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Vasc Med. 2017 Apr;22(2):85-95. doi: 10.1177/1358863X16682107. Epub 2017 Jan 17.

Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers.

Author information

1
1 Department of Pediatrics, Division of Pediatric Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
2
2 Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
3
3 Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
4
4 Denver Veterans Administration Medical Center, Geriatric Research Education and Clinical Center, Denver, CO, USA.
5
5 Department of Medicine, Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
6
6 Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
7
7 Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
8
8 Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
9
9 Center for Women's Health Research, Aurora, CO, USA.

Abstract

Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24±1.86 mg/kg/min vs 9.10±2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima-media thickness (cIMT) (0.49±0.07 mm vs 0.44±0.06; p=0.038), beta stiffness index (5.1±1.3 U vs 4.4±0.9; p=0.037), and reduced arterial compliance (1.95±0.47 mm2/mmHg × 10-1 vs 2.13±0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68±28 μmol/mL vs 41±10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are 'normal'. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development.

KEYWORDS:

carotid intima–media thickness; cholesterol; obesity; pediatrics; polycystic ovarian syndrome; risk factors

PMID:
28095749
PMCID:
PMC5901904
DOI:
10.1177/1358863X16682107
[Indexed for MEDLINE]
Free PMC Article

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