Autonomic dysfunction and flow-mediated dilation in polycystic ovary syndrome (PCOS): A case-control study. Dysautonomia in polycistic ovary syndrome

Aim: a case-control study was conducted on women with polycystic ovary syndrome (PCOS) with a view to identifying endothelial and autonomic nervous system dysfunctions capable of explaining the higher cardiovascular risk associated with PCOS. Material and methods: 35 women (mean age 26.51 \ub13; BMI 24.25 \ub11.65) with documented PCOS and 35 controls matched for age, BMI and cardiovascular risk factors were studied during a solar year. Endothelial dysfunction was assessed using flow-mediated dilation (FMD) and early atherosclerosis from the intima media thickness (IMT) of the carotid district measured using eco-color Doppler. Autonomic dysfunction was assessed with the classic tests (tilt, lying-to-standing, deep breath, Valsalva, Stroop). Results: by comparison with controls, patients with PCOS had an altered response in some of the autonomic tests, i.e. lying-to-standing (mean values 3.25 \ub14 mmHg vs -3.4 \ub12.04, p<0.01); deep breath (RR max/RR min 1.03 \ub10.04 vs 1.35 \ub1 0.05, p<0.01) and Valsalva (RRmax/RRmin 1.10 \ub1 0.05 vs 1.35 \ub1 0.05, p<0.01), but no relevant differences in the tilt, hand grip and Stroop tests. A diminished FMD (0.56 \ub1 0.8mm vs 0.74 \ub1 0.06mm, p