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Vascular abnormalities and low-grade chronic inflammation in women with polycystic ovary syndrome: Relationships with insulin resistance, obesity and hyperandrogenemia

  • Review Article
  • Published:
Central European Journal of Medicine

Abstract

Polycystic ovary syndrome (PCOS) is possibly the most common endocrinopathy of reproductive age, characterized by hyperandrogenism and oligomenorrhea. Additionally, approximately one-third to one-half of all women and adolescent girls with PCOS tend to fulfill many of the metabolic syndrome criteria, and many view PCOS as a premetabolic syndrome condition, predisposing to a high risk for cardiovascular disease. Endothelial dysfunction, impaired arterial structure, or proinflammatory markers are early features of atherosclerosis, and can be used as surrogate indicators of future coronary artery disease in women with PCOS. However, as the latest studies show, these symptoms are the result of deleterious effects that cardiovascular risk factors, in particular insulin resistance and obesity, produce on the vascular wall, rather than to the presence of PCOS per se. The relationship between hyperandrogenemia and the risk of cardiovascular disease is controversial and needs to be clarified. Further research is warranted to understand the pathogenesis of cardiovascular disease in PCOS, and to identify subtypes of PCOS in which the presence of cardiovascular risk factors may result in increased cardiovascular events, leading to high morbidity or mortality rates caused by cardiovascular disease.

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References

  1. Cussons A.J., Stuckey B.G.A., Watts G.F., Cardiovascular disease in the polycystic ovary syndrome: New insights and perspectives, Atherosclerosis, 2006, 185, 227–239

    Article  PubMed  CAS  Google Scholar 

  2. Azziz R., Nestler J., Dewailly D., Androgen excess disorders in women: polycystic ovary syndrome and other disorders, 2nd ed., 2006, Humana Press

  3. Tarkun I., Arslan B.C., Cantürk Z., Türemen E., Sahin T., Duman C., Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and low-grade chronic inflammation, J. Clin. Endocrinol. Metab., 2004, 89, 5592–5596

    Article  PubMed  CAS  Google Scholar 

  4. Essah P., Wickham E., Nestler J., The metabolic syndrome in polycystic ovary syndrome, Clin. Obstretics and Gynecology, 2007, 1, 205–225

    Article  Google Scholar 

  5. Lorenz L., Wild R., Polycystic ovarian syndrome: an evidence-based approach to evaluation and management of diabetes and cardiovascular risks for today’s clinician, Clin. Obstretics and Gynecology, 2007, 1, 226–243

    Article  Google Scholar 

  6. Hoffman L.K., Ehrmann D.A., Cardiometabolic features of polycystic ovary syndrome, Nat. Clin. Pract. Endocrinol. Metab., 2008, 4, 215–222

    Article  PubMed  CAS  Google Scholar 

  7. Shaw L.J., Bairey Merz C.N., Azziz R., Stanczyk F.Z., Sopko G., Braunstein G.D., et al, Post-Menopausal Women with a History of Irregular Menses and Elevated Androgen Measurements at High Risk for Worsening Cardiovascular Event-Free Survival: Results from the National Institutes of Health-National Heart, Lung, and Blood Institute Sponsored Women’s Ischemia Syndrome Evaluation, J. Clin. Endocrin.Metab., 2008, 93, 1276–1284

    Article  CAS  Google Scholar 

  8. Calles-Escandon J., Cipolla M., Diabetes and endothelial dysfunction: a clinical perspective, Endocrine Reviews. 2001, 22, 36–52

    Article  PubMed  CAS  Google Scholar 

  9. Caballero E., Endothelial dysfunction in obesity and insulin resistance: a road to diabetes and heart disease, Obesity Research, 2003, 11, 1278–1289

    Article  PubMed  CAS  Google Scholar 

  10. Meyer C., McGrath B., Cameron J., Kotsopoulos D., Teede H.J., Vascular dysfunction and metabolic parameters in polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2005, 90, 4630–4635

