| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
CLINICAL STUDY |
Department of Endocrinology, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Carretera de Colmenar km 9'1, E-28034 Madrid, and Centre de Investigación Biomédica en Red Diabetes y Enfeimedades Metabólicas Asociadas CIBERDEM, Spain1 Department of Vascular Surgery, Hospital Universitario La Paz, E-28046 Madrid, Spain2 Department of Clinical Biochemistry, Hospital Universitario Ramón y Cajal, E-28034 Madrid, Spain
(Correspondence should be addressed to H F Escobar-Morreale; Email: hescobarm.hrc{at}salud.madrid.org)
Objective: To study the blood clotting tests and endothelial function of polycystic ovary syndrome (PCOS) patients and non-hyperandrogenic women, and their changes during PCOS treatment, as a function of the presence of obesity and smoking.
Design: Case-control study followed by a randomized clinical trial.
Methods: Blood clotting and endothelial function were analyzed in 40 PCOS patients and 20 non-hyperandrogenic women. Thirty-four PCOS women were randomized to an oral contraceptive containing 35 µg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane35Diario) or metformin (850 mg twice daily), monitoring the changes on these parameters during 24 weeks of treatment. The influence of obesity and smoking was also analyzed.
Results: Blood clotting and endothelial function tests were similar among PCOS patients and controls with the exception of a higher platelet count in the former. Obesity increased circulating fibrinogen levels, prothrombin activity and platelet counts, and reduced prothrombin and activated partial thromboplastin times. Smoking increased fibrinogen levels, platelet counts, and prothrombin activity, and reduced prothrombin time, in relation to the larger waist circumference of smokers. Irrespective of the treatment received, PCOS patients showed a decrease in prothrombin time and an increase in prothrombin activity, with a parallel increase in homocysteine levels in metformin users. The activated partial thromboplastin time decreased markedly in the patients treated with Diane35Diario. Finally, flow-mediated dilation improved in non-smokers irrespective of the drug received, but worsened in smokers.
Conclusions: Oral contraceptives and metformin may exert deleterious effects on blood clotting tests of PCOS women, yet the effects of metformin appear to be milder. Because smoking potentiates some of these effects and deteriorates endothelial function, smoking cessation should be promoted in PCOS patients.
This article has been cited by other articles:
|
|
 |
|
  A. Makedos, D. G. Goulis, A. Papanikolaou, and D. Panidis Serum High-Sensitivity C-Reactive Protein and Homocysteine Changes During Hormonal Therapy in Women With Polycystic Ovary Syndrome: A Prospective, Matched Study Angiology, August 1, 2010; 61(6): 595 - 601. [Abstract] [PDF]
|
|
|
|
 |
|
 N. Agarwal, S. P. L. Rice, H. Bolusani, S. D. Luzio, G. Dunseath, M. Ludgate, and D. A. Rees Metformin Reduces Arterial Stiffness and Improves Endothelial Function in Young Women with Polycystic Ovary Syndrome: A Randomized, Placebo-Controlled, Crossover Trial J. Clin. Endocrinol. Metab., February 1, 2010; 95(2): 722 - 730. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
