RISK OF CHD IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

描述：（改编自研究者摘要）患有多囊卵巢综合征的女性 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，提示男性CHD风险 因素概况。 自上次提交以来，调查人员招募了 筛查244例PCO综合征妇女和244例年龄匹配的邻居 对照 此外，作为少数族裔征聘工作的一部分， 确定并筛选了71名符合标准的非白人妇女， study. 总有效率为84.5%。 人们决定， 这种情况在早期有显着升高的CHD危险因素， 年龄 这些因素包括：BMI、LDL和甘油三酯增加（P <.001）， 降低HDLT和HDL2（p <0.01），增加腰臀比，空腹胰岛素， 收缩压（P <0.05）。 也有证据表明LDL 胆固醇在PCO参与者的早期增加，但不 如非PCO妇女中情况一样。 的 研究人员现在建议调查患有PCO综合征的女性是否 （PCOS）有证据表明亚临床 通过斑块的存在来测量的动脉粥样硬化， 颈动脉内膜中层厚度与下肱动脉血流 介导的血管舒张。 在PCOS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 目标如下。 1)评估PCOS与 通过颈动脉超声测量的亚临床动脉粥样硬化。 他们将 确定>= 30岁的PCOS女性是否有更高的患病率 亚临床动脉粥样硬化比年龄匹配的对照妇女（N = 150例， 150个对照）。 2)评估PCOS与亚临床 通过肱动脉血流介导的血管舒张测量的血管疾病。 他们将确定多囊卵巢综合征患者是否有较低的肱动脉血流 介导的血管舒张比对照组，以及是否分配流量 介导的血管舒张与颈动脉壁的程度有关 厚度和斑块（n = 150例病例，150例对照）。 3)评估是否 亚临床动脉粥样硬化和血管疾病与 PCOS病例和对照组中的以下心血管危险因素：HDLc， LDLc、甘油三酯、胰岛素、收缩压和舒张压， 睾酮、腰臀比和体重指数（BMI）。 4)评价 PCOS患者和对照组妇女身体组成的差异。 两 将评估身体组成的各个方面： 通过腹部计算机断层扫描（CT）测量，矢状径和 通过双能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和 分别用于病例和对照的身体组成。 以前的研究 已经清楚地表明，PCOS女性与肥胖的非PCOS女性不同。 此外，胰岛素、睾酮与冠心病危险因素也存在相关性 使用配对t检验进行这些测量。 将使用多元回归 测试PCO病例与对照组相比是否增加了 腹腔内脂肪，这是独立的重要混杂因素。 最后， 他们将5）比较选定的凝血因子的血浆水平， 纤维蛋白原和凝血因子VII对PCOS患者纤溶因子的影响， 对照

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.