Article information
Resumen
Objetivo
Valorar el papel de la resistencia a la insulina de forma independiente de la obesidad, en la determinación del riesgo cardiovascular entre mujeres con el síndrome de ovarios poliquísticos (SOPQ).
DiseñoEstudio transversal que examina las relaciones entre hiperinsulinemia,puntuaciones que componen el riesgo cardiovascular y prevalencia de factores de riesgo individuales entre mujeres delgadas y obesas con SOPQ y controles sanos.
PacientesUn total de 30 mujeres con SOPQ definido clínicamente y 25 controles sanos por la edad no seleccionados.
IntervencionesMediciones clínicas y antropomórficas y determinaciones de los niveles de insulina y lípidos.
Mediciones de los resultados principalesInsulina sérica en ayunas y puntuación de riesgo cardiovascular.
ResultadosLas mujeres hiperinsulinémicas con SOPQ conllevaban un mayor riesgo cardiovascular que sus homólogas normoinsulinémicas,las cuales tenían un mayor riesgo que las mujeres control (p < 0,05 por análisis de covariancia). Además de los cambios en los lípidos esperados por la resistencia a la insulina (valores elevados de triglicéridos y bajos de colesterol unido a lipoproteínas de alta densidad),hubo un exceso de colesterol unido a lipoproteínas de baja densidad entre las mujeres con SOPQ (p < 0,01) por análisis de la covariancia. En el mismo rango de índice de masa corporal,las mujeres con SOPQ tenían mayor resistencia a la insulina que los controles,sugiriendo que tanto el SOPQ,por sí mismo,como el índice de masa corporal contribuyen a la resistencia a la insulina observada.
ConclusionesNuestros resultados apoyan la hipótesis de que la resistencia a la insulina en el SOPQ es un determinante del riesgo cardiovascular en conjunto,con independencia de la obesidad. El mecanismo de esta relación es incierto y es objeto de investigación en marcha.
Summary
Objective
To asses the role of insulin resistance, independent of obesity, in determining cardiovascular risk among women with tile polycystic ovarian sindrome (PCOS).
DesignCross-sectional study examining the relations-hips between hyperinsulinemia, composite cardiovascular risk scores, and prevalence of individual risk factors among lean and obese women with PCOS and healthy controls.
Patients30 women with clinically defined PCOS and 25 unselected healthy age-matched controls.
InterventionsClinical and anthropomorphic measurements and laboratory determinations of insulin and lipid levels.
Main outcome measuresFasting serum insulin and a cardiovascular risk score.
ResultsHyperinsulinemic women with PCOS carried more cardiovascular risk than their normoinsuli-nemic counterparts, who in turn had than tre control women (p < 0.05 by analysis of covariance). In addition to the lipid changes expetec with insulin resistance (high triglyceride and low HDL cholesterol levels), the was and excess of LDL cholesterol among the women with PCOS (p < 0.01 by analysis of covariance). Across the range of body mass index, women with PCOS had greater insulin resistance than controls, suggesting that PCOS itself and body mass index both contribute to the observed insulin resistance.
ConclusionsOur data support the hypothesis that insulin resistance in PCOS is a determinant of overall cardiovascular risk independent obesity. The mechanism of this relationship remains uncertain and is the subjects of ongoing research.
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