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Are women with polycystic ovary syndrome resistant to activated protein C?
W U Atiomo1, J Condon, O Adekanmi
1Department of Obstetrics and Gynaecology, Royal Devon and Exeter Hospital, Exeter, United Kingdom. watiomo@hotmail.com
Objective:
This study was performed to test the hypothesis that an increased prevalence of activated protein C (APC) resistance in women with polycystic ovary syndrome (PCOS) puts them at increased risk of miscarriage and thrombosis.
Design:
Case control study.
Setting:
A district general hospital in the United Kingdom.
Patient(S):
Forty-one women with PCOS and 25 controls.
Intervention(S):
Clinical histories, ultrasound scans, and venepunctures.
Main Outcome Measure(S):
Diagnosis of PCOS or control, clinical histories, APC resistance according to an activated partial thromboplastin time-based assay.
Result(S):
There was no significant difference in the proportion of women with APC resistance in both groups (three women in the PCOS group [7%] vs. one woman in the control group [4%]). The prevalence of APC resistance in the entire study population was 6.5%. In the PCOS group, 29% (12/41) gave a positive family history of thrombosis compared with 8% (2/25) in the control group. None of the women with a positive family history of thrombosis had abnormal antithrombin 111, protein C, or protein S levels.
Conclusion(S):
This study suggests that women with PCOS may have the same prevalence of APC resistance as the background population and that APC resistance may not put them at a higher risk of thrombosis or miscarriage compared with the case of the general population.