Endocan is a predictor of increased cardiovascular risk in women with polycystic ovary syndrome

ABSTRACT

Purpose: Endocan is a proteoglycan secreted mainly from endothelial cells. It has been implicated that there is a link between endocan and endothelial dysfunction. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disease associated with increased risk of cardiovascular events. The aims of this study were to ascertain whether circulating endocan levels are altered in women with PCOS, and whether there is an association between endocan and carotid intima media thickness (cIMT). Materials and methods: This cross-sectional study included 80 women with PCOS and 80 age- and BMI-matched controls without PCOS. Circulating endocan levels were measured using ELISA. Metabolic, hormonal parameters and cIMT were determined. 2-h oral glucose tolerance test (2-h OGTT) was performed on all women. Results: Circulating endocan levels were significantly elevated in women with PCOS compared with controls (5.99 ± 2.37 vs. 3.66 ± 1.79 ng/ml, P < 0.001). Endocan levels positively correlated with BMI, homeostasis model assessment of insulin resistance (HOMA-IR), free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP), and cIMT in both PCOS and control groups. Endocan levels did not correlate with fasting blood glucose, 2-h OGTT, A1_C and lipid parameters. Multiple linear regression analysis revealed that endocan is an independent predictor for cIMT (β = 0.128, 95% CI = 0.118–0.138, P = 0.011). Conclusions: Circulating endocan levels are significantly higher in women with PCOS and endocan is independently associated with cIMT. Elevated endocan levels can be a predictor of increased cardiovascular risk in PCOS subjects.

KEYWORDS:

• Carotid intima media thickness
• endocan
• insulin resistance
• polycystic ovary syndrome

Acknowledgments

Merve Bicer, Aslı Guler, Mehmet Calan, Gokcen Unal Kocabas, Giray Bozkaya, and Oktay Bilgir participated in study design and performed ELISA. Merve Bicer, Aslı Guler, Arif Yuksel, Mehmet Calan, Ali Baloglu, and Cetin Imamoglu participated in study design, analyzed the data, wrote, reviewed and edited the manuscript. Merve Bicer, Aslı Guler, and Mehmet Calan provided serum samples and contributed to discussions of data interpretation. Cetin Imamoglu measured carotid intima media thickness of the participants. Mehmet Calan is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Declaration of interest

The authors declare that they have no conflict of interest.