BibTex RIS Kaynak Göster

Assessment of Endothelium-dependent and Independent Vasodilation of Brachial Artery in Polycystic Ovary Syndrome

Yıl 2012, Cilt: 19 Sayı: 2, 82 - 87, 01.04.2012

Murat Baykara Cumali Gökçe

Öz

Objective: The endothelium plays an important role in the regulation of vascular tone. Arterial distensibility is a marker of functional and structural wall properties. A decreased distensibility is an important risk factor for cardiovascular disease. Hyperandrogenism may be related to impaired systemic arterial vascular compliance. In this study, using a non-invasive ultrasonography method, we investigated endothelium dependent and endothelium independent vasodilation in the brachial artery of the patients with polycystic ovary syndrome (PCOS). Materials and Methods: Fourteen hyperandrogenemic patients with PCOS and 18 healthy age and BMI matched controls were included in the study. Serum DHEAS, androstenedione, total and free testosterone levels were measured for the diagnosis of hyperandrogenism. Brachial artery diameter was measured at baseline, during post-occlusion reactive hyperaemia (flow-mediated, endothelium dependent dilation), and after 400 µg glyceryl trinitrate sublingually (endothelium-independent dilation). Vasodilation was expressed as the percentage change relative to the baseline diameter. Results: Baseline flow and blood pressure were similar in the patients with PCOS and healthy subjects. Baseline vessel diameter (mm) was not statistically different between the patients with PCOS (3.2±0.3) and control group (3.1±0.4). Endothelium dependent dilation in PCOS patients (7.8±5.4%) was significantly (p<0.05) lower than in control subjects (14.9±7.9%). Endothelium-independent dilation in PCOS patients (10.8±4.2%) was also significantly (p<0.01) lower than in controls subjects (20.3±9.9%). Conclusion: The results of this study suggest that the patients with PCOS have impaired endothelium-dependent and independent vasodilation and it could be determined non-invasive methods. Key words: Polycystic Ovary Syndrome; Hyperandrogenism; Brachial Artery; Vasodilation.