    Article  PubMed  CAS  Google Scholar 

  11. Verma S., Anderson T.J., Fundamentals of endothelial function for the clinical cardiologist, Circulation, 2002, 105, 546–549

    Article  PubMed  CAS  Google Scholar 

  12. Quyyumi A.A., Endothelial function in health and disease: new insights into the genesis of cardiovascular disease, Am. J. Med., 1998, 105, 32S–39S

    Article  PubMed  CAS  Google Scholar 

  13. Kravariti M., Naka K.K., Kalantaridou S.N., Kazakos N., Katsouras C.S., Makrigiannakis A., et al., Predictors of endothelial dysfunction in young women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2005, 90, 5088–5095

    Article  PubMed  CAS  Google Scholar 

  14. Orio F.J., Palomba S., Cascella T., De Simone B., Di Biase S., Russo T., et al., Early impairment of endothelial structure and function in young normalweight women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2004, 89, 4588–4593

    Article  PubMed  CAS  Google Scholar 

  15. Diamanti-Kandarakis E., Alexandraki K., Protogerou A., Piperi C., Papamichael C., Aessopos A., et al., Metformin administration improves endothelial function in women with polycystic ovary syndrome, Eur. J. Endocrinol., 2005, 152, 749–756

    Article  PubMed  CAS  Google Scholar 

  16. Tarkun I., Cetinarsian B., Turemen E., Sahin T., Canturk Z., Komsuoglu B., Effect of rosiglitazone on insulin resistance, C-reactive protein and endothelial dysfunction in non-obese young women with polycystic ovary syndrome, Eur. J. Endocrinol., 2005, 153, 115–21

    Article  PubMed  CAS  Google Scholar 

  17. Sorensen M.B., Frankst S., Robertson C., Penemm D.J., Collins P., Severe endothelial dysfunction in young women with polycystic ovary syndrome is only partially explained by known cardiovascular risk factors, Clin. Endocrinol., 2006, 65, 655–659

    Article  Google Scholar 

  18. Paradisi G., Steinberg H.O., Hempfling A., Cronin J., Hook G., Shepard M.K. et al., Polycystic ovary syndrome is associated with endothelial dysfunction, Circulation, 2001, 103, 1410–1415

    PubMed  CAS  Google Scholar 

  19. Paradisi G., Steinberg H.O., Shepard M.K., Hook G., Baron A.D., Troglitazone therapy improves endothelial function to near normal levels in women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2003, 88, 576–580

    Article  PubMed  CAS  Google Scholar 

  20. Kelly C.J., Speirs A., Gould G.W., Petrie J.R., Lyalll H., Connell J.M.C., Altered vascular function in young women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2002, 87, 742–746

    Article  PubMed  CAS  Google Scholar 

  21. Bickerton A.S., Clark N., Meeking D., Shaw K.M., Crook M., Lumb P., et al, Cardiovascular risk in women with polycystic ovarian syndrome (PCOS), J. Clin. Pathol. 2005, 58, 151–154

    Article  PubMed  CAS  Google Scholar 

  22. Carmassi F., Negri F.D., Fioriti R., De Giorgi A., Giannarelli C., Fruzzetti F., et al, Insulin resistance causes impaired vasodilation and hypofibrinolysis in young women with polycystic ovary syndrome, Thrombosis Research, 2005, 116, 207–214

    Article  PubMed  CAS  Google Scholar 

  23. Verma S., Buchanan M.R., Anderson T.J., Endothelial function testing as a biomarker of vascular disease, Circulation, 2003, 108, 2054–2059

    Article  PubMed  Google Scholar 

  24. Nacul A.P., Andrade C.D., Schwarz P., Homem de Bittencourt Jr P.I., Spritzer P.M., Nitric oxide and fibrinogen in polycystic ovary syndrome: associations with insulin resistance and obesity, Europ. J. Obstet. Gynecol., 2007, 133, 191–196

    Article  CAS  Google Scholar 

  25. Dubin D., Pratt R.E., Cooke J.P., Dzau V.J., Endothelin, a potent vasoconstrictor, is a vascular smooth muscle mitogen, J. Vasc. Med. Biol., 1989, 1, 13–16

