Evaluation Of Carotid Artery Stiffness In Patients With Polycystic Ovary Syndrome Using Ultrafast Ultrasound Imaging Technology

Objective:Evaluate the impact of polycystic ovary syndrome on carotid artery stiffness using ultrafast ultrasound imaging technology.Explore the correlation between carotid artery stiffness,sexual hormones and metabolic parameters in patients with polycystic ovary syndrome.Explore the impact of high risk of combined obstructive sleep apnea on carotid artery stiffness in patients with polycystic ovary syndrome.Method:From March 2022 to January 2023,94 patients diagnosed with polycystic ovary syndrome(PCOS)were recruited from Gynecology Clinic and Reproductive Medicine Clinic at the First Affiliated Hospital of Nanchang University as the study subjects.we inquire and record general information such as age,smoking consumption,menstrual condition,etc,After obtaining the patient’s consent.The risk of Obstructive sleep apnea in patients was measured using the Berlin Questionnaire.Measuring general parameters such as waist circumference,blood pressure,heart rate,and body mass index(BMI)of patients.And measuring sexual hormones in patients,including luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2),progesterone(PROG),pituitary prolactin(PRL),testosterone(T).Measuring carotid artery ultrasound indicators,including pulse wave velocity at the beginning of systole(PWV-BS),pulse wave velocity at the end of systole(PWV-ES),intima-media thickness(IMT),peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI),pulsatility index(PI).Using the normal reference values of PWV for women aged 18-29 from a multicenter study as the normal group.In the PCOS group,they were divided into two groups according to their BMI values: normal BMI group and elevated BMI group;According to the results of the Berlin questionnaire,they were divided into a low risk group of obstructive sleep apnea and a high risk group of obstructive sleep apnea.Pulse wave velocity(PWV),routine parameters,and sexual hormones were compared among each group.The correlation and regression analysis of ultrasonic parameters,conventional parameters and sex hormones in PCOS group were also carried out.Result:1.Using the normal reference values provided by a multicenter study as the normal group,compared with the normal group,the PWVBS in the PCOS group increased with statistical significance(P<0.05).There was no significant difference in PWVES between the two groups.2.The carotid artery PWV on the left side of the PCOS group was higher than that on the right side,and the difference was statistically significant(P<0.05).3.In the PCOS group,compared with the normal BMI group,the left PWV value in the BMI increased group was higher,the difference was statistically significant(P<0.05).In the PCOS group,there was no significant difference in left PWV between the hyperandrogenemia group and the normal androgen group.In the PCOS group with normal BMI,there was no significant difference in left PWV between patients with normal androgen and hyperandrogenism.In the PCOS group with increased BMI,there was no significant difference in left PWV between patients with normal androgen and hyperandrogenism.There was no significant difference in left PWV between the normal group and the normal BMI normal androgen group in PCOS.There was no significant difference in left PWV between the PCOS group with normal BMI normal androgen and the multi center normal group.4.In the PCOS group,compared with the normal BMI group,the waist circumference,blood pressure,and heart rate of the BMI increased group increased significantly.In PCOS group,the ratio of luteinizing hormone to follicle stimulating hormone(LH/FSH)in hyperandrogenemia group was higher than that in normal androgen group,and the difference was statistically significant(P < 0.05).In the PCOS group with normal BMI,there was no significant difference in general parameters,sex hormones excludes testosterone,and carotid ultrasound parameters between patients with normal androgen and hyperandrogenism.In the PCOS group with increased BMI,compared with the normal androgen group,the patients with hyperandrogenism showed an increase in diastolic blood pressure and heart rate,the difference is statistically significant(P<0.05).5.Correlation analysis showed that the left PWV-BS was positively correlated with age and diastolic blood pressure;The left PWV-ES was positively correlated with age and BMI.6.Regression analysis showed that age and diastolic blood pressure were predictors of PWV-BS,while age and BMI were predictors of PWV-ES.7.In the PCOS group,there was no significant difference in PWV on the left side between the low risk group and the high risk group of obstructive sleep apnea.BMI,waist circumference and systolic blood pressure in high-risk obstructive sleep apnea group were higher than those in low-risk obstructive sleep apnea group,and the difference was statistically significant(P < 0.05).Conclusion:Carotid PWV increased in PCOS patients with increased BMI.The increase of PWV in PCOS patients may be related to the increase of age,diastolic blood pressure and BMI.Ultrafast ultrasound imaging technology provides a theoretical basis for early clinical intervention of PCOS patients with high BMI.LH/FSH increased in PCOS patients with increased androgens.PCOS patients at high risk for obstructive sleep apnea had increased BMI,waist circumference and systolic blood pressure.