RISK OF CHD IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

描述：（改编自研究者摘要）多囊卵巢 多囊卵巢综合征（PCOS），以慢性无排卵、高雄激素血症和 据估计，胰岛素抵抗影响了4%到8%的 妇女1992年，研究人员开始了第一次大规模的研究， 多囊卵巢综合征妇女的心血管危险因素（1992-1994）。他们招募了244人 PCOS妇女和244名年龄、种族和邻居匹配的对照者 （19-50岁），并确定PCOS病例的特征， 心血管风险增加（LDL c、甘油三酯和 腰臀比、肥胖、HDL c降低、高胰岛素血症和 舒张压和收缩压）。在第二阶段（1996- 1999年）， 调查了颈动脉亚临床动脉粥样硬化（SCA）的患病率 来自原始队列的30岁以上女性的动脉。初步 分析显示，45岁以上的多囊卵巢综合征患者的平均内膜中层壁明显较高 与对照组相比（0.75mm vs.0.70mm，p<0.02）。调查人员 声明，这一成熟的队列提供了一个独特的机会， 他们通过进行更有力的研究， SCA的纵向研究。本研究的具体目标是：1） 招募和筛选160例PCOS病例和160例对照，年龄>=40岁 队列，以确定PCOS病例是否具有更大的初始冠状动脉或主动脉 钙化和/或更大的进展，2）评估 PCOS患者5年内颈动脉粥样硬化的进展， 对照组>=40岁，参加了研究的第二阶段，3）评估 冠心病危险因素是否与冠状动脉和主动脉病变程度有关 病例组和对照组的钙化情况，4）评估PCOS患者的血管硬度 病例和对照组，并确定主动脉僵硬的CHD危险因素，以及5） 评估PCOS患者和对照者的内皮功能， 年CHD风险因素包括：HDLt、LDLc、甘油三酯、葡萄糖， 胰岛素、Lp（a）、派-1、血压和人体测量。信息 将根据病史、生殖史和体力活动史获得。的 研究人员指出，这项研究有可能确定 早期SCA的决定因素在这个高风险的妇女群体，并具有重要的 对初级和二级预防的影响。

DESCRIPTION: (Adapted from the Investigator's Abstract) Polycystic ovary syndrome (PCOS), characterized by chronic anovulation, hyperandrogenism, and insulin resistance, is estimated to affect four percent to eight percent of all women. In 1992, the investigators initiated the first large-scale study of cardiovascular risk factors in women with PCOS (1992-1994). They recruited 244 women with PCOS and 244 age-, race- and neighborhood-matched controls age (19-50 years of age) and determined that PCOS cases had a profile that conferred increased cardiovascular risk (increased LDLc, triglycerides, and waist/hip ratio, obesity, decreased HDLc, hyperinsulinemia, and increased diastolic and systolic blood pressure). During phase II, (1996-99) they investigated the prevalence of subclinical atherosclerosis (SCA) of the carotid arteries in women 30+ years of age from the original cohort. In preliminary analyses, PCOS cases 45+ years had significantly higher mean intima-media wall thickness (IMT) than controls (0.75mm vs. 0.70mm, p<.02). The investigators state that this well established cohort provides a unique opportunity to extend their study of CHD risk in women with PCOS by conducting more powerful longitudinal studies of SCA. The specific aims of the present study are to 1) recruit and screen 160 PCOS cases and 160 controls >=40 years from the original cohort to determine if PCOS cases have greater initial coronary or aortic calcification and/or greater progression during years 4 and 5, 2) evaluate the progression of carotid atherosclerosis over a 5-year period of PCOS cases and controls >=40 years who participated in Phase II of the study, 3) evaluate whether CHD risk factors can be linked to the extent of coronary and aortic calcification within cases and controls, 4) evaluate vascular stiffness in PCOS cases and controls and determine CHD risk factors for aortic stiffness, and 5) evaluate endothelial function in PCOS cases and controls and changes over five years. CHD risk factors will include: HDLt, LDLc, triglycerides, glucose, insulin, Lp(a), PAI-1, blood pressure, and anthropometric measures. Information will be obtained on medical, reproductive and physical activity history. The investigators state that this study has the potential to identify the determinants of early SCA in this high-risk group of women and has important implications for primary as well as secondary prevention.