    Google Scholar 

  26. Diamanti-Kandarakis E., Spina G., Kouli C., Migdalis I., Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy, J. Clin. Endocrinol. Metab., 2001, 86, 4666–4673

    Article  PubMed  CAS  Google Scholar 

  27. Orio F.J., Palomba S., Cascella T., De Simone B., Manguso F., Savastano S., et al., Improvement in endothelial structure and function after metformin treatment in young normal-weigt women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2005, 90, 6072–6076

    Article  PubMed  CAS  Google Scholar 

  28. Talbott E.O., Guzick D.S., Sutton-Tyrrell K., McHugh-Pemu K.P., Zborowski J.V., Remsberg K.E., et al., Evidence for association between polycystic ovary syndrome and premature carotid atherosclerosis in middle-aged women, Arterioscler. Thromb. Vasc. Biol., 2000, 20, 2414–2421

    CAS  Google Scholar 

  29. Vural B., Caliskan E., Turkoz E., Kilic T., Demirci A., Evaluation of metabolic syndrome frequency and premature carotid atherosclerosis in young women with polycystic ovary syndrome, Hum. Reprod., 2005, 20, 2409–13

    Article  PubMed  Google Scholar 

  30. Carmina E., Orio F., Palomba S., Longo R.A., Cascella T., Colao A., et al., Endothelial dysfunction in PCOS: role of obesity and adipose hormones, Am. J. Medicine., 2006, 119, 356.e1–356.e6

    Article  CAS  Google Scholar 

  31. Christian R.C., Dumesic D.A., Behrenbeck T., Oberg A.L., Sheedy II P.F., Fitzpatrick L.A., Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2003, 88, 2562–2568

    Article  PubMed  CAS  Google Scholar 

  32. Talbott E.O., Zborowski J.V., Rager J.R., Boudreaux M.Y., Edmundowicz D.A., Guzick D.S., Evidence for an association between metabolic cardiovascular syndrome and coronary and aortic calcification among women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2004, 89, 5454–5461

    Article  PubMed  CAS  Google Scholar 

  33. Meyer C., McGrath B.P., Teede H.K., Overweight women with polycystic ovary syndrome have evidence of subclinical cardiovascular disease, J. Clin. Endocrinol. Metab., 2005, 90, 5711–5716

    Article  PubMed  CAS  Google Scholar 

  34. Kershaw E.E., Flier J.S., Adipose tissue as an endocrine organ, J. Clin. Endocrinol. Metab., 2004, 89, 2548–2556

    Article  PubMed  CAS  Google Scholar 

  35. Zhang Y., Yang Y., Hong J., Gu W., Shen C., Xu M., et al., Elevated serum levels of Interleukin-18 are associated with insulin resistance in women with polycystic ovary syndrome, Endocrine, 2006, 29, 3, 419–423

    Article  PubMed  CAS  Google Scholar 

  36. Escobar-Morreale H.F., Botella-Carretero J.I., Villuendas G., Sancho J., San Millan J.L., Serum interleukin-18 concentrations are increased in the polycystic ovary syndrome: relationship to insulin resistance and to obesity, J. Clin. Endocrinol. Metab., 2004, 89, 806–811

    Article  PubMed  CAS  Google Scholar 

  37. Linscheid P., Seboek D., Nylen E.S., Langer I., Schlatter M., Becker K.L., et al., In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue, Endocrinology, 2003, 144, 5578–5584

    Article  PubMed  CAS  Google Scholar 

  38. Linscheid P., Seboek D., Schaer D.J., Zulewski H., Keller U., Muller B., Expression and secretion of procalcitonin and calcitonin gene-related peptide by adherent monocytes and by macrophageactivated adipocytes, Crit. Care. Med., 2004, 32, 1715–1721

    Article  PubMed  CAS  Google Scholar 

  39. Pai J.K., Pischon T., Ma J., Manson J.E., Hankinson S.E., Joshipura K., et al., Inflammatory markers and the risk of coronary heart disease in men and women, N. Engl. J. Med., 2004, 351, 2599–2610

