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01.01.2014 | General Gynecology

Elevated diastolic blood pressure in insulin-resistant polycystic ovarian syndrome patients

verfasst von: Angélica Maria Holanda Pascoal da Silva, Ana Carolina Rodrigues de Andrade, Bruno Hállan Meneses Dias, Maria Angelina da Silva Medeiros, Vietla Satianarayana Rao, Francisco das Chagas Medeiros

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 1/2014

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Abstract

Objective

The purpose of this study was to further understand interrelationships between insulin resistance in PCOS and elevated diastolic blood pressure.

Design

A prospective case control study.

Participants

Fifty normal women and 43 PCOS patients, 16 of them with insulin resistance.

Setting

Academic Institution.

Interventions

Clinical, anthropometric and ultrasonographic features of PCOS were assessed, as were blood levels for luteinizing hormone, follicle-stimulating hormone, androstenedione, DHEAS, and basal insulin. A lipid profile and an oral glucose tolerance test (OGTT) were also performed.

Main outcome measures

To demonstrate the effect of insulin resistance on blood pressure in patients with PCOS.

Results

Patients with PCOS and those with PCOS plus insulin resistance (IR) had significantly elevated levels of plasma androgen but only those with IR showed greater body mass index and waist: hip ratios than PCOS or control. PCOS plus IR differed significantly in their response to OGTT when compared to PCOS or control. Alterations in lipid profile were shown to be atherogenic. Patients with PCOS plus IR demonstrated a significant elevation of diastolic blood pressure when compared to PCOS alone or controls.

Conclusions

We hypothesize that hyperlipidemia and IR may be involved in the pathophysiologic features of the elevated diastolic blood pressure in PCOS patients.

Capello M, Simonsen U, Rungby J (2010) Prevalencia de Hipertensión y Microalbuminuria en el Síndrome de Ovarios Poliquísticos. Rev Argent Endocrinol Metab 47(2):40–52

The Amsterdam ESHRE/ASRM–Sponsored 3rd PCOS Consensus Workshop Group (2012) Consensus on women′s health aspects of polycystic ovary syndrome (PCOS). Hum Reprod 27(1):14–24CrossRef

Olefsky JM, Glass CK (2010) Macrophages, Inflammation, and Insulin resistance. Annu Rev Physiol 72(1):219PubMedCrossRef

Levin G, Kestenbaum B, Chen YDI, Jacobs DR, Psaty BM, Rotter JL, Siscovick DS, Boer IH (2010) Glucose, insulin and incident hypertension in the multi-ethinic study of atherosclerosis. Am J Epidemiol 172(10):1144–1154PubMedCrossRef

Conway GS, Agrawal R, Betteridge DJ, Jacobs HS (1992) Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol 37:119–125CrossRef

Mattsson LA, Cullberg G, Hamberger L, Samsioe G, Silfverstolpe G (1984) Lipid metabolism in women with polycystic ovary syndrome: possible implications for an increased risk of coronary heart disease. Fertil Steril 42:579–584PubMed

Zimmerman S, Phillips RA, Dunaif A, Finegood DT, Wilkenfeld C, Ardeljan M, Gorlin R, Krakoff LR (1992) Polycystic ovary syndrome: lack of hypertension despite profound insulin resistance. J Clin Endocrinol Metab 75:508–513CrossRef

Holte J, Genarelli G, Berne C, Bergh T, Lithell H 1996 Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state? Hum Reprod 11(1):23-28

Rotterdam ESHRE/ASRM–Sponsored PCOS consensus workshop group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19(1):41–47CrossRef

10.

Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stein MP (1992) Prospective analysis of the insulin-resistance syndrome (X syndrome). Diabetes 41:715–722PubMedCrossRef

11.

World Health Organization. WHO Expert Committee on Diabetes Mellitus: second report. Geneva, World Health Org 1980. Tech Rep Ser 646:1–80

12.

Hollenbeck CB, Chen YDI, Reaven GM (1984) Relationship between plasma insulin response to oral glucose and insulin stimulated glucose utilization in normal subjects. Diabetes 38:460–463CrossRef

13.

Dale PO, Tanbo T, Vaaler S, Abyholm T (1992) Body weight, hyperinsulinemia and gonadotropin levels in the polycystic ovarian syndrome: evidence of two distinct populations. Fertil Steril 58:487–491PubMed

14.

Muller DC, Elahi D, Pratley RE, Tobin JD, Andres R (1993) And epidemiological test of the hyperinsulinemia hypertension hypothesis. J Clin Endocrinol Metab 76:544–548PubMedCrossRef

15.

Bonora E, Zavaroni I, Alpi O et al (1987) Relationship between blood pressure and plasma insulin in non-obese and obese non-diabetic subjects. Diabetologia 30:719–723PubMedCrossRef

16.

Haffner SM (1993) Editorial: insulin and blood pressure: fact of fantasy? J Clin Endocrinal Metab 76:541–543CrossRef

17.

Prakash J (2012) Dyslipidemia in diabetic kidney disease. Clinical Queries. Nephrology 1(2):115–118

18.

Azziz R (2002) Polycystic ovary syndrome, Insulin resistance, and Molecular defects of insulin signaling. J Clin Endocrinol Metab 87(9):4085PubMedCrossRef

19.

Golden SH, Folsom AR, Coresh J, Sharett AR, Szklo M, Brancati F (2002) Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis. Diabetes 51(10):3069–3076PubMedCrossRef

20.

Rossing P, Hommel E, Smidt UM, Parving H–H (1993) Impact of arterial blood pressure and albuminuria on the progression of diabetic nephropathy in IDDM patients. Diabetes 42:715–719PubMedCrossRef

21.

Mogensen CE (1976) Progression of nephropathy in long-term diabetics with proteinuria and effect of initial antihypertensive treatment. Scand J Clin Lab Invest 36:383–388PubMedCrossRef

22.

Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J (2011) Harrison’s Principles of internal medicine, 18th edn. McGraw-Hill, New York

Titel: Elevated diastolic blood pressure in insulin-resistant polycystic ovarian syndrome patients
verfasst von: Angélica Maria Holanda Pascoal da Silva
Ana Carolina Rodrigues de Andrade
Bruno Hállan Meneses Dias
Maria Angelina da Silva Medeiros
Vietla Satianarayana Rao
Francisco das Chagas Medeiros
Publikationsdatum: 01.01.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 1/2014
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-2953-2

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Elevated diastolic blood pressure in insulin-resistant polycystic ovarian syndrome patients