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Journal of Ovarian Research

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Open Access 01-12-2014 | Research

Epicardial adipose tissue thickness and NGAL levels in women with polycystic ovary syndrome

Authors: Serap Baydur Sahin, Medine Cumhur Cure, Yavuz Ugurlu, Elif Ergul, Emine Uslu Gur, Nese Alyildiz, Mehmet Bostan

Published in: Journal of Ovarian Research | Issue 1/2014

Abstract

Background

Polycystic ovary syndrome (PCOS) is associated with an increased cardiovascular disease (CVD) risk and early atherosclerosis. Epicardial adipose tissue thickness (EATT) is clinically related to subclinical atherosclerosis. In the present study, considering the major role of neutrophil gelatinase-associated lipocalin (NGAL) which is an acute phase protein rapidly releasing upon inflammation and tissue injury, we aimed to evaluate NGAL levels and EATT in PCOS patients and assess their relationship with cardiometabolic factors.

Methods

64 patients with PCOS and 50 age- and body mass index-matched healthy controls were included in the study. We evaluated anthropometric, hormonal and metabolic parameters. EATT was measured by echocardiography above the free wall of the right ventricle. Serum NGAL and high-sensitive C- reactive protein (hsCRP) levels were measured by ELISA.

Results

Mean EATT was 0,38 +/-0,16 mm in the PCOS group and 0,34 +/-0,36 mm in the control group (p = 0,144). In the obese PCOS group (n = 44) EAT was thicker compared to the obese control group (n = 41) (p = 0.026). Mean NGAL levels of the patients with PCOS were 101,98 +/-21,53 pg/ml, while mean NGAL levels were 107,40 +/-26,44 pg/ml in the control group (p = 0,228). We found a significant positive correlation between EATT and age, BMI, waist circumference, fasting insulin, HOMA-IR, triglyceride and hsCRP levels in PCOS group.

Conclusions

Thickness of the epicardial adipose tissue can be used to follow the risk of CVD development in obese PCOS cases. However serum NGAL levels do not differ in patients with PCOS and control group.

Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO: The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004,89(6):2745–2749. 10.1210/jc.2003-032046CrossRefPubMed

Wild S, Pierpoint T, McKeigue P, Jacobs H: Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000,52(5):595–600. 10.1046/j.1365-2265.2000.01000.xCrossRef

Christian RC, Dumesic DA, Behrenbeck T, Oberg AL, Sheedy PF 2nd, Fitzpatrick LA: Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003,88(6):2562–2568. 10.1210/jc.2003-030334CrossRefPubMed

Ross R: Atherosclerosis--an inflammatory disease. N Engl J Med 1999,340(2):115–126. 10.1056/NEJM199901143400207CrossRefPubMed

Schmidt-Ott KM, Mori K, Li JY, Kalandadze A, Cohen DJ, Devarajan P, et al.: Dual action of neutrophil gelatinase-associated lipocalin. J Am Soc Nephrol 2007,18(2):407–413. 10.1681/ASN.2006080882CrossRefPubMed

Chen X, Jia X, Qiao J, Guan Y, Kang J: Adipokines in reproductive function: a link between obesity and polycystic ovary syndrome. Mol Endocrinol 2013,50(2):R21-R37. 10.1530/JME-12-0247CrossRef

Zhang J, Wu Y, Zhang Y, Leroith D, Bernlohr DA, Chen X: The role of lipocalin 2 in the regulation of inflammation in adipocytes and macrophages. Mol Endocrinol 2008,22(6):1416–1426. 10.1210/me.2007-0420PubMedCentralCrossRefPubMed

Yan QW, Yang Q, Mody N, Graham TE, Hsu CH, Xu Z, et al.: The adipokine lipocalin 2 is regulated by obesity and promotes insulin resistance. Diabetes 2007,56(10):2533–2540. 10.2337/db07-0007CrossRefPubMed

Wang Y, Lam KS, Kraegen EW, Sweeney G, Zhang J, Tso AW, et al.: Lipocalin-2 is an inflammatory marker closely associated with obesity, insulin resistance, and hyperglycemia in humans. Clin Chem 2007,53(1):34–41.CrossRefPubMed

10.

Kafkas N, Demponeras C, Zoubouloglou F, Spanou L, Babalis D, Makris K: Serum levels of gelatinase associated lipocalin as indicator of the inflammatory status in coronary artery disease. Int J Inflam 2012, 2012: 189797.PubMedCentralCrossRefPubMed

11.

Iacobellis G, Corradi D, Sharma AM: Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005,2(10):536–543. 10.1038/ncpcardio0319CrossRefPubMed

12.

Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al.: Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006, 5: 1. 10.1186/1475-2840-5-1PubMedCentralCrossRefPubMed

13.

Iacobellis G, Assael F, Ribaudo MC, Zappaterreno A, Alessi G, Di Mario U, et al.: Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 2003,11(2):304–310. 10.1038/oby.2003.45CrossRefPubMed

14.

Ahn SG, Lim HS, Joe DY, Kang SJ, Choi BJ, Choi SY, et al.: Relationship of epicardial adipose tissue by echocardiography to coronary artery disease. Heart 2008,94(3):e7. 10.1136/hrt.2007.118471CrossRefPubMed

15.

Eroglu S, Sade LE, Yildirir A, Bal U, Ozbicer S, Ozgul AS, et al.: Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis 2009,19(3):211–217. 10.1016/j.numecd.2008.05.002CrossRefPubMed

16.

Djaberi R, Schuijf JD, van Werkhoven JM, Nucifora G, Jukema JW, Bax JJ: Relation of epicardial adipose tissue to coronary atherosclerosis. Am J Cardiol 2008,102(12):1602–1607. 10.1016/j.amjcard.2008.08.010CrossRefPubMed

17.

