Risk of Atherosclerosis in Women with Polycystic Ovary Syndrome: A Study from South India

Abstract

Women with polycystic ovary syndrome (PCOS) often present for cosmetic and or reproductive symptoms; attention is generally not paid to the future risk of atherosclerosis for these women. Given that Asian Indians are insulin resistant and prone to metabolic syndrome at an earlier age, we assessed glucose/insulin ratio and intimal medial thickness (IMT) in young women with PCOS from south India. In this cross-sectional case control study, we assessed insulin resistance and carotid IMT in 40 women presenting with hyperandrogenic features of PCOS. Insulin resistance was assessed by fasting glucose/insulin ratio and IMT by the Doppler system with electrical linear transducer midfrequency of 12 MHz. Women with PCOS had higher fasting insulin levels (36.58 ± 17.81 μU/mL, vs. 16.60 ± 3.22 μU/mL in controls; p < 0.001), higher insulin resistance (glucose/insulin ratio 2.81 ± 1.47 vs. 5.47 ± 1.46 in controls; p < 0.001), and greater IMT (0.53 ± 0.14 mm vs. 0.39 ± 0.06 mm in controls; p < 0.001). Women with PCOS had a higher body mass index (BMI) (26.46 ± 5.24 vs. 23.24 ± 3.05 in controls; p < 0.001), and the differences between PCOS and controls persisted, even among those who had a BMI of less than 25. We concluded that South Indian women with the reproductive abnormalities of PCOS have greater insulin resistance and IMT, and therefore they must be advised about lowering the risk of future vascular disease.