Endothelial Function and Matrix Metalloproteinase 9 (MMP9) in Women with Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a complex endocrine disease. This study investigates the relationship between endothelial function, insulin resistance, and hormonal profiles in women with PCOS. Forty women with PCOS were included: metformin (n = 20), GLP1-RAs (n = 10), and oral contraceptive pills (n = 10). A 75 g oral glucose tolerance test (OGTT) was performed, and the 0, 60, and 120 min insulin, glucose, and endothelial functions were evaluated. The postprandial and fasting state Matsuda Index and HOMA Index were measured. All measurements were performed at baseline and at a 6-month follow-up. At baseline, the percentage change in the Perfused Boundary Region (PBR) was associated with the percentage change in glucose at 120 min of the OGTT (r = 0.42, p < 0.05). The Matsuda Index, Homa Index, and testosterone levels were associated with the PBR (2.91 ± 0.1 μm) at 120 min of the OGTT (r = 0.41, r = 0.38 and r = 0.28, respectively). MMP9 levels were associated with the Matsuda and Homa Index (r = 0.45, p < 0.05 and r = 0.41, p < 0.05, respectively). At the 6-month follow-up, all the participants presented improvements of the Matsuda Index (7 ± 0.31 vs. 9.1 ± 0.2), Homa Index (5.3 ± 0.8 vs. 2.91 ± 0.1), MMP9 (210 ± 30 vs. 178 ± 28 ng/mL), and testosterone levels (44.2 ± 5 vs. 39.1 ± 2 ng/dL) compared to the baseline (p < 0.05 for all the comparisons). Patients who received GLP1-RA agonists presented the greatest improvement in MMP9 levels. Postprandial hyperglycemia, insulin resistance, and testosterone levels are associated with an impaired glycocalyx thickness in women with PCOS.