You are here

Home » Content

Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması

Assessment of Endothelium-dependent and Independent Vasodilation of Brachial Artery in Polycystic Ovary Syndrome

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2012

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: The endothelium plays an important role in the regulation of vascular tone. Arterial distensibility is a marker of functional and structural wall properties. A decreased distensibility is an important risk factor for cardiovascular disease. Hyperandrogenism may be related to impaired systemic arterial vascular compliance. In this study, using a non-invasive ultrasonography method, we investigated endothelium dependent and endothelium independent vasodilation in the brachial artery of the patients with polycystic ovary syndrome (PCOS). Materials and Methods: Fourteen hyperandrogenemic patients with PCOS and 18 healthy age and BMI matched controls were included in the study. Serum DHEAS, androstenedione, total and free testosterone levels were measured for the diagnosis of hyperandrogenism. Brachial artery diameter was measured at baseline, during postocclusion reactive hyperaemia (flow-mediated, endothelium dependent dilation), and after 400 μg glyceryl trinitrate sublingually (endothelium-independent dilation). Vasodilation was expressed as the percentage change relative to the baseline diameter. Results: Baseline flow and blood pressure were similar in the patients with PCOS and healthy subjects. Baseline vessel diameter (mm) was not statistically different between the patients with PCOS (3.2±0.3) and control group (3.1±0.4). Endothelium dependent dilation in PCOS patients (7.8±5.4%) was significantly (p<0.05) lower than in control subjects (14.9±7.9%). Endothelium-independent dilation in PCOS patients (10.8±4.2%) was also significantly (p<0.01) lower than in controls subjects (20.3±9.9%). Conclusion: The results of this study suggest that the patients with PCOS have impaired endothelium-dependent and independent vasodilation and it could be determined noninvasive methods.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Endotel vasküler tonusun düzenlenmesinde önemli bir rol oynar. Arteryel esneklik fonksiyonel ve yapısal duvar özelliklerinin bir göstergesidir. Azalmış esneklik kardiyovasküler hastalıklar için önemli bir risk faktörüdür. Hiperandrojenizm sistemik arteryel kompliyans bozukluğu ile ilgili olabilir. Bu çalışmada, non invaziv ultrasonografi yöntemi kullanarak polikistik over sendromlu (PKOS) kadınlarda brakiyal arterde endotel bağımlı ve endotel bağımsız vazodilatasyonu araştırdık. Gereç ve Yöntem: Ondört PKOS’lu hiperandrojenemik kadın ile yaş ve vücut kitle indeksi uyumlu 18 olguluk sağlıklı kontrol grubu çalışmaya alındı. Hiperandrojenizm tanısı için serum DHEAS, androstenedion, total ve serbest testosteron düzeyleri ölçüldü. Brakiyal arter çapı başlangıçta, tıkanık sonrası reaktif hiperemi (akım aracılı, endotel bağımlı dilatasyon) ile dilaltı 400 mikrogram gliseril trinitrat sonrasında (endotel bağımsız dilatasyon) ölçüldü. Vazodilatasyon başlangıç çapına göreceli olarak yüzde değişim olarak ifade edildi. Bulgular: Başlangıç akımı ve kan basıncı PKOS’lu kadınlarda ve sağlıklı kontrollerde benzerdi. Başlangıç damar çapı (mm) PKOS’lu kadınlarla (3,2±0,3) kontrol grubu (3,1±0,4) arasında istatistiksel olarak farklı değildi. Akım aracılı dilatasyon PKOS’lu kadınlarda (%7,8±5,4) kontrol grubuna (%14,9±7,9) göre anlamlı olarak (p<0,05) daha düşüktü. PKOS’lu kadınlardaki (%10,8±4,2) endotel bağımsız dilatasyon da kontrol olgularına (%20,3±9,9) göre belirgin olarak (p<0,01) daha düşüktü. Sonuç: Bu çalışmanın sonuçları, PKOS’lu kadınlarda endotel bağımlı ve bağımsız vazodilatasyon bozukluğu olduğunu ve bunun noninvaziv yöntemlerle belirlenebileceğini ileri sürmektedir.
FULL TEXT (PDF): 
PDF icon arastirmax-polikistik-over-sendromunda-brakiyal-arterin-endotel-bagimli-bagimsiz-vazodilatasyonun-arastirilmasi.pdf
  • 2
82-87
  • Turkish

REFERENCES

References: 

