PCOS is associated with increased biochemical risk markers for cardiovascular disease, particularly low HDL cholesterol and increased triglycerides. There is accelerated progression to type 2 diabetes and hypertension in middle age. These biochemical abnormalities associate with insulin resistance which is present to a greater extent than can be explained by obesity alone. Notwithstanding, hard endpoint data in terms of increased cardiovascular mortality remains elusive. Inflammatory processes are now recognised as being important in atherogenesis and the inflammatory marker CRP has been shown to be a powerful predictor of cardiovascular morbidty and mortality, independent of conventional risk factors, in several studies. We defined PCOS as hyperandrogenaemia associated with menstrual disturbance, hirsutism and infertility in any combination. To further investigate cardiovascular risk in PCOS we studied serum CRP in patients and controls and its relationship to age, body mass index and insulin sensitivity. CRP was measured by high sensitivity ELISA and insulin sensitivity (HOMA-S) was derived from fasting glucose and insulin pairs. Serum CRP in patients (n=37) was 1.59mg/l (interquartile range 0.53-0.38) and not significantly different to controls (n=21) 1.27 mg/l ( interquartile range 0.32-2.25). In the group as a whole CRP was significantly correlated with BMI (rs=0.70:p<0.001) and insulin sensitivity (rs= -0.38;p=0.004) but not with age (rs =0.197;p=0.077). In a multiple regression CRP was correlated with BMI ( P<0.001) but not with insulin sensitivity (p= 0.448) or age (p=0.075). In controls, CRP was significantly correlated with BMI (rs=0.52;p=0.014) but not with age or insulin sensitivity. In PCOS, CRP was significantly correlated with BMI (rs = 0.72;p<0.001), insulin sensitivity (rs=-0.38;p=0.022) and age (rs=0.489;p=0.005). In a multiple regression, CRP was correlated with BMI (p<0.001) and age (p=0.005) but not with insulin sensitivity (p=0.157). These data suggest that the increased cardiovascular risk observed in PCOS may not be further exacerbated by accelerated inflammatory processes.
03 - 05 Nov 2003
Society for Endocrinology