    Article  PubMed  CAS  Google Scholar 

  40. Danesh J., Wheeler J.G., Hirschfield G.M., Eda S., Eiriksdottir G., Rumley A., et al., C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease, N. Engl. J. Med., 2004, 350, 1387–1397

    Article  PubMed  CAS  Google Scholar 

  41. Yudkin J.S., Kumari M., Humphries S.E., Mohamed-Ali V., Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link?, Atherosclerosis., 2000, 148:209–14

    Article  PubMed  CAS  Google Scholar 

  42. Olszanecka-Glinianowicz M., Banas M., Zahorska-Markiewicz B., Janowska J., Kocelak P., Madej P., et al., Is the polycystic ovary syndrome associated with chronic inflammation per se?, Eur. J. Obstet. Gynecol. Reprod. Biol., 2007, 133, 197–202

    Article  PubMed  CAS  Google Scholar 

  43. Blankenberg, S., Tiret L., Bickel C., Peetz D., Cambien F., Meyer J., et al., Interleukin-18 is a strong predictor of cardiovascular death in stable and unstable angina, Circulation, 2002, 106, 24–30

    Article  PubMed  CAS  Google Scholar 

  44. Esposito K., Pontillo A., Ciotola M., Di Palo C., Grella E., Nicoletti G., et al., Weight loss reduces interleukin-18 levels in obese women, J. Clin. Endocrinol. Metab., 2002, 87, 3864–3866

    Article  PubMed  CAS  Google Scholar 

  45. Devaraj S., Xu D.Y., Jialal I., C-reactive protein increases plasminogen activator inhibitor-1 expression and activity in human aorthic endothelial cells: implications for the metabolic syndrome and atherothrombosis, Circulation, 2003, 107, 398–404

    Article  PubMed  CAS  Google Scholar 

  46. Wang C.H., Li S.H., Weisel R.D., Fedak P.W., Dumont A.S., Szmitko P., et al., C-reactive protein upregulates angiotensin type 1 receptors in vascular smooth muscle, Circulation, 2003, 107, 1783–1790

    Article  PubMed  CAS  Google Scholar 

  47. Kelly C.C., Lyah H., Petrie J.R., Gould G.W., Connell J.M., Sattar N., Low grade chronic inflammation in women with polycystic ovarian syndrome, J. Clin. Endocrinol. Metab., 2001, 86, 2453–2455

    Article  PubMed  CAS  Google Scholar 

  48. Talbott E.O., Zborowski J.V., Boudreaux M.Y., McHugh-Pemu K.P., Sutton-Tyrrell K., Guzick D.S., The relationship between C-reactive protein and carotid intima-media wall thickness in middle-aged women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2004, 89, 6061–6067

    Article  PubMed  CAS  Google Scholar 

  49. Orio F. Jr., Palomba S., Cascella T., Di Biase S., Manguso F., Tauchmanova L., et al., The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2005, 90, 2–5

    Article  PubMed  CAS  Google Scholar 

  50. Morin-Papunen L., Rautio K., Ruokonen A., Hedeberg P., Puukka M., Tapanainen J.S., Metformin reduces serum C-reactive protein levels in women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2003, 88, 4649–4654

    Article  PubMed  CAS  Google Scholar 

  51. Diamanti-Kandarakis E., Paterakis T., Alexandraki K., Piperi C., Aessopos A., Katsikis I., et al., Indices of low-grade chronic inflammation in polycystic ovary syndrome and the beneficial effect of metformin, Hum. Reprod., 2006, 21, 1426–1431

    Article  PubMed  CAS  Google Scholar 

  52. 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

    Article  PubMed  CAS  Google Scholar 

  53. Ibanez L., Jaramillo A.M., Ferrer A., de Zegher F., High neutrophil count in girls and women with hyperinsulinaemic hyperandrogenism: normalization with metformin and flutamide overcomes the aggravation by oral contraception, Hum. Reprod., 2005, 20, 2457–2462

