Autonomic Functions in Young Infertile Women with Polycystic Ovarian Syndrome: A Case-control Study

Abstract

Introduction: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine and metabolic disorder in women of reproductive age, characterised by chronic anovulation, high androgen levels, Insulin Resistance (IR), and low-grade inflammation. Women with PCOS face increased risks of cardiac and metabolic issues, along with observed sympathetic overactivity. Aim: To assess the status of autonomic responses in women with and without PCOS through Autonomic Function Tests (AFT). Materials and Methods: The present study was designed as a case-control study, volunteers were recruited from the infertility centre of a tertiary care hospital and studied in the Department of Physiology. The study included 80 infertile women aged between 18 and 40 years. The study participants were divided into two groups: Group P included 40 volunteers with PCOS, while Group N included 40 healthy volunteers without PCOS and without any co-morbid conditions. Autonomic functions, which determine the sympathovagal balance, were evaluated. The data were analysed using IBM Statistical Package for the Social Sciences (SPSS) version 20.0. Results: The cold pressor test failed to raise Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) in Group P (124.45±8.55 mmHg and 83.75±8.27 mmHg, respectively) as effectively as in Group N (131.40±4.69 mmHg and 89.80±6.79 mmHg, respectively), indicating baroreceptor reflex insensitivity. Similarly, during the hand grip test, the rise in SBP and DBP was significantly lower (p-value<0.001) in Group P (119.10±7.79 mmHg and 85.45±8.49 mmHg, respectively) compared to Group N (128±6.50 mmHg and 92.65±6.5 mmHg, respectively). The 30:15 RR ratio and Valsalva maneuver results showed that DBP was significantly lower in Group P compared to Group N, with no significant difference in SBP after standing in both groups. The 30:15 RR ratio and Valsalva ratio were significantly (p-value=0.008 and p-value=0.004, respectively) lower in Group P (0.73±0.11 and 1.23±0.16, respectively) compared to Group N (0.82±0.16 and 1.36±0.23, respectively). Conclusions: The present study reported diminished sympathetic overactivity and increased parasympathetic activity due to normal Body Mass Index (BMI) in both groups.

Keywords

• autonomic nervous system diseases
• maneuver
• ovary syndrome
• polycystic
• valsalva