Fertility and Sterility
Volume 80, Issue 1 , Pages 123-127 , July 2003

Decreased total antioxidant status and increased oxidative stress in women with polycystic ovary syndrome may contribute to the risk of cardiovascular disease

  • Veysel Fenkci, M.D.

      Affiliations

    • Departments of Obstetrics and Gynecology, School of Medicine, Kocatepe University, Afyon, Turkey
    • Corresponding Author InformationReprint requests: Veysel Fenkci, M.D., Cumhuriyet Mh. H. Ogdum C., Gozde Apt. No. 16/1, 03200, Afyon, Turkey (FAX: 90-272-214-49-96).
  • ,
  • Semin Fenkci, M.D.

      Affiliations

    • Department of Internal Medicine, School of Medicine, Kocatepe University, Afyon, Turkey
    • Present address: Department of Endocrinology and Metabolism, School of Medicine, Pamukkale University, Denizli, Turkey
  • ,
  • Mehmet Yilmazer, M.D.

      Affiliations

    • Departments of Obstetrics and Gynecology, School of Medicine, Kocatepe University, Afyon, Turkey
  • ,
  • Mustafa Serteser, M.D.

      Affiliations

    • Department of Biochemistry, School of Medicine, Kocatepe University, Afyon, Turkey

Received 4 September 2002 ,Revised 23 December 2002 ,Accepted 23 December 2002.

