Visceral fat is associated with cardiovascular risk in women with polycystic ovary syndrome

BACKGROUND: Women with polycystic ovary syndrome (PCOS) have been reported to have subclinical cardiovascular disease (CVD) and increased abdominal fat. The aim of this study was to evaluate the relationship between visceral fat (VF) and early markers of CVD in PCOS women. METHODS: Two hundred overweight PCOS women [(mean ± SD) age 24.6 ± 3.2 years, body mass index (BMI) 28.5 ± 2.8 kg/m²] and 100 healthy age- and BMI-matched volunteer controls entered this cross-sectional study. In all subjects, the amount of VF was measured by ultrasonography. Anthropometric measurements [BMI and waist circumference (WC)], complete hormonal and metabolic pattern, carotid intima-media thickness (IMT), brachial arterial flow-mediated dilation (FMD) and inflammatory biomarkers [C-reactive protein (CRP), fibrinogen, white blood cells count and plasminogen activated inhibitor-1] were also obtained from all subjects. A stepwise linear regression model was used in PCOS patients to verify if IMT or FMD as dependent variables are affected by other independent variables. RESULTS: VF amount was significantly (P <0.001) higher in PCOS subjects than in healthy controls [31.4 ± 7.3 versus 28.0 ± 6.1 (mean±SD) mm, respectively] and directly related to insulin resistance: HOMA (r = 0.918, P <0.001) and AUC_INS (r = 0.879, P <0.001), and to WC (r = 0.658; P <0.001). In PCOS, the two linear regression analyses showed that IMT is positively affected by VF and CRP, whereas FMD is positively affected by IMT and negatively by VF and CRP. CONCLUSIONS: VF amount is associated with subclinical CVD in PCOS patients.