RISK OF CHD IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

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The risk of coronary heart disease (CHD) is lower in women than men. This has been attributed to differences in 1) sex hormones, 2) insulin sensitivity and 3) environmental factors. Women with Polycystic Ovary (PCO) syndrome have characteristics, including anovulation, hyperandrogenism and insulin resistance, which suggests a male risk factor profile. In the proposed study, we investigate the hypothesis that women with PCO, who comprise 5% of the female population, are at greater risk of CHD then non-PCO women. Although there has been great interest in studying the endocrinology and pathophysiology of PCO, there are relatively little data on long term follow-up cohorts of women with PCO syndrome. In the proposed study we will trace and follow-up, via telephone interview, 600 women with PCO identified through office records from 1970-86. We will then conduct a cross-sectional study to assess reproductive, hormonal, and other CHD risk factors in this group of women with PCO compared with a control population. It is anticipated that successful tracing and recruitment will result in ascertainment of approximately 390 cases and 390 age-matched neighborhood controls. Evaluation will consist of an office visit to determine: total cholesterol, triglycerides, HDL cholesterol, fasting and 2 hour glucose and insulin, blood pressure, lifetime cigarette smoking, alcohol intake, reproductive history, lifetime medication usage, family history of PCO, and serum hormone concentrations. At this evaluation, a physician diagnosis of PCO from history, physical examination, and hormone studies will be made. In addition, information on the number of pregnancies, number of live births, menstrual history, and history of surgical or natural menopause will be obtained. Women with evidence of thyroid, adrenal or pituitary disease will be excluded. Comparisons of cases with controls will include tests for differences in known risk factors for CHD: hormones, blood pressure, lipoprotein lipids, glucose and insulin. Body mass index, weight, diet, exercise, alcohol, cigarette smoking, CHD history, blood pressure, and reproductive history will be examined as independent variables that might explain variation in CHD risk factors. The estimated effect of PCO on risk factors will be adjusted for significant independent variables. In summary, our study will provide information on whether women with PCO have a greater incidence of known risk factors for CHD than matched non-PCO women and will also provide information on the subsequent health status of these women. The results of this study will provide the feasibility for a multicenter study of the risks of heart and other diseases among women with PCO.