    Article  PubMed  CAS  Google Scholar 

  54. Orio F., Manguso F., Di Biase S., Falbo A., Giallauria F., Labella D., et al., Metformin administration improves leukocyte count in women with polycystic ovary syndrome: a 6-month prospective study, Eur. J. Endocrinol., 2007, 157, 69–73

    Article  PubMed  CAS  Google Scholar 

  55. Steinberg H.O., Baron A.D., Vascular function, insulin resistance and fatty acids, Diabetologia, 2002, 45, 623–634

    Article  PubMed  CAS  Google Scholar 

  56. Caballero E., Metabolic and vascular abnormalities in subjects at risk for type 2 diabetes: the early start of a dangerous situation, Archives of Medical Research, 2005, 36, 241–249

    Article  PubMed  CAS  Google Scholar 

  57. Diamanti-Kandarakis E., Paterakis T., Kandarkis H.A., Indices of low-grade inflammation in polycystic ovary syndrome, Ann. N.Y. Acad. Sci., 2006, 1092, 175–186

    Article  PubMed  CAS  Google Scholar 

  58. Mohlig M., Spranger J., Osterhoff M., Ristow M., Pfeiffer A.F.H., Schill T., et al, The polycystic ovary syndrome per se is not associated with increased chronic inflammation, Eur. J.Endocrinol., 2004, 150, 525–532

    Article  PubMed  Google Scholar 

  59. Puder J.J., Varga S., Kraenzlin M., De Geyter C., Keller U., Muller B., Central fat excess in polycystic ovary syndrome: reltion to low-grade inflammation and insulin resistance, J. Clin. Endocrinol. Metab., 2005, 90, 6014–6021

    Article  PubMed  CAS  Google Scholar 

  60. Kearney M.T., Duncan E.R., Kahn M., Wheatcroft S.B., Insulin resistance and endothelial cell dysfunction: studies in mammalian models, Exp Physiol, 2008, 93, 158–163

    Article  PubMed  CAS  Google Scholar 

  61. Katusic Z., Vascular endothelial dysfunction: does tetrahydrobiopterin play a role?, Am. J. Physiol. Heart Circ. Physiol., 2001, 281, H981–H986

    PubMed  CAS  Google Scholar 

  62. Nystrom T., Nygren A., Sjoholm A., Tetra-hydrobiopterin increases insulin sensitivity in patients with type 2 diabetes and coronary heart disease, Am. J. Physiol. Endocrinol. Metab., 2004, 287, E919–E925

    Article  PubMed  Google Scholar 

  63. Carvalheira J.B.C., Calegari V.C., Zecchin HG., Nadruz V., Guimaraes R.B., Ribeiro E.B., et al., The crosstalk between insulin and angiotensin and insulin differentially affects phosphatidylinositol 3-kinase-and mitogen-activated protein kinasemediated signaling in rat heart: implications for insulin resistance, Endocrinology, 2003, 144, 5604–5614

    Article  PubMed  CAS  Google Scholar 

  64. Andreozzi F., Laratta E., Sciacqua A., Perticone F., Sesti G., Angiotensin II impairs the insulin signaling pathaway promoting production of nitric oxide by inducing phosphorylation of insulin receptor substrate-1 on Ser 312 and Ser 616 in human umbilical vein endothelial cells, Circulation Research, 2004, 94, 1211–1218

    Article  PubMed  CAS  Google Scholar 

  65. Piatti P.M., Monti L.D., Galli L., Fragasso G., Valsecchi G., Conti M., et al., Relationship between endothelin-1 concentrations and metabolic alterations typical of the insulin resistance syndrome, Metabolism, 2000, 49,748–752

    Article  PubMed  CAS  Google Scholar 

  66. Kim Jeong-a, Montagnani M., Koh K.K., Quon M.J., Reciprocal relationship between insulin resistance and endothelial dysfunction: molecular pathophysiological mechanisms, Circulation, 2006, 113, 1888–1904

