis T, et al. Inflammatory and endothelial markers in women with polycystic ovary syndrome. Eur J Clin Invest. 2006; 36: 691–697.
28.
Foltyn W, Strzelczyk J, Marek B, Kajdaniuk D, Siemińska L, Zemczak A, et al. Selected markers of endothelial dysfunction in women with polycystic ovary syndrome. Endokrynol Pol. 2011; 62: 243–248.
29.
Fulghesu AM, Sanna F, Uda S, Magnini R, Portoghese E, Batetta B. IL-6 serum levels and production is related to an altered immune response in polycystic ovary syndrome girls with insulin resistance. Mediators Inflamm. 2011; doi:10.1155/2011/389317.
30.
Benson S, Janssen OE, Hahn S, Tan S, Dietz T, Mann K, et al. Obesity, depression, and chronic low-grade inflammation in women with polycystic ovary syndrome. Brain Behav Immun. 2008; 22: 177–184.
31.
Ridker PM. Review C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol. 2007; 49: 2129–2138.
32.
Rosenzweig JL, Ferrannini E, Grundy SM, Haffner SM, Heine RJ, Horton ES, et al. Endocrine Society. Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008; 93: 3671–3689.
33.
Mosca L. Guidelines for prevention of cardiovascular disease in women: a summary of recommendations. Prev Cardiol. 2007; 10: 19–25.
34.
Salley KE, Wickham EP, Cheang KI, Essah PA, Karjane NW, Nestler JE. Glucose intolerance in polycystic ovary syndrome—a position statement of the Androgen Excess Society. J Clin Endocrinol Metab. 2007; 92: 4546–4556.
35.
Cushman WC. JNC-7 guidelines: are they still relevant? Curr Hypertens Rep. 2007; 9: 380–386.
36.
Norman RJ, Davies MJ, Lord J, Moran LJ. The role of lifestyle modification in polycystic ovary syndrome. Trends Endocrinol Metab. 2002; 13: 251–257.
37.
Hoeger K, Davidson K, Kochman L, Cherry T, Kopin L, Guzick DS. The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials. J Clin Endocrinol Metab. 2008; 93: 4299–4306.
38.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346: 393–403.
39.
Sharma ST, Wickham 3rd EP, Nestler JE. Changes in glucose tolerance with metformin treatment in polycystic ovary syndrome: a retrospective analysis. Endocr Pract. 2007; 13: 373–379.
40.
Agarwal N, Rice SP, Bolusani H, Luzio SD, Dunseath G, Ludgate M, et al. Metformin reduces arterial stiffness and improves endothelial function in young women with polycystic ovary syndrome: a randomized, placebo-controlled, crossover trial. J Clin Endocrinol Metab. 2010; 95: 722–730.
41.
Singh B, Panda S, Nanda R, Pati S, Mangaraj M, Sahu PK, et al. Effect of Metformin on Hormonal and Biochemical Profile in PCOS Before and After Therapy. Indian J Clin Biochem. 2010; 25: 367–370.
42.
Sathyapalan T, Kilpatrick ES, Coady AM, Atkin SL. The effect of atorvastatin in patients with polycystic ovary syndrome: a randomized double-blind placebo-controlled study. J Clin Endocrinol Metab. 2009; 94: 103–108.
43.
Lindholm A, Bixo M, Björn I, Wölner-Hanssen P, Eliasson M, Larsson A, et al. Effect of sibutramine on weight reduction in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Fertil Steril. 2008; 89: 1221–1228.
44.
Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ. Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril. 2009; 92: 1966–1982.
Share
RELATED ARTICLE
| eISSN: | 1898-2263 |
| ISSN: | 1232-1966 |
Improvement of visual identification of the journal - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher Education allocated to the activities of disseminating science.
Generation of the DOI (Digital Object Identifier) - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher
© 2006-2024 Journal hosting platform by Bentus
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
