1001 J. Endocrinol. Invest. 31: 1001-1007, 2008 ABSTRACT. Young, normotensive, and non-obese women with polycystic ovary syndrome (PCOS) may present abnor- mal hemodynamic alterations (HA). The purpose of this study was to investigate heart rate (HR), intima-media thickness (IMT), and diameter (DCCA) in the common carotid arteries (CCA), flow velocities, and resistance index in both extracra- nial carotid and vertebral arteries (VA), in the abdominal aor- ta (AO) and in the renal arteries (RA) in PCOS women and matched controls. This was a case-control study conducted at a tertiary University Hospital. We studied 53 PCOS women and 53 healthy matched volunteers as controls. The previ- ously reported parameters were assessed using color Doppler ultrasonography. HR, IMT in the CCA, and peak sys- tolic velocity in all examined arteries were significantly in- creased in PCOS women compared to controls. On the con- trary, DCCA was significantly decreased in PCOS women compared to controls. End diastolic velocity (EDV) in both VA and RA, in the AO and in the left extracranial carotid sys- tem was significantly increased in the PCOS group compared to controls. Furthermore, the peripheral resistance (PR) of AO and right external carotid artery was also found to be in- creased while in both RA and in left VA, PR was decreased. No further statistical significant HA in EDV and PR were not- ed. The results of this study provide evidence for a mild hy- perdynamic circulation in young, normotensive, non-obese women with PCOS compared to controls, indicating a mild sympathetic activation at an early age, which may be an un- derlying cause of hypertension and cardiovascular risk. (J. Endocrinol. Invest. 31: 1001-1007, 2008) © 2008, Editrice Kurtis INTRODUCTION Polycystic ovary syndrome (PCOS) is a frequent en- docrine entity in women of reproductive age with a prevalence ranging between 5% and 15% (1). The find- ing of polycystic morphology of ovaries in ultrasound examination has been estimated to be up to 20% in women of reproductive age (2). In women with idiopathic hirsutism, a mild form of PCOS up to 40-50% has been found (3). Recently, most studies have linked PCOS with a potentially increased risk of cardiovascular disease (4- 13). Hypertension has a high prevalence in women with PCOS, not only in reproductive age and in overweight PCOS women aged 35-44 yr but also in the peri- menopausal period (14-16). It is also known that patients with hypertension present abnormal hemodynamic al- terations (HA) such as increased stroke volume (SV) and/or heart rate (HR) in the large arteries compared to controls. On the contrary, little is known about the HA in the carotid arteries (CA) system (17), the vertebral arter- ies (VA), the abdominal aorta (AO), and the renal arter- ies (RA) in young, normotensive, and non-obese women with PCOS compared to controls. The purpose of this study was to investigate not only the intima media thick- ness (IMT) and diameter of common CA (DCCA), but al- so the HR and HA associated with blood flow velocities (BFV) and especially peak systolic velocity (PSV), end di- astolic velocity (EDV), and resistance index (RI) in the CA system, in the VA, in the AO, and in the RA in women with PCOS compared to controls. MATERIALS AND METHODS Study design Fifty-three women with PCOS and 53 healthy women were en- rolled in this case-control study. Informed consent for the study was obtained according to our institutional guidelines. All pa- tients and controls were informed about and accepted the di- agnostic procedure and presented at the Reproductive En- docrinology Outpatient Clinic of the Third Department of Ob- stetrics and Gynecology, Athens University. Their age ranged between 17-35 yr. The diagnosis of PCOS was made accord- ing to the criteria of the Rotterdam ESHRE ASRM-sponsored PCOS consensus workshop group (2004) (18), where 2 out of 3 criteria were present: I) oligo and/or anovulation (menstrual cy- cle between 35-50 days or secondary amenorrhea and/or anovulation); II) clinical and/or biochemical signs of hyperan- drogenism [Ferriman-Gallway modified score ≥8 and/or acne, and/or hyperandrogenemia: total testosterone (T) >0.6 ng/ml (2 nmol/l) and/or Δ 4 -androstenedione ( Δ 4 -A) >3 ng/ml (10.5 nmol/l)]; III) polycystic ovaries (PCO), identified by transvaginal or abdominal ultrasonography (presence of ≥12 follicles in each ovary, measuring 2-9 mm in diameter and/or increased ovarian volume >10 cm 3 ). Key-words: Cardiovascular risk, polycystic ovary syndrome. Correspondence: E. Trakakis, Third Department of Obstetrics and Gynecology, Uni- versity of Athens, Attikon University Hospital Athens Greece, Rimini 1 Chaidari, Athens Greece, PC 12461. E-mail: trakakis@yahoo.gr Accepted February 23, 2008. Hemodynamic alterations and wall properties in large arteries of young, normotensive, and non-obese women with polycystic ovary syndrome E. Trakakis 1 , A. Balanika 2 , C. Baltas 3 , C. Loghis 1 , G. Simeonidis 1 , V. Vaggopoulos 1 , O. Papakonstantinou 2 , A. Gouliamos 2 , G. Salamalekis 1 , and D. Kassanos 1 1 Third Department of Obstetrics and Gynecology; 2 Second Laboratory of Radiology, University of Athens, Attikon University Hospital; 3 Imaging Radiology Department, G. Gennimatas, General Hospital, Athens, Greece