ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Assessment of aortic wave reflection in lean and obese women with polycystic ovary syndrome



Introduction. Conflicting findings have been published regarding the pressure wave reflection and the arterial stiffness in young women with polycystic ovary syndrome (PCOS) as opposed to the overt ab initio presence of endothelial dysfunction, which can be reversed six months after metformin administration.

The aim of this study was to investigate wave reflections in women with PCOS and to evaluate the effect of metformin treatment.

Material and methods. Sixty-four young women, 35 with PCOS (P) (20 lean(L), PL; 15 overweight/ obese (OWB), POWB) and 29 controls (18 CL;11 COWB) were studied. Wave reflection was assessed by the Augmentation Index (AIx) as central augmentation pressure-to-pulse height ratio corrected for heart rate (HR) 75 bpm (AIX@75) or without HR correction AIx and the central augmentation time index (Tr). The endothelial function was evaluated biochemically by plasma endothelin 1(ET-1) levels. The metabolic and hormonal profile and a dvanced glycated end-products (AGEs) levels were also assessed. Metformin (1700 mg/daily) was administered for six months in 20 (9 lean, 11 obese) women with PCOS and the measurements were repeated.

Results. All subgroups had comparable age. Wave reflection indices did not differ between PCOS and controls. AIx@75 significantly improved post-metformin treatment in POWB (p=0.046). AGE levels differed between PCOS women groups and controls (p<0.001), but their values became normal after metformin treatment. ET-1 levels did not differ between PCOS and controls, but they were significantly improved post-metformin treatment in both lean and obese PCOS groups (p=0.01, p=0.04, respectively).

Conclusions. Wave reflection markers seem to be a covert negative predictor in PCOS, which ameliorates after treatment with metformin, particularly in the overweight/obese subgroup of PCOS women.

Keywords: aortic wave reflection, insulin resistance, polycystic ovarian syndrome, metformin, endothelin-1.

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Address for correspondence:
Krystallenia I. ALEXANDRAKI
Endocrine Unit, 1st Department of Propaedeutic Internal Medicine, Laiko University Hospital, National and Kapodistrian University of Athens, Medical School
Address: Mikras Asias 75, 11527, Athens, Greece
E-mail:; Phone: +306977616161; fax: +302108024440


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Alexandraki KI, Kandaraki E, Papaioannou TG, Piperi C, Argyris AA, Aznaouridis K, Papamichael C, Stamatelopoulos K, Protogerou A, Lekakis J. Assessment of aortic wave reflection in lean and obese women with polycystic ovary syndrome. Arch Balk Med Union. 2020;55(2):224-232.