Elevated circulating levels of tissue factor in polycystic ovary syndrome

Women with polycystic ovary syndrome (PCOS) have coagulation disturbances and inflammation, which increases the risk of atherothrombosis. We evaluated the status of circulating tissue factor (TF), the receptor for coagulation factor VII involved in atherothrombosis, in women with PCOS and weight-matched controls. Two-way analysis of variance models were fit to evaluate the effect of PCOS status and weight class on TF and other parameters. The TF levels were significantly higher in lean women with PCOS compared to lean controls. Plasminogen activator inhibitor 1 (PAI-1) levels were significantly higher in obese participants compared to lean participants after controlling for PCOS status. The TF levels directly correlated with percentage of truncal fat and plasma levels of PAI-1, testosterone, androstendione, and dehydroepiandrosterone-sulfate; and inversely correlated with insulin sensitivity index-OGTT(IS(OGTT)). Circulating TF is elevated in PCOS independent of obesity, but both PCOS and obesity contribute to a prothrombotic state. In PCOS, abdominal adiposity and hyperandrogenism may exacerbate the risk of atherothrombosis.