Τομέας Υγείας - Μητέρας - ΠαιδιούLibrary of the School of Health Sciences
Αραβαντινός Λέων (επιβλέπων), Επίκουρος Καθηγητής, Ιατρική, Αρεταίειο Νοσοκομείο, ΕΚΠΑ
Κουσκούνη Ευαγγελία, Καθηγήτρια, Ιατρική, Αρεταίειο Νοσοκομείο, ΕΚΠΑ
Λαμπρινουδάκη Ειρήνη, Καθηγήτρια, Ιατρική, Αρεταίειο Νοσοκομείο, ΕΚΠΑ
Μπάκα Σταυρούλα, Αναπληρώτρια Καθηγήτρια, Ιατρική, Αρεταίειο Νοσοκομείο, ΕΚΠΑ
Πανουλής Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική, Αρεταίειο Νοσοκομείο, ΕΚΠΑ
Σταματελόπουλος Κίμων, Αναπληρωτής Καθηγητής, Ιατρική, Νοσοκομείο Αλεξάνδρα, ΕΚΠΑ
Καπαρός Γεώργιος, Επίκουρος Καθηγητής, Ιατρική, Αρεταίειο Νοσοκομείο, ΕΚΠΑ
Η επίδραση του προεμμηνορυσιακού συνδρόμου (pms) σε δομικούς και λειτουργικούς δείκτες καρδιαγγειακού κινδύνου
The impact of premenstrual syndrome (pms) on on stuctural and functional indices of cardiovascular risk
Backround: The premenstrual syndrome (PMS) is characterised by physical and emotional changes before and during menstruation with significant effect on the quality of life of the individual. The precise causative mechanisms are not fully elucidated. It appears, however, that both physical and psychological symptoms are associated with conditions of increased inflammatory and oxidative stress. Since the above procedures are related to the occurrence of cardiovascular events, premenstrual syndrome is likely to increase cardiovascular risk.
Scope: In the present study we evaluated the effect of premenstrual syndrome on both structural and functional vascular indices and the possibility of increased cardiovascular risk in women of reproductive age. Additionally, we examined the correlation between subclinical vascular disease and the presence of the polymorphisms C242T of CYBA gene and G894T of NOS3 gene in combination with traditional cardiovascular risk factors.
Material and Methods: 70 healthy, normally ovulating women, aged 18-45 who responded to an announcement from the 2nd Department of Obstetrics and Gynaecology of Aretaieion University Hospital of Athens were recruited. Women's medical history and demographic data were recorded and all participants were examined in two distinct phases of their menstrual cycle (late ovulatory and luteal). During the two visits, somatometric and haemodynamic (blood pressure) parameters were assessed, whereas venus blood samples were obtained for biochemical / hormonal testing and genotyping. The diagnosis of premenstrual syndrome was based on Moos-scale questionnaire and on a second symptom-based prospective calendar meeting the diagnostic criteria defined by the University of San Diego, California (USDC). The 30% increase in premenstrual distress between the 1st and 2nd visit was diagnosed as PMS, according to the criteria of the National Institute of Mental Health (NIMH). Sonographically assessed indices of vascular structure and function included carotid intima-media thickness (IMT), flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (PWV) and augmentation index (Aix).
Results: 64 out of the 70 women of the study attended the second visit. 48 of them (75%) were classified as PMS, while 16 as control group. The hormonal examination revealed that prolactin levels during the luteal phase were decreased in PMS women compared to those in the control group. In addition, women with PMS demonstrated lower blood pressure levels during the ovulatory phase and that the levels of the central diastolic pressure remained unchangeable during the luteal phase compared to controls. Furthermore, the assessment of the two polymorphisms in the 70 women of the study showed that C242T homozygotes (TT) had lower combined and ICA-IMT and FMD values after adjustment for traditional cardiovascular risk factors, while the presence of the T-allele of NOS3 polymorphism was associated with higher CB-IMT and PWV values in the univariate analysis. Nevertheless, the association of the NOS3 polymorphism and PWV was significant after adjustment for traditional cardiovascular risk factors in the multivariate analysis. Moreover, a stepwise increase in PWV levels was observed in women with cumulative presence of both NOS3 and CYBA genetic polymorphisms, indicative of an upward trend in arterial stiffness compared to those with a wild-type genotype.
Conclusions: Our results indicate that premenstrual syndrome affect haemodynamic parameters, such as blood pressure, while the presence of C242T and G894T polymorphisms showed an adverse effect on structural and functional vascular properties in combination with traditional cardiovascular risk factors. The stepwise increase of arterial stiffness due to the cumulative presence of the two polymorphisms could possibly substantiate their correlation with subclinical vascular risk.
Main subject category:
Premenstrual syndrome, Cardiovascular risk
Number of references:
Panagiota Chatzivasileiou PhD.pdf
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