Cigarette Smoking and Cardiovascular Risk in Young Women with Polycystic Ovary Syndrome

Background: To verify if in lean polycystic ovary syndrome (PCOS) patients, the smoking habitude might increase the risk of cardiovascular (CV) disease. Materials and Methods: In this prospective observational study, eighty-one women were divided into the following three groups: group I with 27 non-smokers, group II with 26 light-smokers (1-10 cigarettes/day), and group III with 28 heavy smokers ( > 10 cigarettes/ day). They were submitted to fasting blood sampling; blood measurement of nitrites/nitrates (NO2-/ NO3), biochemical and hormonal parameters; ovarian ultrasonographic (US) analysis; doppler evaluation of uterine and ophthalmic arteries; brachial artery flow-mediated vasodilatation; 24-hour ambulatory blood pressure monitoring; and oral glucose tolerance test (OGTT). Results: Doppler analysis revealed higher uterine and ophthalmic arteries pulsatility index (PI) and ophthalmic artery back pressure in group III compared with group I. The brachial artery diameter and PI, at baseline, was similar among all groups. After the reactive hyperemia, a more intense vasodilatation was observed in group I in comparison with group III. The 24-hour blood pressure demonstrated that, in group III patients, the 24-hour, day- and night-time diastolic blood pressure (DBP), was higher in comparison with non-smokers. The atherogenic index of plasma (AIP) was higher in heavy smokers than in non-smokers. The leukocytes and homocysteine (HCY) values were increased in group III. The NO2-/ NO3- plasma levels were reduced in heavy smokers in comparison with non-smokers. The insulin, glucose and C-peptide plasma values were higher in group III than in other groups. In heavy smokers, the estimates of insulin sensitivity (ISI) and pancreatic B-cell function (HOMA-B) were higher compared to the other groups. Conclusion: Smoking habitude in lean PCOS patients may increase the soft markers of CV risk.