Abstract
Objective
Hyperhomocysteinaemia is a well-established risk factor for cardiovascular disease.
This study investigated the relationship between hyperhomocysteinaemia and factors
related to polycystic ovary syndrome (PCOS).
Study design
Case–control study. Three hundred and thirty-nine women were included; of these, 84
had hyperhomocysteinaemia (homocysteine >12.4 μmol/l) and 255 had normal homocysteine levels. Homocysteine, high-sensitivity C-reactive
protein, insulin resistance, metabolic disturbance and PCOS-related disturbance were
evaluated. The clinical and biochemical characteristics of women with hyperhomocysteinaemia
and normal homocysteine levels, including insulin resistance, metabolic disturbance
and PCOS-related disturbance, were compared.
Results
Correlation was found between serum homocysteine level and serum total testosterone
level and diastolic blood pressure. No correlation was found between serum homocysteine
level and age, body mass index, insulin resistance and lipid profile. Women with hyperhomocysteinaemia
had a significantly higher risk for biochemical hyperandrogenaemia and higher serum
total testosterone levels than women with normal homocysteine levels. The prevalence
rates of PCOS, oligo-amenorrhoea, polycystic ovary morphology and metabolic disturbance
did not differ between the two groups. The parameters of insulin resistance and lipid
profiles were similar between the two groups, and signs of clinical hyperandrogenism
(hirsutism and the modified Ferriman–Gallwey score) did not differ between the two
groups. Logistic regression analysis found a significant association between hyperandrogenaemia
and hyperhomocysteinaemia (odds ratio 2.24, 95% confidence interval 1.26–4.01).
Conclusions
For women with PCOS, an elevated serum total testosterone level is the main factor
associated with hyperhomocysteinaemia. The association between biochemical hyperandrogenism
and hyperhomocysteinaemia may contribute to cardiovascular risk for women with PCOS.
Keywords
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References
- Mortality of women with polycystic ovary syndrome at long-term follow-up.J Clin Epidemiol. 1998; 51: 581-586
- Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome.Hum Reprod Update. 2011; 17: 741-760
- PCOS in adolescents.Best Pract Res Clin Obstet Gynaecol. 2010; 24: 173-183
- Polycystic ovary syndrome and cardiovascular disease: a premature association?.Endocr Rev. 2003; 24: 302-312
- Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health–National Heart, Lung, and Blood Institute sponsored Women's Ischemia Syndrome Evaluation.J Clin Endocrinol Metab. 2008; 93: 1276-1284
- Hyperhomocysteinemia: an independent risk factor for vascular disease.N Engl J Med. 1991; 324: 1149-1155
- Drugs affecting homocysteine metabolism: impact on cardiovascular risk.Drugs. 2002; 62: 605-616
- Homocysteine metabolism in polycystic ovary syndrome.Gynecol Endocrinol. 2012; 28: 186-189
- Increased arterial stiffness in nonobese women with polycystic ovary syndrome (PCOS) without comorbidities: one more characteristic inherent to the syndrome?.Clin Endocrinol (Oxf). 2009; 71: 406-411
- The cardiovascular risk factor homocysteine is not elevated in young women with hyperandrogenism or hypoestrogenism.Gynecol Obstet Invest. 2002; 53: 200-203
- Asymmetric dimethylarginine levels and carotid intima-media thickness in obese patients with polycystic ovary syndrome and their relationship to metabolic parameters.Fertil Steril. 2010; 93: 1227-1233
- Advanced oxidation protein products are increased in women with polycystic ovary syndrome: relationship with traditional and nontraditional cardiovascular risk factors in patients with polycystic ovary syndrome.Fertil Steril. 2009; 92: 1372-1377
- Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters.J Clin Endocrinol Metab. 2005; 90: 2545-2549
- Clinical and biochemical presentation of polycystic ovary syndrome in women between the ages of 20 and 40.Hum Reprod. 2011; 26: 3443-3449
- Inappropriate gonadotropin secretion in polycystic ovary syndrome.Fertil Steril. 2009; 91: 1168-1174
- Homocysteine and vascular disease in diabetes: a double hit?.Clin Chem Lab Med. 2005; 43: 993-1000
- Coronary heart disease risk factors in women with polycystic ovary syndrome.Arterioscler Thromb Vasc Biol. 1995; 15: 821-826
- Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study.Clin Endocrinol (Oxf). 2000; 52: 595-600
- Menstrual cycle irregularity and risk for future cardiovascular disease.J Clin Endocrinol Metab. 2002; 87: 2013-2017
- Homocysteine – an underestimated atheromatosis risk factor. Do sex hormones influence homocysteine concentrations?.Postepy Hig Med Dosw (Online). 2004; 58: 381-389
- Clinical signs of androgen excess as risk factors for coronary artery disease.Fertil Steril. 1990; 54: 255-259
- Homocysteine and blood pressure.Curr Hypertens Rep. 2003; 5: 26-31
- Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome.Hypertension. 2007; 49: 1442-1447
- Diagnostic criteria for polycystic ovary syndrome in Taiwanese Chinese women: comparison between Rotterdam 2003 and NIH 1990.Fertil Steril. 2007; 88: 727-729
Article info
Publication history
Published online: October 16, 2013
Accepted:
September 27,
2013
Received in revised form:
July 17,
2013
Received:
February 21,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