Anahtar Kelimeler

-

Kaynakça

  • Garland CJ, Plane F, Kemp BK, Cocks TM. Endothelium-dependent hyperpolarization: a role in the control of vascular tone. Trends Pharmacol Sci 1995; 16 (1): 23-30. DOI: 10.1016/S0165-6147(00)88969-5
  • Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001; 103(10): 1410-5.
  • Baron AD, Steinberg HO. Endothelial function, insulin sensitivity, and hypertension. Circulation 1997; 96 (3): 725-6.
  • Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD. Obesity/insulin resistance is associated with endothelial dysfunction: implications for the syndrome of insulin resistance. J Clin Invest 1996; 97(11): 2601-10. DOI: 10.1172/JCI118709
  • Laakso M, Edelman SV, Olefsky JM, Brechtel G, Wallace P, Baron AD. Kinetics of in vivo muscle insulin mediated glucose uptake in human obesity. Diabetes 1990; 39(8): 965-74. DOI: 10.2337/diabetes.39.8.965
  • Steinberg HO, Paradisi G, Cronin J, et al. Type II diabetes abrogates sex differences in endothelial function in premenopausal women. Circulation 2000; 101(17): 2040-6.
  • Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow up of the Framingham Study. Am Heart J 1986; 111(2): 383-90. DOI: 10.1016/0002-8703(86)90155-9
  • Kallen AN, Pal L. Cardiovascular disease and ovarian function. Curr Opin Obstet Gynecol 2011; 23(4): 258- 67. DOI: 10.1097/GCO.0b013e3283488a21
  • Lieberman EH, Gerhard MD, Uehata A, et al. Estrogen improves endothelium-dependent, flow-mediated vasodilation in postmenopausal women. Ann Intern Med 1994; 121(12): 936-41.
  • Wilcox JG, Hwang J, Hodis HN, Sevanian A, Stanczyk FZ, Lobo RA. Cardioprotective effects of individual conjugated equine estrogens through their possible modulation of insulin resistance and oxidation of low- density lipoprotein. Fertil Steril 1997; 67(1): 57-62. DOI: 10.1016/S0015-0282(97)81856-0
  • Brussaard HE, Gevers Leuven JA, Frölich M, Kluft C, Krans HM. Short-term oestrogen replacement therapy improves insulin resistance, lipids and fibrinolysis in postmenopausal women with NIDDM. Diabetologia 1997; 40(7): 843-9. DOI: 10.1007/s001250050758
  • Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2006; 295(11): 1288-99. DOI: 10.1001/jama.295.11.1288
  • Percheron C, Colette C, Mariano-Goulart D, et al. Relationship between insulin sensitivity, obesity, body fat distribution and b-endorphinaemia in obese women. Int J Obes Relat Metabol Disord 1998; 22(2): 143-8. DOI: 10.1038/sj.ijo.0800556
  • Jones AE. Diagnosis and treatment of polycystic ovarian syndrome. Nurs Times 2005; 101(3): 40-3.
  • Botwood N, Hamilton-Fairley D, Kiddy D, Robinson S, Franks S. Sex hormone-binding globulin and female reproductive function. J Steroid Biochem Mol Biol 1995; 53(1-6): 529-31.
  • Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertil Steril 2008; 89(4): 899-906. DOI: 10.1016/j.fertnstert.2007.04.043
  • Wild RA, Grubb B, Hartz A, Van Nort JJ, Bachman W, Bartholomew M. Clinical signs of androgen excess as risk factors for coronary artery disease. Fertil Steril 1990; 54(2): 255-9.
  • 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(1): 32-5.
  • Anderson TJ, Uehata A, Gerhard MD, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26(5): 1235-41. DOI: 10.1016/0735-1097(95)00327-4
  • Talbott E, Guzick D, Clerici A, et al. Coronary heart disease risk factors in women with polycystic ovary syndrome. Arterioscler Thromb Vasc Biol 1995; 15(7): 821-6. DOI: 10.1161/01.ATV.15.7.821
  • Celermajer DS, Sorensen KE, Gooch VM, et al. Non- invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340(8828): 1111-5. DOI: 10.1016/0140- 6736(92)93147-F
  • Sorensen KE, Kristensen IB, Celermajer DS.
  • Atherosclerosis in the human brachial artery. J Am Coll Cardiol 1997; 29(2): 318-22. DOI: 10.1016/S0735- 1097(96)00474-3
  • Hashimoto M, Akishita M, Eto M, et al. Modulation of endothelium dependent flow-mediated dilatation of the brachial artery by sex and menstrual cycle. Circulation 1995; 92(12): 3431-5.
  • Palmer RMJ, Ferrige AJ, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987; 327(6122): 524-6. DOI: 10.1038/327524a0
  • Pasquali R, Casimirri F, Vincennati V. Weight control and its beneficial effect on fertility in women with obesity and polycystic ovary syndrome. Hum Reprod 1997; 12(Suppl 1): 82-7.
  • Staessen JA, Thijisq L, Fagard R, et al. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Effects of immediate versus delayed antihypertensive therapy on outcome in the Systolic Hypertension in Europe Trial. J Hypertens 2004; 22(4): 847-57. DOI: 10.1097/00004872-200404000-00029
  • Herman SM, Robinson JT, McCredie RJ, Adams MR, Boyer MJ, Celermajer DS. Androgen deprivation is associated with enhanced endothelium-dependent dilatation in adult men. Arterioscler Thromb Vasc Biol 1997; 17(10): 2004-9. DOI: 10.1161/01.ATV.17.10.2004
  • Creager MA, Gallagher SJ, Girerd XJ, Coleman SM, Dzau VJ, Cooke JP. L-Arginine improves endothelium- dependent vasodilation in hypercholesterolemic humans. J Clin Invest 1992; 90(4): 1248-53. DOI: 10.1172/JCI115987
  • Hashimoto M, Akishita M, Eto M, et al. The impairment of flowmediated vasodilation in obese men with visceral fat accumulation. Int J Obes Relat Metab Disord 1998; 22(5): 477-84. DOI: 10.1038/sj.ijo.0800620
  • Panza JA, Casino PR, Badar DM, Quyyumi AA. Effects of increased availability of endothelium-derived nitric oxide precursor on independent vascular relaxation in normal subjects and in patients with essential hypertension. Circulation 1993; 87(5): 1475-81.
  • Graf MJ, Richards CJ, Brown V, Meissner L, Dunaif A. The independent effects of hyperandrogenaemia, hyperinsulinaemia, and obesity on lipid and lipoprotein profiles in women. Clin Endocrinol (Oxf) 1990; 33(1): 119-31. DOI: 10.1111/j.1365-2265.1990.tb00472.x
  • Kawano H, Motoyama T, Kugiyama K, et al. Gender differences in improvement of endothelial-dependent vasodilation after estrogen supplementation. J Am Coll Cardiol 1997; 30(4): 914-9. DOI: 10.1016/S0735- 1097(97)00234-9
  • Webb CM, Ghatei MA, McNeill JG, Collins P. 17beta- estradiol decreases endothelin-1 levels in the coronary circulation of postmenopausal women with coronary artery disease. Circulation 2000; 102(14): 1617-22.
  • Bu makaleye atıf yapmak için: Baykara M, Gökçe
  • C. Polikistik Over Sendromunda, Brakiyal Arter’in
  • Endotel Bağımlı ve Bağımsız Vazodilatasyonun
  • Araştırılması. JIUMF 2012; 19(2): 82-7. DOI:
  • 7247/jiumf.19.2.4

Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+

Yıl 2012, Cilt: 19 Sayı: 2, 82 - 87, 01.04.2012

Murat Baykara Cumali Gökçe

Öz

Amaç: Endotel vasküler tonusun düzenlenmesinde önemli bir rol oynar. Arteryel esneklik fonksiyonel ve yapısal duvar özelliklerinin bir göstergesidir. Azalmış esneklik kardiyovasküler hastalıklar için önemli bir risk faktörüdür. Hiperandrojenizm sistemik arteryel kompliyans bozukluğu ile ilgili olabilir. Bu çalışmada, non invaziv ultrasonografi yöntemi kullanarak polikistik over sendromlu (PKOS) kadınlarda brakiyal arterde endotel bağımlı ve endotel bağımsız vazodilatasyonu araştırdık. Gereç ve Yöntem: Ondört PKOS'lu hiperandrojenemik kadın ile yaş ve vücut kitle indeksi uyumlu 18 olguluk sağlıklı kontrol grubu çalışmaya alındı. Hiperandrojenizm tanısı için serum DHEAS, androstenedion, total ve serbest testosteron düzeyleri ölçüldü. Brakiyal arter çapı başlangıçta, tıkanık sonrası reaktif hiperemi (akım aracılı, endotel bağımlı dilatasyon) ile dilaltı 400 mikrogram gliseril trinitrat sonrasında (endotel bağımsız dilatasyon) ölçüldü. Vazodilatasyon başlangıç çapına göreceli olarak yüzde değişim olarak ifade edildi. Bulgular: Başlangıç akımı ve kan basıncı PKOS'lu kadınlarda ve sağlıklı kontrollerde benzerdi. Başlangıç damar çapı (mm) PKOS'lu kadınlarla (3,2±0,3) kontrol grubu (3,1±0,4) arasında istatistiksel olarak farklı değildi. Akım aracılı dilatasyon PKOS'lu kadınlarda (%7,8±5,4) kontrol grubuna (%14,9±7,9) göre anlamlı olarak (p<0,05) daha düşüktü. PKOS'lu kadınlardaki (%10,8±4,2) endotel bağımsız dilatasyon da kontrol olgularına (%20,3±9,9) göre belirgin olarak (p<0,01) daha düşüktü. Sonuç: Bu çalışmanın sonuçları, PKOS'lu kadınlarda endotel bağımlı ve bağımsız vazodilatasyon bozukluğu olduğunu ve bunun noninvaziv yöntemlerle belirlenebileceğini ileri sürmektedir. Anahtar Sözcükler: Polikistik Over Sendromu; Hiperandrojenizm; Brakiyal Arter; Damar Genişlemesi.

