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Archives of Gynecology and Obstetrics

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01-08-2009 | Original Article

High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome

Authors: Levent Kebapcilar, Cuneyt Eftal Taner, Ayse Gul Kebapcilar, Ismail Sari

Published in: Archives of Gynecology and Obstetrics | Issue 2/2009

Abstract

Objectives

The present study was designed to determine (a) the coagulation parameters, WBC and MPV levels; (b) whether there was any association between androgen and mean platelet volume and low-grade systemic coagulation in PCOS patients.

Methods

A total of 48 patients with non-diabetic PCOS were studied in order to evaluate and compare with a non-PCOS group of 30 subjects.

Results

D-dimer, homeostatic model assessment (HOMA-IR), insulin, androgens, glucose, WBC and MPV concentrations were higher in women with PCOS. No difference was observed in fibrinogen, activated partial thromboplastin time and prothrombin time values between the two groups. Free testosterone was positively correlated with D-dimer, insulin, DHEAS, and MPV levels. In multiple stepwise regression analyses, free testosterone positively associated with D-dimer and DHEAS. MPV was positively correlated with insulin levels, HOMA-IR values, DHEAS and free testosterone levels in PCOS patients. In multiple stepwise regression analyses, MPV positively associated with insulin and DHEAS.

Conclusion

PCOS patients had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, and increased WBC and MPV levels suggesting that hematological parameters could potentially be used as indicators of risk factor for atherosclerosis in PCOS women.

Franks S (1995) Polycystic ovary syndrome. N Engl J Med 333:853–861PubMedCrossRef

Atiomo WU, Bates SA, Condon JE, Shaw S, West JH, Prentice AG (1998) The plasminogen activator system in women with polycystic ovary syndrome. Fertil Steril 69(2):236–241PubMedCrossRef

Tarkun I, Canturk Z, Arslan BC, Turemen E, Tarkun P (2004) The plasminogen activator system in young and lean women with polycystic ovary syndrome. Endocr J 51:467–472PubMedCrossRef

Yildiz BO, Haznedaroğlu IC, Kirazli S, Bayraktar M (2002) Global fibrinolytic capacity is decreased in polycystic ovary syndrome, suggesting a prothrombotic state. J Clin Endocrinol Metab 87(8):3871–3875PubMedCrossRef

Słopień R, Lewandowski K, Kolacz E, Zawilska K, Warenik-Szymankiewicz A (2006) Comparison of fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome and women with simple obesity. Gynecol Endocrinol 22(11):651–654PubMedCrossRef

Kelly CJ, Lyall H, Petrie JR, Gould GW, Connell JM, Rumley A, Lowe GD, Sattar N (2002) A specific elevation in tissue plasminogen activator antigen in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 87(7):3287–3290PubMedCrossRef

Danesh J, Collins R, Appleby P et al (1998) Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA 279:1477–1482PubMedCrossRef

Horne BD, Anderson JL, John JM, Intermountain Heart Collabarative Study Group et al (2005) Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 45:1638–1643PubMedCrossRef

Orio F Jr, Palomba S, Cascella T, Di Biase S, Manguso F, Tauchmanova L, Nardo LG, Labella D, Savastano S, Russo T, Zullo F, Colao A, Lombardi G (2005) The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol Metab 90:2–5PubMedCrossRef

10.

Hekimsoy Z, Payzin B, Ornek T, Kandoğan G (2004) Mean platelet volume in type 2 diabetic patients. J Diabetes Complicat 18(3):173–176PubMedCrossRef

11.

Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY (2004) Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol 44(2):415–422PubMedCrossRef

12.

The Rotterdam ESHRE/ASRM-sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria, long-term health risks related to polycystic ovary syndrome PCOS. Hum Reprod 19:41–47CrossRef

13.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419PubMedCrossRef

14.

Koenig W (1998) Haemostatic risk factors for cardiovascular diseases. Eur Heart J 19:C39–C43PubMed

15.

