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Previous data suggest autonomic imbalance [elevated sympathetic nervous system (<jats:styled-content style=\"fixed-case\">SNS<\/jats:styled-content>) activity and decreased heart rate variability (<jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content>)] as well as endothelial dysfunction in <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content>. However, it is not clear whether these abnormalities are driven by obesity and metabolic disturbance or whether they are independently related to <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants and methods<\/jats:title><jats:p>We examined multiunit and single\u2010unit muscle <jats:styled-content style=\"fixed-case\">SNS<\/jats:styled-content> activity (by microneurography), <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> (time and frequency domain analysis) and endothelial function [ischaemic reactive hyperaemia index (<jats:styled-content style=\"fixed-case\">RHI<\/jats:styled-content>) using the Endo<jats:styled-content style=\"fixed-case\">PAT<\/jats:styled-content> device] in 19 overweight\/obese women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>: 31\u00b73\u00a0\u00b1\u00a01\u00b75\u00a0kg\/m<jats:sup>2<\/jats:sup>, age: 31\u00b73\u00a0\u00b1\u00a01\u00b76\u00a0years) and compared them with 21 control overweight\/obese women (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>: 33\u00b70\u00a0\u00b1\u00a01\u00b74\u00a0kg\/m<jats:sup>2<\/jats:sup>, age: 28\u00b72\u00a0\u00b1\u00a01\u00b76\u00a0years) presenting a similar metabolic profile (fasting total, <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content> cholesterol, glucose, triglycerides, insulin sensitivity and blood pressure).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content> had elevated multiunit muscle <jats:styled-content style=\"fixed-case\">SNS<\/jats:styled-content> activity (41\u00a0\u00b1\u00a02 <jats:italic>vs<\/jats:italic> 33\u00a0\u00b1\u00a03 bursts per 100 heartbeats, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705). Single\u2010unit analysis showed that vasoconstrictor neurons were characterized by elevated firing rate and probability and incidence of multiple spikes (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701 for all parameters). Women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content> also had impaired endothelial function (<jats:styled-content style=\"fixed-case\">RHI<\/jats:styled-content>: 1\u00b777\u00a0\u00b1\u00a00\u00b714 <jats:italic>vs<\/jats:italic> 2\u00b718\u00a0\u00b1\u00a00\u00b714, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705). <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> did not differ between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content> have increased sympathetic drive and impaired endothelial function independent of obesity and metabolic disturbances. Sympathetic activation and endothelial dysfunction may confer greater cardiovascular risk in women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12803","type":"journal-article","created":{"date-parts":[[2015,4,27]],"date-time":"2015-04-27T15:24:13Z","timestamp":1430148253000},"page":"812-819","source":"Crossref","is-referenced-by-count":72,"title":["Sympathetic activation and endothelial dysfunction in polycystic ovary syndrome are not explained by either obesity or insulin resistance"],"prefix":"10.1111","volume":"83","author":[{"given":"Elisabeth A.","family":"Lambert","sequence":"first","affiliation":[{"name":"Human Neurotransmitters Laboratory Baker IDI Heart &amp; Diabetes Institute Melbourne Vic. Australia"},{"name":"Department of Physiology Monash University Clayton Vic. 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