    Article  PubMed  Google Scholar 

  67. Rosano G.M., Sheiban I., Massaro R., Pagnotta P., Marazzi G., Vitale C., et al., Low testosterone levels are associated with coronary artery disease in male patients with angina, Int. J. Impot. Res., 2007, 19, 176–182

    Article  PubMed  CAS  Google Scholar 

  68. Vryonidou A., Papatheodorou A., Tavridou A., Terzi T., Loi V., Vatalas I.A., et al., Association of hyperandrogenemic and metabolic phenotype with carotid intima-media thickness in young women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2005, 90, 2740–2746

    Article  PubMed  CAS  Google Scholar 

  69. Dagre A., Lekakis J., Mihas C., Protogerou A., Thalassinou L., Tryfonopoulos D., et al., Association of dehydroepiandrosterone-sulfate with endothelial function in young women with polycystic ovary syndrome, Eur. J. Endocrinol., 2006, 154, 883–890

    Article  PubMed  CAS  Google Scholar 

  70. Worboys S., Kotsopoulos D., Teede H., McGrath B., Davis S.R., Evidence that parenteral testosterone therapy may improve endothelium-dependent and-independent vasodilation in postmenopausal women already receiving estrogen, J. Clin. Endocrinol. Metab., 2001, 86, 158–161

    Article  PubMed  CAS  Google Scholar 

  71. Zhang Z., Wang L., Dou Y., Zhao J., Jiang T., Qiao Z., et al., Testosterone and estradiol modulate TNFalpha-induced expression of adhesion molecules in endothelial cells, Methods Find. Exp. Clin. Pharmacol., 2002, 24, 125–30

    Article  PubMed  CAS  Google Scholar 

  72. McChrohon J.A., Jessup W., Handelsmann D.J., Celermajer D.S., Androgen exposure increases human monocyte adhesion to vascular endothelium and endothelial cell expression of vascular cell adhesion molecule-1, Circulation, 1999, 99, 2317–2322

    Google Scholar 

  73. Death A.K., McGrath K., Sader M., Nakhla S., Jessup W., Handelsman D.J., et al. Dihydrotestosterone promotes vascular cell adhesion molecule-1 expression in male human endothelial cells via a nuclear factor-?B-dependent patway, Endocrinology, 2004, 145,1889–1897

    Article  PubMed  CAS  Google Scholar 

  74. Gooren L.J., Giltay E.J., Review of studies of androgen treatment of female-to-male transsexuals: effects and risks of administration of androgens to females, J. Sex. Med., 2008, 5, 765–76

    Article  PubMed  CAS  Google Scholar 

  75. Elbers J.M., Giltay E.J., Teerlink T., Scheffer P.G., Asscheman H., Seidell J.C., et al., Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects, Clin. Endocrinol. (Oxf), 2003, 58, 562–71

    Article  CAS  Google Scholar 

  76. Berra M., Armillotta F., D’Emidio L., Costantino A., Martorana G., Pelusi G., et al., Testosterone decreases adiponectin levels in female to male transsexuals, Asian J. Androl., 2006, 8, 725–729

    Article  PubMed  CAS  Google Scholar 

  77. McCredie R.J., McCrohon J.A., Turner L., Griffiths K.A., Handelsman D.J., Celermajer D.S., Vascular reactivity is impaired in genetic females taking high-dose androgens, J. Am. Coll. Cardiol., 1998, 32, 1331–1335

    Article  PubMed  CAS  Google Scholar 

  78. Simoncini T., Mannella P., Fornari L., Varone G., Caruso A., Genazzani A.R., Dehydroepiandrosterone modulates endothelial nitric oxide synthesis via direct genomic and nongenomic mechanisms, Endocrinology, 2003, 144, 3449–3455

    Article  PubMed  CAS  Google Scholar 

  79. Williams M.R.I., Ling S., Dawood T., Hshimura K., Dai A., Li H., et al., Dehydroepiandrosterone inhibits human vascular smooth muscle cell proliferation independent of ARs and ERs, J. Clin. Endocrinol. Metab., 2002, 87, 176–181