Yang A, Pizzulli L, Luderitz B (2006) Mean platelet volume as a marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris. Thromb Res 117:371–377PubMedCrossRef

16.

Glud T, Schnidt EB, Kristensen SD et al (1986) Platelet number and volume during myocardial infarction in relation to infarct size. Acta Med Scand 220:401–405PubMed

17.

Ylmanaz MB, Akin Y, Biyikoglu SF et al (2004) Left ventricular thrombosis is associated with increased mean platelet volume in patients with dilated cardiomyopathy and sinus rhythm. Acta Cardiol 59:41–45CrossRef

18.

Martin JF, Trowbridge EA, Salmon G, Plumb J (1983) The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res 32(5):443–460PubMedCrossRef

19.

Jakubowski JA, Thompson CB, Vaillancourt R et al (1983) Arachidonic acid metabolism by platelets of differing size. Br J Haematol 53:503–511PubMedCrossRef

20.

Gillum RF, Mussolino ME, Madans JH (2005) Counts of neutrophils, lymphocytes, and monocytes cause specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol 15(4):266–271PubMedCrossRef

21.

Margolis KL, Manson JE, Greenland P, Rodabough RJ, Bray PF, Safford M, Grimm RH Jr, Howard BV, Assaf AR, Prentice R, Women’s Health Initiative Research Group (2005) Leukocyte count as a predictor of cardiovascular events and mortality in postmenopausal women: the Women’s Health Initiative Observational Study. Arch Intern Med 165(5):500–508PubMedCrossRef

22.

Ross R (1999) Atherosclerosis: an inflammatory diesase. N Engl J Med 340:115–126PubMedCrossRef

23.

Galvani M, Ferrini D, Ghezzi F, Ottani F (2001) Cardiac markers and risk stratification: an integrated approach. Clin Chim Acta 311(1):9–17PubMedCrossRef

24.

Hsieh CH, Pei D, Kuo SW, Chen CY, Tsai SL, Lai CL, Lee CH, Wu CZ, Hung YJ, Hsieh MC (2007) Correlation between white blood cell count and metabolic syndrome in adolescence. Pediatr Int 49(6):827–832PubMedCrossRef

25.

Wang YY, Lin SY, Liu PH, Cheung BM, Lai WA (2004) Association between hematological parameters and metabolic syndrome components in a Chinese population. J Diabetes Complicat 18(6):322–327PubMedCrossRef

26.

Chuo SK, Li JC, Tsai WC, Wu DA, Kuo SW, Pei D, Chen SP, Shen DC (2005) Correlations between white blood cell count and metabolic syndrome in middle-age Taiwanese. Endocr Res 31(1):39–50PubMedCrossRef

27.

Park SH, Kang JM, Kim BS, Kim BJ, Sung KC, Kang JH, Lee MH, Park JR (2004) Relationship between peripheral leukocyte count and the severity of stable angina determined by coronary angiography. Korean J Intern Med 19(2):99–103PubMed

28.

Hasegawa T, Watase H (2003) Association of heart rate with coronary risk factors and increased white blood cell counts in healthy Japanese people. J Atheroscler Thromb 10(4):259–263PubMed

29.

Papanas N, Symeonidis G, Maltezos E et al (2004) Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 15:475–478PubMedCrossRef

30.

Oh JY, Barrett-Connor E, Wedick NM, Wingard DL (2002) Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo Study. Diabetes Care 25:55–60PubMedCrossRef

31.

Goodman-Gruen D, Barrett-Connor E (2000) Sex differences in the association of endogenous sex hormone levels and glucose tolerance status in older men and women. Diabetes Care 23:912–918PubMedCrossRef

32.

Khaw KT, Barrett-Connor E (1991) Fasting plasma glucose levels and endogenous androgens in non-diabetic postmenopausal women. Clin Sci 80:199–203PubMed

Title: High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome
Authors: Levent Kebapcilar
Cuneyt Eftal Taner
Ayse Gul Kebapcilar
Ismail Sari
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 2/2009
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-008-0884-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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