Endocrine Abstracts

JOINT3750

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorder affecting women of reproductive age. Insulin resistance and consequent cardiometabolic disorders are the main components of PCOS. The data regarding the presence of clinical or subclinical cardiovascular disease in PCOS, are controversial. Moreover, the impact of potential treatment intervention in markers of hormonal, cardiovascular and endothelial function in PCOS has not yet been fully elucidated.

Objective: The aim of the present study is to investigate a) the association between subclinical markers of cardiovascular and endothelial integrity with insulin resistance and hormonal profil in women with PCOS and b) the impact of potential treatment interventions on these markers.

Methods: In total, 40 women with PCOS recruited in the study and received metformin (n=20), GLP1-agonists (n = 10), or oral contraceptive pills (n = 10). At baseline and six months after treatment, 75g-oral glucose tolerance test (OGTT) was performed in all patients. At 0, 60, and 120 min of glucose load insulin, glucose, and the perfused boundary region of sublingual microvessels (high PBR values represent reduced glycocalyx thickness) were measured. Insulin resistance was evaluated using Matsuda index and HOMA index. At baseline and six months after treatment, androgen levels and matrix metalloproteinase 9 (MMP9) concentration were also assessed.

Results: The mean age of all the participants was 30±3years old. At baseline, the percentage change of PBR was associated with the percentage change of glucose at 120min of OGTT (r = 0,42, P < 0.05). At baseline, Matsuda Index, Homa Index and Testosterone levels were associated with PBR (2.91±0.1μm) at 120min OGTT (r = 0.41, r = 0.38 and r = 0.28, respectively). Moreover, MMP9 levels were associated with Matsuda and Homa Index (r = 0.45, P < 0.05 and r = 0.41, P < 0.05 respectively). Six months after treatment, all the participants presented improvement of Matsuda Index (7±0.31 vs 9.1±0.2), Homa Index (5.3±0.8 vs 2.91±0.1), MMP9 (210±30 vs 178±28ng/ml) and testosterone levels (44.2±5 vs 39.1±2ng/dl) compared to baseline (P < 0.05 for all the comparisons). Six months post treatment, no association was observed between markers of insulin resistance and testosterone levels with PBR or its change during OGTT. Six months post-treatment, patients received GLP-1 agonists presented the greatest improvement in MMP9 levels compared to baseline.

Conclusion: Postprandial hyperglycemia, insulin resistance and testosterone levels are associated with impaired glycocalyx thickness in women with PCOS. The different treatment options resulted in the improvement of insulin resistance and biochemical markers of atherosclerosis, with GLP-1 agonists presenting the most prominent Results.