The association of urinary albumin excretion and metabolic complications in polycystic ovary syndrome
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Objective:This study was planned to screen polycystic ovary syndrome (PCOS) women for albuminuria and to evaluate the association between urinary albumin excretion (UAE) and metabolic disturbances of PCOS. In addition, this is the first study in the literature evaluating the association between UAE and carotid intima-media thickness (CIMT) in PCOS cases.Study Design:The study population consisted of 65 PCOS women. The study was prospectively designed and performed in a university hospital. The diagnosis of PCOS was made according to the Rotterdam criteria: exclusion criteria were hyperprolactinemia, thyroid dysfunction, adrenal dysfunction, diabetes mellitus, hypertension, and pregnancy. Blood samples were collected in the follicular phase of a menstrual cycle and serum samples were analyzed for fasting glucose, insulin, and hormone and lipid profiles. Twenty-four hour urine specimens were collected for the detection of UAE. CIMT was estimated by visual assessment of the distance between the lumen-intima and intima-adventitia interfaces.Results:The mean age and BMI were 23 years and 23 kg/m(2), respectively. The median UAE was 7 mg/day (range: 0.3-154 mg/day). The median UAE as micrograms of albumin per milligram of creatinine (uACR) was 5.6 (0.28-159). Regarding the uACR cutoff value (>6.93 µg/mg), significantly higher levels of triglycerides, 17 OH-progesterone, insulin resistance (HOMA index > 2.1) and increased CIMT were present in these cases. Microalbuminuria (uACR > 25 µg/mg) was present in 6.2%. In the regression analyses serum HDL-C levels were found to be independent predictor for uACR > 2 µg/mg (OR: 0.85) and estradiol levels were the independent predicting factor for uACR > 6.93 µg/mg even after adjustments for age and BMI were performed (OR:1.02).Conclusions:UAE, expressed as uACR > 6.93 µg/mg, seems to be an associated sign of metabolic problems which might help in discriminating PCOS at risk of future CVD. Further studies are needed before routine use of albuminuria in PCOS cases for the detection of CVD risk.