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004, 81: 19–25.

18.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28: 412–419. 10.1007/BF00280883CrossRefPubMed

19.

Gokcel A, Ozsahin AK, Sezgin N, et al.: High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes Care 2003, 26: 3031–3034. 10.2337/diacare.26.11.3031CrossRefPubMed

20.

Iacobellis G, Willens HJ, Barbaro G, Sharma AM: Threshold values of high-risk echocardiographic epicardial Fat thickness. Obesity (Silver Spring) 2008,16(4):887–892. 10.1038/oby.2008.6CrossRef

21.

Mariani S, Fiore D, Barbaro G, Basciani S, Saponara M, D’Arcangelo E, et al.: Association of epicardial fat thickness with the severity of obstructive sleep apnea in obese patients. Int J Cardiol 2013,167(5):2244–2249. 10.1016/j.ijcard.2012.06.011CrossRefPubMed

22.

Kim JW, Han JE, Kim YS, Won HJ, Yoon TK, Lee WS: High sensitivity C-reactive protein and its relationship with impaired glucose regulation in lean patients with polycystic ovary syndrome. Gynecol Endocrinol 2012,28(4):259–263. 10.3109/09513590.2011.613967CrossRefPubMed

23.

Talbott E, Guzick D, Clerici A, Berga S, Detre K, Weimer K, et al.: Coronary heart disease risk factors in women with polycystic ovary syndrome. Arterioscler Thromb Vasc Biol 1995,15(7):821–826. 10.1161/01.ATV.15.7.821CrossRefPubMed

24.

Graf M, Richards C, Brown V, Meissner L, Dunaif A: The independent effects of hyperandrogenaemia, hyperinsulinaemia and obesity on lipid and lipoprotein profiles in women. Clin Endocrinol (Oxf) 1990,33(1):119–131. 10.1111/j.1365-2265.1990.tb00472.xCrossRef

25.

Talbott EO, Zborowski JV, Rager JR, Boudreaux MY, Edmundowicz DA, Guzick DS: Evidence for an association between metabolic cardiovascular syndrome and coronary and aortic calcification among women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89: 5454–5461. 10.1210/jc.2003-032237CrossRefPubMed

26.

Shaw LJ, Bairey Merz CN, Azziz R, Stanczyk FZ, Sopko G, Braunstein GD, et al.: Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the national institutes of health--national heart, lung, and blood institute sponsored Women’s ischemia syndrome evaluatio. J Clin Endocrinol Metab 2008,93(4):1276–1284. 10.1210/jc.2007-0425PubMedCentralCrossRefPubMed

27.

Talbott EO, Zborowski JV, Boudreaux MY, McHugh-Pemu KP, Sutton-Tyrrell K, Guzick DS: The relationship between C-reactive protein and carotid intima-media wall thickness in middle-aged women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004,89(12):6061–6067. 10.1210/jc.2003-032110CrossRefPubMed

28.

Ketel IJ, Stehouwer CD, Henry RM, Serné EH, Hompes P, Homburg R, et al.: Greater arterial stiffness in polycystic ovary syndrome (PCOS) is an obesity–but not a PCOS-associated phenomenon. J Clin Endocrinol Metab 2010,95(10):4566–4575. 10.1210/jc.2010-0868CrossRefPubMed

29.

Cakal E, Ozkaya M, Engin-Ustun Y, Ustun Y: Serum lipocalin-2 as an insulin resistance marker in patients with polycystic ovary syndrome. J Endocrinol Invest 2011,34(2):97–100.CrossRefPubMed

30.

Diamanti-Kandarakis E, Livadas S, Kandarakis SA, Margeli A, Papassotiriou I: Serum concentrations of atherogenic proteins neutrophil gelatinase-associated lipocalin and its complex with matrix metalloproteinase-9 are significantly lower in women with polycystic ovary syndrome: hint of a protective mechanism? Eur J Endocrinol 2008,158(4):525–531. 10.1530/EJE-07-0822CrossRefPubMed

31.

Choi KM, Lee JS, Kim EJ, Baik SH, Seo HS, Choi DS, et al.: Implication of lipocalin-2 and visfatin levels in patients with coronary heart disease. Eur J Endocrinol 2008,158(2):203–207. 10.1530/EJE-07-0633CrossRefPubMed

32.

Zografos T, Haliassos A, Korovesis S, Giazitzoglou E, Voridis E, Katritsis D: Association of neutrophil gelatinase-associated lipocalin with the severity of coronary artery disease. Am J Cardiol 2009,104(7):917–920. 10.1016/j.amjcard.2009.05.023CrossRefPubMed

33.

Aydogdu A, Uckaya G, Tasci I, Baysan O, Tapan S, Bugan B, et al.: The relationship of epicardial adipose tissue thickness to clinical and biochemical features in women with polycystic ovary syndrome. Endocr J 2012,59(6):509–516. 10.1507/endocrj.EJ11-0328CrossRefPubMed

34.

Cakir E, Doğan M, Topaloglu O, Ozbek M, Cakal E, Vural MG, et al.: Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis 2013,226(1):291–295.CrossRefPubMed

Title: Epicardial adipose tissue thickness and NGAL levels in women with polycystic ovary syndrome
Authors: Serap Baydur Sahin
Medine Cumhur Cure
Yavuz Ugurlu
Elif Ergul
Emine Uslu Gur
Nese Alyildiz
Mehmet Bostan
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of Ovarian Research / Issue 1/2014
Electronic ISSN: 1757-2215
DOI: https://doi.org/10.1186/1757-2215-7-24

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Epicardial adipose tissue thickness and NGAL levels in women with polycystic ovary syndrome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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