1. Garland CJ, Plane F, Kemp BK, Cocks TM.
Endothelium-dependent hyperpolarization: a role in the
control of vascular tone. Trends Pharmacol Sci 1995;
16 (1): 23-30. DOI: 10.1016/S0165-6147(00)88969-5
2. Paradisi G, Steinberg HO, Hempfling A, et al.
Polycystic ovary syndrome is associated with
endothelial dysfunction. Circulation 2001; 103(10):
1410-5.
3. Baron AD, Steinberg HO. Endothelial function, insulin
sensitivity, and hypertension. Circulation 1997; 96 (3):
725-6.
4. Steinberg HO, Chaker H, Leaming R, Johnson A,
Brechtel G, Baron AD. Obesity/insulin resistance is
associated with endothelial dysfunction: implications
for the syndrome of insulin resistance. J Clin Invest
1996; 97(11): 2601-10. DOI: 10.1172/JCI118709
5. Laakso M, Edelman SV, Olefsky JM, Brechtel G,
Wallace P, Baron AD. Kinetics of in vivo muscle
insulin mediated glucose uptake in human obesity.
Diabetes 1990; 39(8): 965-74. DOI:
10.2337/diabetes.39.8.965
6. Steinberg HO, Paradisi G, Cronin J, et al. Type II
diabetes abrogates sex differences in endothelial
function in premenopausal women. Circulation 2000;
101(17): 2040-6.
7. Lerner DJ, Kannel WB. Patterns of coronary heart
disease morbidity and mortality in the sexes: a 26-year
follow up of the Framingham Study. Am Heart J 1986;
111(2): 383-90. DOI: 10.1016/0002-8703(86)90155-9
8. Kallen AN, Pal L. Cardiovascular disease and ovarian
function. Curr Opin Obstet Gynecol 2011; 23(4): 258-
67. DOI: 10.1097/GCO.0b013e3283488a21
9. Lieberman EH, Gerhard MD, Uehata A, et al. Estrogen
improves endothelium-dependent, flow-mediated
vasodilation in postmenopausal women. Ann Intern
Med 1994; 121(12): 936-41.
10. Wilcox JG, Hwang J, Hodis HN, Sevanian A, Stanczyk
FZ, Lobo RA. Cardioprotective effects of individual
conjugated equine estrogens through their possible
modulation of insulin resistance and oxidation of lowdensity
lipoprotein. Fertil Steril 1997; 67(1): 57-62.
DOI: 10.1016/S0015-0282(97)81856-0
11. Brussaard HE, Gevers Leuven JA, Frölich M, Kluft C,
Krans HM. Short-term oestrogen replacement therapy
improves insulin resistance, lipids and fibrinolysis in
postmenopausal women with NIDDM. Diabetologia
1997; 40(7): 843-9. DOI: 10.1007/s001250050758
Baykara ve ark.
87
12. Ding EL, Song Y, Malik VS, Liu S. Sex differences of
endogenous sex hormones and risk of type 2 diabetes: a
systematic review and meta-analysis. JAMA 2006;
295(11): 1288-99. DOI: 10.1001/jama.295.11.1288
13. Percheron C, Colette C, Mariano-Goulart D, et al.
Relationship between insulin sensitivity, obesity, body
fat distribution and b-endorphinaemia in obese women.
Int J Obes Relat Metabol Disord 1998; 22(2): 143-8.
DOI: 10.1038/sj.ijo.0800556
14. Jones AE. Diagnosis and treatment of polycystic
ovarian syndrome. Nurs Times 2005; 101(3): 40-3.
15. Botwood N, Hamilton-Fairley D, Kiddy D, Robinson
S, Franks S. Sex hormone-binding globulin and female
reproductive function. J Steroid Biochem Mol Biol
1995; 53(1-6): 529-31.
16. Panidis D, Farmakiotis D, Rousso D, Kourtis A,
Katsikis I, Krassas G. Obesity, weight loss, and the
polycystic ovary syndrome: effect of treatment with diet
and orlistat for 24 weeks on insulin resistance and
androgen levels. Fertil Steril 2008; 89(4): 899-906. DOI:
10.1016/j.fertnstert.2007.04.043
17. Wild RA, Grubb B, Hartz A, Van Nort JJ, Bachman W,
Bartholomew M. Clinical signs of androgen excess as
risk factors for coronary artery disease. Fertil Steril
1990; 54(2): 255-9.
18. Birdsall MA, Farquhar CM, White HD. Association
