Elisabeth A Lambert1,2, Helena Teede3, Carolina Ika Sari1, Eveline Jona3, Soulmaz Shorakae3, Kiri Woodington1, Robyn Hemmes1, Nina Eikelis1, Nora E Straznicky1, Barbora De Courten3, John B Dixon4, Markus P Schlaich5,6, Gavin W Lambert1,7. 1. Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Vic., Australia. 2. Department of Physiology, Monash University, Clayton, Vic., Australia. 3. Monash Centre for Health Research and Implementation, Monash University and Monash Health, Clayton, Vic., Australia. 4. Clinical Obesity Research laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Vic., Australia. 5. Hypertension & Kidney Disease Laboratories, Baker IDI Heart & Diabetes Institute, Melbourne, Vic., Australia. 6. Primary Health Care and the Department of Cardiovascular Medicine, Alfred Hospital, Prahran, Vic., Australia. 7. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia.
Abstract
OBJECTIVE: Polycystic ovary syndrome (PCOS) is a common endocrine condition underpinned by insulin resistance and associated with increased risk of obesity, type 2 diabetes and adverse cardiovascular risk profile. Previous data suggest autonomic imbalance [elevated sympathetic nervous system (SNS) activity and decreased heart rate variability (HRV)] as well as endothelial dysfunction in PCOS. However, it is not clear whether these abnormalities are driven by obesity and metabolic disturbance or whether they are independently related to PCOS. PARTICIPANTS AND METHODS: We examined multiunit and single-unit muscle SNS activity (by microneurography), HRV (time and frequency domain analysis) and endothelial function [ischaemic reactive hyperaemia index (RHI) using the EndoPAT device] in 19 overweight/obese women with PCOS (BMI: 31·3 ± 1·5 kg/m(2), age: 31·3 ± 1·6 years) and compared them with 21 control overweight/obese women (BMI: 33·0 ± 1·4 kg/m(2), age: 28·2 ± 1·6 years) presenting a similar metabolic profile (fasting total, HDL and LDL cholesterol, glucose, triglycerides, insulin sensitivity and blood pressure). RESULTS: Women with PCOS had elevated multiunit muscle SNS activity (41 ± 2 vs 33 ± 3 bursts per 100 heartbeats, P < 0·05). Single-unit analysis showed that vasoconstrictor neurons were characterized by elevated firing rate and probability and incidence of multiple spikes (P < 0·01 for all parameters). Women with PCOS also had impaired endothelial function (RHI: 1·77 ± 0·14 vs 2·18 ± 0·14, P < 0·05). HRV did not differ between the groups. CONCLUSION: Women with PCOS have increased sympathetic drive and impaired endothelial function independent of obesity and metabolic disturbances. Sympathetic activation and endothelial dysfunction may confer greater cardiovascular risk in women with PCOS.
OBJECTIVE:Polycystic ovary syndrome (PCOS) is a common endocrine condition underpinned by insulin resistance and associated with increased risk of obesity, type 2 diabetes and adverse cardiovascular risk profile. Previous data suggest autonomic imbalance [elevated sympathetic nervous system (SNS) activity and decreased heart rate variability (HRV)] as well as endothelial dysfunction in PCOS. However, it is not clear whether these abnormalities are driven by obesity and metabolic disturbance or whether they are independently related to PCOS. PARTICIPANTS AND METHODS: We examined multiunit and single-unit muscle SNS activity (by microneurography), HRV (time and frequency domain analysis) and endothelial function [ischaemic reactive hyperaemia index (RHI) using the EndoPAT device] in 19 overweight/obesewomen with PCOS (BMI: 31·3 ± 1·5 kg/m(2), age: 31·3 ± 1·6 years) and compared them with 21 control overweight/obesewomen (BMI: 33·0 ± 1·4 kg/m(2), age: 28·2 ± 1·6 years) presenting a similar metabolic profile (fasting total, HDL and LDL cholesterol, glucose, triglycerides, insulin sensitivity and blood pressure). RESULTS:Women with PCOS had elevated multiunit muscle SNS activity (41 ± 2 vs 33 ± 3 bursts per 100 heartbeats, P < 0·05). Single-unit analysis showed that vasoconstrictor neurons were characterized by elevated firing rate and probability and incidence of multiple spikes (P < 0·01 for all parameters). Women with PCOS also had impaired endothelial function (RHI: 1·77 ± 0·14 vs 2·18 ± 0·14, P < 0·05). HRV did not differ between the groups. CONCLUSION:Women with PCOS have increased sympathetic drive and impaired endothelial function independent of obesity and metabolic disturbances. Sympathetic activation and endothelial dysfunction may confer greater cardiovascular risk in women with PCOS.
Authors: Barbara I Gulanski; Clare A Flannery; Patricia R Peter; Cheryl A Leone; Nina S Stachenfeld Journal: Clin Endocrinol (Oxf) Date: 2019-12-13 Impact factor: 3.478
Authors: Elisabet Stener-Victorin; Vasantha Padmanabhan; Kirsty A Walters; Rebecca E Campbell; Anna Benrick; Paolo Giacobini; Daniel A Dumesic; David H Abbott Journal: Endocr Rev Date: 2020-07-01 Impact factor: 19.871