Anahtar Kelimeler

-

Kaynakça

  • Garland CJ, Plane F, Kemp BK, Cocks TM. Endothelium-dependent hyperpolarization: a role in the control of vascular tone. Trends Pharmacol Sci 1995; 16 (1): 23-30. DOI: 10.1016/S0165-6147(00)88969-5
  • Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001; 103(10): 1410-5.
  • Baron AD, Steinberg HO. Endothelial function, insulin sensitivity, and hypertension. Circulation 1997; 96 (3): 725-6.
  • Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD. Obesity/insulin resistance is associated with endothelial dysfunction: implications for the syndrome of insulin resistance. J Clin Invest 1996; 97(11): 2601-10. DOI: 10.1172/JCI118709
  • Laakso M, Edelman SV, Olefsky JM, Brechtel G, Wallace P, Baron AD. Kinetics of in vivo muscle insulin mediated glucose uptake in human obesity. Diabetes 1990; 39(8): 965-74. DOI: 10.2337/diabetes.39.8.965
  • Steinberg HO, Paradisi G, Cronin J, et al. Type II diabetes abrogates sex differences in endothelial function in premenopausal women. Circulation 2000; 101(17): 2040-6.
  • Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow up of the Framingham Study. Am Heart J 1986; 111(2): 383-90. DOI: 10.1016/0002-8703(86)90155-9
  • Kallen AN, Pal L. Cardiovascular disease and ovarian function. Curr Opin Obstet Gynecol 2011; 23(4): 258- 67. DOI: 10.1097/GCO.0b013e3283488a21
  • Lieberman EH, Gerhard MD, Uehata A, et al. Estrogen improves endothelium-dependent, flow-mediated vasodilation in postmenopausal women. Ann Intern Med 1994; 121(12): 936-41.
  • Wilcox JG, Hwang J, Hodis HN, Sevanian A, Stanczyk FZ, Lobo RA. Cardioprotective effects of individual conjugated equine estrogens through their possible modulation of insulin resistance and oxidation of low- density lipoprotein. Fertil Steril 1997; 67(1): 57-62. DOI: 10.1016/S0015-0282(97)81856-0
  • Brussaard HE, Gevers Leuven JA, Frölich M, Kluft C, Krans HM. Short-term oestrogen replacement therapy improves insulin resistance, lipids and fibrinolysis in postmenopausal women with NIDDM. Diabetologia 1997; 40(7): 843-9. DOI: 10.1007/s001250050758
  • Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2006; 295(11): 1288-99. DOI: 10.1001/jama.295.11.1288
  • Percheron C, Colette C, Mariano-Goulart D, et al. Relationship between insulin sensitivity, obesity, body fat distribution and b-endorphinaemia in obese women. Int J Obes Relat Metabol Disord 1998; 22(2): 143-8. DOI: 10.1038/sj.ijo.0800556
  • Jones AE. Diagnosis and treatment of polycystic ovarian syndrome. Nurs Times 2005; 101(3): 40-3.
  • Botwood N, Hamilton-Fairley D, Kiddy D, Robinson S, Franks S. Sex hormone-binding globulin and female reproductive function. J Steroid Biochem Mol Biol 1995; 53(1-6): 529-31.
  • Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertil Steril 2008; 89(4): 899-906. DOI: 10.1016/j.fertnstert.2007.04.043
  • Wild RA, Grubb B, Hartz A, Van Nort JJ, Bachman W, Bartholomew M. Clinical signs of androgen excess as risk factors for coronary artery disease. Fertil Steril 1990; 54(2): 255-9.
  • 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(1): 32-5.
  • Anderson TJ, Uehata A, Gerhard MD, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26(5): 1235-41. DOI: 10.1016/0735-1097(95)00327-4
  • Talbott E, Guzick D, Clerici A, et al. Coronary heart disease risk factors in women with polycystic ovary syndrome. Arterioscler Thromb Vasc Biol 1995; 15(7): 821-6. DOI: 10.1161/01.ATV.15.7.821
  • Celermajer DS, Sorensen KE, Gooch VM, et al. Non- invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340(8828): 1111-5. DOI: 10.1016/0140- 6736(92)93147-F
  • Sorensen KE, Kristensen IB, Celermajer DS.
  • Atherosclerosis in the human brachial artery. J Am Coll Cardiol 1997; 29(2): 318-22. DOI: 10.1016/S0735- 1097(96)00474-3
  • Hashimoto M, Akishita M, Eto M, et al. Modulation of endothelium dependent flow-mediated dilatation of the brachial artery by sex and menstrual cycle. Circulation 1995; 92(12): 3431-5.
  • Palmer RMJ, Ferrige AJ, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987; 327(6122): 524-6. DOI: 10.1038/327524a0
  • Pasquali R, Casimirri F, Vincennati V. Weight control and its beneficial effect on fertility in women with obesity and polycystic ovary syndrome. Hum Reprod 1997; 12(Suppl 1): 82-7.
  • Staessen JA, Thijisq L, Fagard R, et al. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Effects of immediate versus delayed antihypertensive therapy on outcome in the Systolic Hypertension in Europe Trial. J Hypertens 2004; 22(4): 847-57. DOI: 10.1097/00004872-200404000-00029
  • Herman SM, Robinson JT, McCredie RJ, Adams MR, Boyer MJ, Celermajer DS. Androgen deprivation is associated with enhanced endothelium-dependent dilatation in adult men. Arterioscler Thromb Vasc Biol 1997; 17(10): 2004-9. DOI: 10.1161/01.ATV.17.10.2004
  • Creager MA, Gallagher SJ, Girerd XJ, Coleman SM, Dzau VJ, Cooke JP. L-Arginine improves endothelium- dependent vasodilation in hypercholesterolemic humans. J Clin Invest 1992; 90(4): 1248-53. DOI: 10.1172/JCI115987
  • Hashimoto M, Akishita M, Eto M, et al. The impairment of flowmediated vasodilation in obese men with visceral fat accumulation. Int J Obes Relat Metab Disord 1998; 22(5): 477-84. DOI: 10.1038/sj.ijo.0800620
  • Panza JA, Casino PR, Badar DM, Quyyumi AA. Effects of increased availability of endothelium-derived nitric oxide precursor on independent vascular relaxation in normal subjects and in patients with essential hypertension. Circulation 1993; 87(5): 1475-81.
  • Graf MJ, Richards CJ, Brown V, Meissner L, Dunaif A. The independent effects of hyperandrogenaemia, hyperinsulinaemia, and obesity on lipid and lipoprotein profiles in women. Clin Endocrinol (Oxf) 1990; 33(1): 119-31. DOI: 10.1111/j.1365-2265.1990.tb00472.x
  • Kawano H, Motoyama T, Kugiyama K, et al. Gender differences in improvement of endothelial-dependent vasodilation after estrogen supplementation. J Am Coll Cardiol 1997; 30(4): 914-9. DOI: 10.1016/S0735- 1097(97)00234-9
  • Webb CM, Ghatei MA, McNeill JG, Collins P. 17beta- estradiol decreases endothelin-1 levels in the coronary circulation of postmenopausal women with coronary artery disease. Circulation 2000; 102(14): 1617-22.
  • Bu makaleye atıf yapmak için: Baykara M, Gökçe
  • C. Polikistik Over Sendromunda, Brakiyal Arter’in
  • Endotel Bağımlı ve Bağımsız Vazodilatasyonun
  • Araştırılması. JIUMF 2012; 19(2): 82-7. DOI:
  • 7247/jiumf.19.2.4
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Murat Baykara