between polycystic ovaries and extent of coronary
artery disease in women having cardiac catheterization.
Ann Intern Med 1997; 126(1): 32-5.
19. Anderson TJ, Uehata A, Gerhard MD, et al. Close
relation of endothelial function in the human coronary
and peripheral circulations. J Am Coll Cardiol 1995;
26(5): 1235-41. DOI: 10.1016/0735-1097(95)00327-4
20. Talbott E, Guzick D, Clerici A, et al. Coronary heart
disease risk factors in women with polycystic ovary
syndrome. Arterioscler Thromb Vasc Biol 1995; 15(7):
821-6. DOI: 10.1161/01.ATV.15.7.821
21. Celermajer DS, Sorensen KE, Gooch VM, et al. Noninvasive
detection of endothelial dysfunction in
children and adults at risk of atherosclerosis. Lancet
1992; 340(8828): 1111-5. DOI: 10.1016/0140-
6736(92)93147-F
22. Sorensen KE, Kristensen IB, Celermajer DS.
Atherosclerosis in the human brachial artery. J Am Coll
Cardiol 1997; 29(2): 318-22. DOI: 10.1016/S0735-
1097(96)00474-3
23. Hashimoto M, Akishita M, Eto M, et al. Modulation of
endothelium dependent flow-mediated dilatation of the
brachial artery by sex and menstrual cycle. Circulation
1995; 92(12): 3431-5.
24. Palmer RMJ, Ferrige AJ, Moncada S. Nitric oxide
release accounts for the biological activity of
endothelium-derived relaxing factor. Nature 1987;
327(6122): 524-6. DOI: 10.1038/327524a0
25. Pasquali R, Casimirri F, Vincennati V. Weight control
and its beneficial effect on fertility in women with
obesity and polycystic ovary syndrome. Hum Reprod
1997; 12(Suppl 1): 82-7.
26. Staessen JA, Thijisq L, Fagard R, et al. Systolic
Hypertension in Europe (Syst-Eur) Trial Investigators.
Effects of immediate versus delayed antihypertensive
therapy on outcome in the Systolic Hypertension in
Europe Trial. J Hypertens 2004; 22(4): 847-57. DOI:
10.1097/00004872-200404000-00029
27. Herman SM, Robinson JT, McCredie RJ, Adams MR,
Boyer MJ, Celermajer DS. Androgen deprivation is
associated with enhanced endothelium-dependent
dilatation in adult men. Arterioscler Thromb Vasc Biol
1997; 17(10): 2004-9. DOI:
10.1161/01.ATV.17.10.2004
28. Creager MA, Gallagher SJ, Girerd XJ, Coleman SM,
Dzau VJ, Cooke JP. L-Arginine improves endotheliumdependent
vasodilation in hypercholesterolemic
humans. J Clin Invest 1992; 90(4): 1248-53. DOI:
10.1172/JCI115987
29. Hashimoto M, Akishita M, Eto M, et al. The
impairment of flowmediated vasodilation in obese men
with visceral fat accumulation. Int J Obes Relat Metab
Disord 1998; 22(5): 477-84. DOI:
10.1038/sj.ijo.0800620
30. Panza JA, Casino PR, Badar DM, Quyyumi AA. Effects
of increased availability of endothelium-derived nitric
oxide precursor on independent vascular relaxation in
normal subjects and in patients with essential
hypertension. Circulation 1993; 87(5): 1475-81.
31. Graf MJ, Richards CJ, Brown V, Meissner L, Dunaif A.
The independent effects of hyperandrogenaemia,
hyperinsulinaemia, and obesity on lipid and lipoprotein
profiles in women. Clin Endocrinol (Oxf) 1990; 33(1):
119-31. DOI: 10.1111/j.1365-2265.1990.tb00472.x
32. Kawano H, Motoyama T, Kugiyama K, et al. Gender
differences in improvement of endothelial-dependent
vasodilation after estrogen supplementation. J Am Coll
Cardiol 1997; 30(4): 914-9. DOI: 10.1016/S0735-
1097(97)00234-9
33. Webb CM, Ghatei MA, McNeill JG, Collins P. 17betaestradiol
decreases endothelin-1 levels in the coronary
circulation of postmenopausal women with coronary
artery disease. Circulation 2000; 102(14): 1617-22.

Thank you for copying data from http://www.arastirmax.com