    Article  PubMed  CAS  Google Scholar 

  80. Liu D., Dillon J.S., Dehydroepiandroterone activates endothelial cell nitric-oxide synthase by a specific plasma membrane receptor, The Journal of Biological Chemistry, 2002, 24, 21379–21388

    Article  Google Scholar 

  81. Liu D., Dillon J.S., Dehydroepiandroterone stimulates nitric oxide release in vascular endothelial cells: evidence for a cell surface receptor, Steroids, 2004, 69, 279–89

    Article  PubMed  CAS  Google Scholar 

  82. Formoso G., Chen H., Kim J., Montagnani M., Consoli A., Quon M.J., Dehydroepiandroterone mimics acute actions of insulin to stimulate production of both nitric oxide and endothelin 1 via distinct phosphatidylinositol 3-kinase and mitogenactivated protein kinase-dependent pathways in vascular endothelium, Molecular Endocrinology, 2006, 20, 1153–1163

    Article  PubMed  CAS  Google Scholar 

  83. Ibanez L., de Zegher F., Ethinylestradiol-drospire-none, flutamide-metformin, or both for adolescents and women with hyperinsulinemic hyperandrogenism: opposite effects on adipocytokines and body adiposity, J. Clin. Endocrinol. Metab., 2004, 89, 592–1597

    Google Scholar 

  84. Cho L.W., Randeva H.S., Atkin S.L., Cardiometabolic aspects of polycystic ovarian syndrome, Vasc. Health Risk Manag., 2007, 3, 55–63

    PubMed  Google Scholar 

  85. Ouedraogo R., Gong Y., Berzins B., Wu X., Mahadev K., Hough K., et al., Adiponectin deficiency increases leukocyte-endothelium interactions via upregulation of endothelial cell adhesion molecules in vivo, J. Clin. Investig., 2007, 117, 1718–1726

    Article  PubMed  CAS  Google Scholar 

  86. Escobar-Morreale H.F., Villuendas G., Botella-Carretero J.I., Álvarez-Blasco F., Sanchón R., Luque-Ramírez M., Adiponectin and resistin in PCOS: a clinical, biochemical and molecular genetic study, Human Reproduction, 2006, 21, 2257–2265

    Article  PubMed  CAS  Google Scholar 

  87. Ardawi M.S., Rouzi A.A., Plasma adiponectin and insulin resistance in women with polycystic ovary syndrome, Fertil. Steril., 2005, 83, 1708–1716

    Article  PubMed  CAS  Google Scholar 

  88. Ducluzeau P.H., Cousin P., Malvoisin E., Bornet H., Vidal H., Laville M., et al., Glucose-to-insulin ratio rather than sex hormone-binding globulin and adiponectin levels is the best predictor of insulin resistance in nonobese women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab., 2003, 88, 3626–3631

    Article  PubMed  CAS  Google Scholar 

  89. Gulcelik N.E., Aral Y., Serter R., Koc G., Association of hypoadiponectinemia with metabolic syndrome in patients with polycystic ovary syndrome, J. Natl. Med. Assoc., 2008, 100, 64–68

    PubMed  Google Scholar 

  90. Bik W., Baranowska-Bik A., Wolinska-Witort E., Chmielowska M., Martynska L., Baranowska B., The relationship between metabolic status and levels of adiponectin and ghrelin in lean women with polycystic ovary syndrome, Gynecol. Endocrinol., 2007, 23, 325–331

    Article  PubMed  CAS  Google Scholar 

  91. Escobar-Moreale H.F., San Millan J.L., Abdominal adiposity and the polycystic ovary syndrome, Trends in Endocrinology and Metabolism, 2007, 18, 266–272

    Article  Google Scholar 

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Ilie, I.R., Pepene, C.E., Duncea, I. et al. Vascular abnormalities and low-grade chronic inflammation in women with polycystic ovary syndrome: Relationships with insulin resistance, obesity and hyperandrogenemia. cent.eur.j.med 3, 257–270 (2008). https://doi.org/10.2478/s11536-008-0044-8

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