Cumali Gökçe Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2012
Yayımlandığı Sayı Yıl 2012 Cilt: 19 Sayı: 2

Kaynak Göster

APA Baykara, M., & Gökçe, C. (2012). Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+. Journal of Turgut Ozal Medical Center, 19(2), 82-87.
AMA Baykara M, Gökçe C. Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+. Turgut Özal Tıp Merk Derg. Nisan 2012;19(2):82-87.
Chicago Baykara, Murat, ve Cumali Gökçe. “Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı Ve Bağımsız Vazodilatasyonun Araştırılması+”. Journal of Turgut Ozal Medical Center 19, sy. 2 (Nisan 2012): 82-87.
EndNote Baykara M, Gökçe C (01 Nisan 2012) Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+. Journal of Turgut Ozal Medical Center 19 2 82–87.
IEEE M. Baykara ve C. Gökçe, “Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+”, Turgut Özal Tıp Merk Derg, c. 19, sy. 2, ss. 82–87, 2012.
ISNAD Baykara, Murat - Gökçe, Cumali. “Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı Ve Bağımsız Vazodilatasyonun Araştırılması+”. Journal of Turgut Ozal Medical Center 19/2 (Nisan 2012), 82-87.
JAMA Baykara M, Gökçe C. Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+. Turgut Özal Tıp Merk Derg. 2012;19:82–87.
MLA Baykara, Murat ve Cumali Gökçe. “Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı Ve Bağımsız Vazodilatasyonun Araştırılması+”. Journal of Turgut Ozal Medical Center, c. 19, sy. 2, 2012, ss. 82-87.
Vancouver Baykara M, Gökçe C. Polikistik Over Sendromunda, Brakiyal Arter’in Endotel Bağımlı ve Bağımsız Vazodilatasyonun Araştırılması+. Turgut Özal Tıp Merk Derg. 2012;19(2):82-7.