References 

  1. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of polycystic ovary syndrome in unselected black and white women of the southeastern United States (a prospective study). J Clin Endocrinol Metab. 1998;83:3078–3082
  2. Utiger RD. Insulin and the polycystic ovary syndrome. N Engl J Med. 1996;335:657–658
  3. Franks S, Gilling-Smith C, Watson H, Willis D. Insulin action in the normal and polycystic ovary. Endocrinol Metab Clin North Am. 1999;28:361–378
  4. Meirow D, Yossepowitch O, Rosler A, Brzezinski A, Schenker JG, Laufer N, et al.  Insulin resistant and non-resistant polycystic ovary syndrome represent two clinical and endocrinological subgroups. Hum Reprod. 1995;10:1951–1956
  5. Poretsky L, Piper B. Insulin resistance, hypersecretion of LH and a dual-defect hypothesis for the pathogenesis of polycystic ovary syndrome. Obstet Gynecol. 1994;84:613–621
  6. Pasquali R, Venturoli S, Paradisi R, Capelli M, Parenti N, Melchionda N. Insulin and C-peptide levels in obese patients with polycystic ovaries. Horm Metab Res. 1982;14:284–287
  7. Shoupe D, Kumar DD, Lobo RA. Insulin resistance in polycystic ovary syndrome. Am J Obstet Gynecol. 1983;147:588–592
  8. Chang RJ, Nakamura RM, Judd HL, Kaplan SA. Insulin resistance in nonobese patients with polycystic ovarian disease. J Clin Endocrinol Metab. 1983;57:356–359
  9. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance independent of obesity in polycystic ovary syndrome. Diabetes. 1989;38:1165–1174
  10. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–1607
  11. Wild RA. Cardiovascular disease risks, insulin resistance, and androgen excess. Semin Reprod Endocrinol. 1994;12:38–44
  12. Guzick DS, Talbott EO, Sutton-Tyrrell K, Herzog HC, Kuller LH, Wolfson SK. Carotid atherosclerosis in women with polycystic ovary syndrome (initial results from a case-control study). Am J Obstet Gynecol. 1996;174:1224–1232
  13. Talbott E, Guzick D, Clerici A, Berga S, Detre K, Weimer K, et al.  Coronary heart disease risk factors in women with polycystic ovary syndrome. Arterioscler Thromb Vasc Biol. 1995;15:821–826
  14. Dunaif A. Insulin resistance and the polycystic ovary syndrome (mechanism and implications for pathogenesis). Endocr Rev. 1997;18:774–800
  15. 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;126:32–35
  16. Conway GS, Agrawal R, Betteridge DJ, Jacobs HS. Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol (Oxf). 1992;37:119–125
  17. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141–146
  18. Guzick DS. Cardiovascular risk in women with polycystic ovarian syndrome. Semin Reprod Endocrinol. 1996;14:45–49
  19. Conway GS, Jacobs HS. Clinical implications of hyperinsulinemia in women. Clin Endocrinol (Oxf). 1993;39:623–632
  20. DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care. 1991;14:173–194
  21. Barbieri R, Makris A, Randall R, Daniels G, Kistner R, Ryan K. Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. J Clin Endocrinol Metab. 1986;62:904–910
  22. Cara J, Rosenfield R. Insulin-like growth factor-I and insulin potentiate luteinizing hormone-induced androgen synthesis by rat ovarian theca-interstitial cells. Endocrinology. 1988;123:733–739
  23. Stuart D, Nagamani M. Acute augmentation of plasma androstenedione and dehydroepiandrosterone by euglycemic insulin infusion (evidence for a direct effect of insulin on ovarian steroidogenesis). In:  Dunaif A,  Givens J,  Haseltine F,  Merriam G editor. Current issues in endocrinology and metabolism (polycystic ovary syndrome). Cambridge, MA: Blackwell; 1992;p. 279–288
  24. Slowinska-Srzednicka J, Zgliczynski S, Wierzbicki M, Srzednicki M, Stopinska-Gluszak U, Zgliczynski W, et al.  The role of hyperinsulinemia in the development of lipid disturbances in nonobese and obese women with the polycystic ovary syndrome. J Endocrinol Invest. 1991;14:569–575
  25. Writing Group for the PEPI Trial . Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA. 1995;273:199–208
  26. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, et al.  Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in post-menopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998;280:605–613
  27. Lieberman EH, Gerhard MD, Uehata A, Walsh BW, Selwyn AP, Ganz P, et al.  Estrogen improves endothelium-dependent, flow-mediated vasodilation in post-menopausal women. Ann Intern Med. 1994;121:936–941
  28. Wild RA, Grubb BG, Hartz A, VanNort JJ, Bachman W, Bartholomew M. Clinical signs of androgen excess as risk factors for coronary artery disease. Fertil Steril. 1990;54:255–259
  29. Dahlgren E, Janson PO, Johansson S, Lapidus L, Oden A. Polycystic ovary syndrome and risk for myocardial infarction. Evaluated from a risk factor model based on a prospective population study of women. Acta Obstet Gynecol Scand. 1992;71:599–604
  30. Paradisi G, Steinberg HO, Hempfling A, Cronin J, Hook G, Shepard MK, et al.  Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation. 2001;103:1410–1415
  31. Mather KJ, Kwan F, Corenblum B. Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity. Fertil Steril. 2000;73:150–156
  32. Giugliano D, Ceriello A, Paolisso G. Oxidative stress and diabetic vascular complications. Diabetes Care. 1996;19:257–267
  33. Baynes JW. Role of oxidative stress in development of complications in diabetes. Diabetes. 1991;40:405–412
  34. Riemersma RA, Wood DA, Macintyre CC, Elton RA, Gey KF, Oliver MF. Risk of angina pectoris and plasma concentrations of vitamins A, C and E and carotene. Lancet. 1991;337:1–5
  35. Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med. 1993;328:1444–1449
  36. Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC. Vitamin E consumption and the risk of coronary disease in men. N Engl J Med. 1993;328:1450–1456
  37. Hertog MG, Feskens EJ, Hollman PC, Katan MB, Kromhout D. Dietary antioxidant flavonoids and risk of coronary heart disease (the Zutphen Elderly Study). Lancet. 1993;342:1007–1011
  38. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–1447
  39. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment (insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man). Diabetologia. 1985;28:412–419
  40. Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998;21:2191–2192
  41. Levine RL, Garland D, Oliver CN, Amici A, Climent I, Lenz AG, et al.  Determination of carbonyl content in oxidatively modified proteins. Methods Enzymol. 1990;186:464–478
  42. Halliwell B. Free radicals, antioxidants and human disease (curiosity, cause or consequence?). Lancet. 1994;344:721–724
  43. Beckman KB, Ames BN. The free radical theory of aging matures. Physiol Rev. 1998;78:547–581
  44. Wallace DC, Melov S. Radicals r’aging. Nat Genet. 1998;19:105–106
  45. Sohal RS. The free radical hypothesis of ageing (an appraisal of the current status). Aging (Milano). 1993;5:3–17
  46. Betteridge DJ. What is the oxidative stress?. Metabolism. 2000;49(Suppl 1):3–8
  47. Garibaldi S, Valentini S, Aragno I, Pronzato MA, Traverso N, Odetti P. Plasma protein oxidation and antioxidant defense during aging. Int J Vitam Nutr Res. 2001;71:332–338
  48. Sabuncu T, Vural H, Harma M, Harma M. Oxidative stress in polycystic ovary syndrome and its contribution to the risk of cardiovascular disease. Clin Biochem. 2001;34:407–413
  49. Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation. 1998;98:731–733
  50. Brousseau ME, Schaefer EJ. New targets for medical treatment of lipid disorders. Curr Atheroscler Rep. 2002;4:343–349

PII: S0015-0282(03)00571-5

doi: 10.1016/S0015-0282(03)00571-5

Fertility and Sterility
Volume 80, Issue 1 , Pages 123-127 , July 2003