RISK OF CHD IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

描述：(改编自《调查者摘要》)患有多囊症的妇女 卵巢(PCO)综合征的特征包括无排卵、 高雄激素血症和胰岛素抵抗，这表明男性存在冠心病风险 因子配置文件。自上次提交以来，调查人员已经招募了 筛查了244名患有多囊卵巢综合征的女性和244名年龄匹配的邻居 控制。此外，作为少数族裔招聘努力的一部分，他们已经 确定并筛选了71名符合标准的非白人女性 学习。总有效率为84.5%。人们断定，女性 有这种情况的人在早期就显著增加了冠心病的危险因素 年龄。其中包括：体重指数、低密度脂蛋白和甘油三酯的增加(P&lt；.001)， 降低高密度脂蛋白和高密度脂蛋白，增加腰臀比，空腹胰岛素， 和收缩压(p&lt；0.05)。还有证据表明，低密度脂蛋白 PCO参与者的胆固醇在早期就会增加，但不会 随着年龄的增长，这种情况急剧增加，在非PCO女性中也是如此。这个 调查人员现在提议调查患有多囊卵巢综合征的女性 (多囊卵巢综合征)有证据表明亚临床发病率增加 动脉粥样硬化，通过斑块的存在来衡量，增加 颈动脉内膜-中层动脉壁厚度与下臂动脉血流 介导的血管扩张。在多囊卵巢综合征人群中，他们将进一步 确定亚临床动脉粥样硬化的危险因素。因此，具体的 目标如下。1)评估多囊卵巢综合征与 颈动脉超声检测亚临床动脉粥样硬化。他们会 确定患有多囊卵巢综合征的30岁女性患病率是否更高 亚临床动脉粥样硬化的发生率高于年龄匹配的对照组妇女(N=150例， 150控制)。2)评估多囊卵巢综合征与亚临床的关系 通过臂动脉血流介导的血管扩张来衡量血管疾病。 他们将确定多囊卵巢综合征患者是否有较低的臂动脉血流 介导性血管扩张作用优于对照组，且是否分布于血流 介导性血管扩张与颈动脉壁的范围有关 厚度和斑块(n=150例，对照组150例)。3)评估是否 亚临床动脉粥样硬化和血管疾病与 多囊卵巢综合征患者和对照组中的以下心血管危险因素：高密度脂蛋白胆固醇、 低密度脂蛋白、甘油三酯、胰岛素、收缩压和舒张压 睾丸激素、腰臀比和体重指数(BMI)。4)评估 多囊卵巢综合征患者和对照妇女身体成分的差异。二 将评估身体成分的各个方面：腹内脂肪作为 通过计算机断层扫描(CT)测量腹部、矢状径和 用双能X射线吸收法(DEXA)测量的体脂百分比。 他们将评估亚临床动脉粥样硬化与 分别用于病例和对照的身体成分。以前的研究 已经清楚地表明，多囊卵巢综合征妇女与肥胖的非多囊卵巢综合征妇女不同。 此外，胰岛素、睾丸素和冠心病风险因素也将相互关联。 这些测量使用配对t检验。将使用多元回归 为了测试PCO病例与对照组相比是否有增加 不受重要混杂因素影响的腹内脂肪。最后， 他们将比较选定凝血因子的血浆水平，包括 纤维蛋白原和凝血因子VII对PCOS患者纤溶因子的影响 控制。

DESCRIPTION: (Adapted from Investigator's Abstract) Women with Polycystic Ovary (PCO) syndrome have characteristics including anovulation, hyperandrogenism and insulin resistance, which suggest a male CHD risk factor profile. Since the last submission, the investigators have recruited and screened 244 women with PCO syndrome and 244 age matched neighborhood controls. In addition, as part of a minority recruitment effort they have identified and screened 71 non-white women who met the criteria for the study. The overall response rate was 84.5%. It was determined that women with this condition have significantly elevated CHD risk factors at an early age. These include: increased BMI, LDL, and triglycerides (P<.001), decreased HDLT and HDL2 (p<.01), increase waist-hip ratio, fasting insulin, and systolic blood pressure (p<.05). There is also evidence that the LDL cholesterol is increased at an early age in PCO participants but does not increase dramatically with age as is that case among non-PCO women. The investigators now propose to investigate whether women with PCO syndrome (PCOS) have evidence of an increased prevalence rate of subclinical atherosclerosis as measured by the presence of plaque, increased intima-medial carotid artery wall thickness and lower brachial artery flow mediated vasodilation. Within the PCOS population they will further determine risk factors for subclinical atherosclerosis. Thus, the specific aims are as follow. 1) Evaluate the relationship between PCOS and subclinical atherosclerosis as measured by carotid ultrasound. They will determine whether women >=30 years of age with PCOS have a higher prevalence of subclinical atherosclerosis than age-matched control women (N=150 cases, 150 controls). 2) Evaluate the relationship between PCOS and subclinical vascular disease as measured by brachial artery flow mediated vasodilation. They will determine whether PCOS cases have lower brachial artery flow mediated vasodilation than controls, and whether the distribution of flow mediated vasodilation is related to the extent of carotid artery wall thickness and plaque (n=150 cases, 150 controls). 3) Evaluate whether subclinical atherosclerosis and vascular disease are related to the following cardiovascular risk factors within PCOS cases and controls: HDLc, LDLc, triglycerides, insulin, systolic and diastolic blood pressure and testosterone, waist-to-hip ratio and body mass index (BMI). 4) Evaluate differences in body composition between PCOS cases and control women. Two aspects of body composition will be assessed: intra-abdominal fat as measured by computed tomography (CT) of the abdomen, sagittal diameter and percent body fat as measured by dual energy x-ray absorptiometry (DEXA). They will evaluate the relationship between subclinical atherosclerosis and body composition separately for cases and for controls. Previous studies have clearly shown that PCOS women are different from obese non-PCOS women. Moreover, insulin, testosterone and CHD risk factors will also be correlated with these measures using paired t-tests. Multiple regression will be used to test whether PCO cases compared to controls have an increase in intra-abdominal fat which is independent of important confounders. Finally, they will 5) compare plasma levels of selected coagulation factors including fibrinogen and factor VII to fibrinolytic factors for PCOS cases and controls.