RISK OF CHD IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

女性患冠心病(CHD)的风险比男性低。这 被归因于1)性激素、2)胰岛素的差异 敏感性和3)环境因素。患有多囊卵巢的女性 (PCO)综合征有一些特征，包括无排卵， 高雄激素血症和胰岛素抵抗，这表明这是男性的危险因素 侧写。在这项拟议的研究中，我们调查了女性 多囊卵巢综合征占女性人口的5%，患上这种疾病的风险更大。 然后是CHD和非PCO女性。尽管人们对研究有很大的兴趣 多囊卵巢的内分泌学和病理生理学方面的研究相对较少 多囊卵巢综合征妇女的长期随访队列数据。在 我们将通过电话采访，追踪和跟进拟议的研究，600 1970年至1986年，通过办公室记录确认患有多囊卵巢综合征的女性。我们会 然后进行一项横断面研究，以评估生殖、激素和 在这组患有PCO的女性中，其他冠心病危险因素与 控制人口数量。预计成功的跟踪和 征聘将导致查明约390起案件和390起 年龄相仿的邻里控制。评估将由一个办公室组成 访问以确定：总胆固醇，甘油三酯，高密度脂蛋白， 禁食和2小时血糖、胰岛素、血压、终生吸烟 吸烟，饮酒，生育史，终生用药， 多囊卵巢综合征家族史和血清激素水平。对此 评估，医生根据病史、体格检查诊断多囊卵巢 检查，并进行荷尔蒙研究。此外，有关以下方面的信息 怀孕次数、活产次数、月经史和 将获得手术或自然绝经史。女性与 甲状腺、肾上腺或脑垂体疾病的证据将被排除在外。 病例与对照的比较将包括对 已知的冠心病危险因素：荷尔蒙、血压、脂蛋白脂、 葡萄糖和胰岛素。体重指数，体重，饮食，锻炼，酒精， 吸烟、冠心病病史、血压和生育史 将被作为独立变量进行检验，这可能解释 冠心病危险因素。PCO对风险因素的估计影响将是 对重要的自变量进行了调整。总而言之，我们的研究将 提供有关患有多囊卵巢综合征的妇女是否有更高的发病率的信息 与匹配的非PCO女性相比，CHD的已知危险因素也将提供 关于这些妇女后来的健康状况的信息。结果是 这项研究将为多中心研究提供可行性。 患有多囊卵巢的妇女患心脏病和其他疾病的风险。

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.