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Tissue Plasminogen Activator and Plasminogen Activator Inhibitor 1 in Overweight and Lean Patients with Polycystic Ovary Syndrome
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (reproduktiv hälsa)
Klinisk vetenskap, Umeå universitet.
Folkhälsa och klinisk medicin, Umeå universitet.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (reproduktiv hälsa)
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(English)Manuscript (preprint) (Other (popular science, discussion, etc.))
Abstract [en]

Objective: Disturbances in the fibrinolytic system are predictors of future cardiovascular events. The aim of the present study was to compare PAI-1 activity and tPA mass concentration between patients with polycystic ovary syndrome (PCOS) and control subjects.

Design: 135 PCOS patients (lean and overweight) and 81 healthy controls were recruited for the study. Blood samples for PAI-1 activity and tPA mass were collected together with anthropometric measures.

Results: Overweigth PCOS patients displayed increased tPA mass concentration in comparison with controls (p < 0.05), and this finding was consistent regardless of whether patients displayed signs of hyperandrogenism or not. When hyperandrogenism was introduced as a prerequisite for the PCOS diagnosis, overweight PCOS patients displayed increased PAI-1 activity as well, p < 0.05. Lean PCOS patients did not differ in terms of PAI-1 activity or tPA mass concentration in comparison to controls.

Conclusion: Overweight women with PCOS have impaired fibrinolysis, in particular if they also display objective biochemical markers of hyperandrogenism.

Keyword [en]
polycystic ovary syndrome, PAI-1, tPA, obesity, free androgen index (FAI)
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-120221OAI: oai:DiVA.org:uu-120221DiVA: diva2:302898
Available from: 2010-03-10 Created: 2010-03-10 Last updated: 2010-03-10Bibliographically approved
In thesis
1. Metabolic Aspects in the Polycystic Ovary Syndrome
Open this publication in new window or tab >>Metabolic Aspects in the Polycystic Ovary Syndrome
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of childbearing age and is associated with a number of metabolic disturbances. It has been hypothesised these women carry an increased risk of developing cardiovascular diseases (CVD) with advancing age.

The first aim of this thesis was to establish the prevalence of PCOS-related symptoms in Northern Sweden. The Northern part of the WHO MONICA project was used for this purpose. Based on self-reported menstrual disturbances and hirsutism together with biochemical analyses of free androgen index, the estimated prevalence of PCOS in Northern Sweden was 4.8%, which corresponded with previous prevalence studies.

Disturbances in the fibrinolytic system are predictors of future cardiovascular events and measurements of plasminogen activator inhibitor 1 (PAI-1) activity and tissue plasminogen activator (tPA) mass concentration may be used to assess fibrinolytic activity in women with PCOS. From the findings, over-weight women with PCOS had impaired fibrinolysis, especially if they displayed objective biochemical markers of hyperandrogenism. Conversely, lean women with PCOS, displayed no signs of disturbed fibrinolysis.

The adipose tissue is an active endocrine organ that produces and releases hormones, pro- and anti-inflammatory cytokines, and chemoattractant cytokines. Proinflammatory molecules produced by adipose tissue can be active participants in the development of insulin resistance and the increased risk of cardiovascular disease associated with obesity. The findings suggested being overweight, rather than the PCOS diagnosis per se, was the main explanatory variable for elevated adipose tissue inflammation in PCOS patients.

Weight reduction is the primary target for intervention in overweight and obese women with PCOS. When this thesis was planned, no placebo-controlled trials on anti-obesity drugs in women with PCOS had been conducted. Sibutramine in combination with lifestyle intervention resulted in significant weight reduction in overweight women with PCOS. In addition to the weight loss, sibutramine appeared to have a beneficial effect on metabolic and cardiovascular risk factors.

 

 

 

 

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 65 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 534
Keyword
PCOS, prevalence, fibrinolysis, inflammatory markers, over weight
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-120235 (URN)978-91-554-7746-2 (ISBN)
Public defence
2010-04-23, Konferenscentrum, Sunderby sjukhus, Luleå, 12:00 (Swedish)
Opponent
Supervisors
Available from: 2010-04-01 Created: 2010-03-10 Last updated: 2010-04-01Bibliographically approved

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Lindholm, Åsa Maria

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