Abstract
To study and critically analyze the published evidence on correlation of hormonal
abnormalities and endothelial dysfunction (ED) in polycystic ovary syndrome (PCOS)
through a systematic review. The databases including MEDLINE, PubMed, Up-To-Date,
and Science Direct were searched using Medical subject handling terms and free text
term keywords such as endocrine abnormalities in PCOS, ED assessment in PCOS, ED in
combination with insulin resistance (IR), hyperandrogenism (HA), increased free testosterone,
free androgen index (FAI), gonadotrophin levels, luteinizing hormone (LH), prolactin,
estrogen, adipocytokines to search trials, and observational studies published from
January 1987 to September 2015. Authors of original studies were contacted for additional
data when necessary. PCOS increases the risk of cardiovascular disease in women. ED,
which is a reliable indicator of cardiovascular risk in general population, is seen
in most (but not all) women with PCOS. IR, seen in 70% patients with PCOS, is associated
with ED in these women, but patients can have normal endothelial function even in
the presence of IR. Free testosterone and FAI are consistently associated with ED,
but endothelial function can be normal despite HA. Estradiol (not estrone) appears
to be protective against ED though estrone is the predominant estrogen produced in
PCOS. Increased levels of adipocytokines (visfatin) are promising in predicting ED
and cardiovascular risk. However, more studies are required focusing on direct correlation
of levels of prolactin, LH, estrone, and visfatin with ED in PCOS.
Keywords
Adipocyte-secreted hormones - endothelial dysfunction - estrogen - follicular stimulating
hormone - hyperandrogenism - insulin resistance - luteinizing hormone - polycystic
ovary syndrome - prolactin