CLINICAL ARTICLE Metabolic and cardiovascular changes in women with polycystic ovary syndrome H. Meden-Vrtovec a, ⁎ , B. Vrtovec b , J. Osredkar c a Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia b Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia c Institute for Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia Received 29 December 2006; received in revised form 7 June 2007; accepted 14 June 2007 Abstract Objective: To analyze the relationship between QTc interval and cardiovascular risk factors in women with polycystic ovary syndrome (PCOS). Methods: Study group included 119 PCOS women (age: 32.2 ± 5.2 years) and the control group 64 age-matched healthy women; they all underwent QT interval measurement, and plasma levels of high-sensitivity CRP (hsCRP), endothelin-1 (ET1), insulin, and testosterone determinations. Results: In PCOS women hsCRP (2.35 ± 2.14 mg/L vs. 1.01 ± 1.28 mg/L; P = 0.04), ET1 (23.6 ± 10.3 ng/L vs. 7.7 ± 15.9 ng/L; P = 0.01), and insulin (16.5 ± 7.8 mIU/L vs. 11.8 ± 10.7 mIU/L; P =0.03) levels were significantly higher, and QTc interval significantly shorter than in controls (401±61 ms vs. 467±61 ms; P =0.007). In 67 (56%) PCOS patients with a short QTc interval (b 400 ms), plasma testosterone levels were significantly higher than in PCOS women with normal QTc interval (2.3 ± 2.1 nmol/L vs. 1.4 ± 1.7 nmol/L; P = 0.02). Conclusions: In patients with polycystic ovary syndrome increased testosterone levels may attenuate the effects of coronary risk factors. © 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. KEYWORDS PCOS; QTc interval; Androgens; Cardiovascular risk ⁎ Corresponding author. Department of Obstetrics and Gynecology, UMC Ljubljana, Slajmerjeva 3, SI-1000 Ljubljana, Slovenia. Fax: +386 1 439 75 90. E-mail address: helena.meden@kclj.si (H. Meden-Vrtovec). 1. Introduction Polycystic ovary syndrome (PCOS) encompasses different levels of manifestation. Clinical features include anovula- tion, hirsutism and obesity, whereas biological changes are reflected through elevated LH, impaired LH/FSH relation and elevated testosterone levels. Hyperandrogenism is partly linked to hyperinsulinism caused by insulin resistance. Morphological signs are manifested as a typical ultrasono- graphic appearance of polycystic ovaries [1]. In 2003, the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) revised the definition of PCOS [2]; the syndrome is now defined as the presence of any two of the following three criteria: polycystic ovaries, oligo/anovulation and/or clinical or biochemical evidence of hyperandrogenism. The impact of hormonal changes in PCOS women has been extensively studied, whereas metabolic dysfunction manifested 0020-7292/$ - see front matter © 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2007.06.005 available at www.sciencedirect.com www.elsevier.com/locate/ijgo International Journal of Gynecology and Obstetrics (2007) 99, 87–90