Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20:2414-2421
© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Evidence for Association Between Polycystic Ovary Syndrome and Premature Carotid Atherosclerosis in Middle-Aged Women
From the Department of Epidemiology (E.O.T., K.S.-T., K.P.M.-P., J.V.Z., K.E.R., L.H.K.), University of Pittsburgh, Pittsburgh, Pa, and the Department of Obstetrics/Gynecology (D.S.G.), University of Rochester Medical Center, Rochester, NY.
Abstract—Polycystic ovary
syndrome (PCOS) is a common reproductive endocrine disorder
characterized by obesity, hyperandrogenism, and insulin resistance. An
adverse lipid profile has also been observed in PCOS-affected women,
suggesting that these individuals may be at increased risk for
coronary heart disease at a young age. The objective of the
present study was to evaluate subclinical
atherosclerosis among women with PCOS and age-matched
control subjects. A total of 125 white PCOS cases and 142
controls, aged 
30 years were recruited. Collection of baseline
sociodemographic data, reproductive hormone levels, and
cardiovascular risk factors was conducted from 1992 to
1994. During follow-up (1996 to 1999), these women underwent B-mode
ultrasonography of the carotid arteries for the evaluation of carotid
intima-media wall thickness (IMT) and the prevalence of plaque. A
significant difference was observed in the distribution of carotid
plaque among PCOS cases compared with controls: 7.2% (9 of 125) of
PCOS cases had a plaque index of 3 compared with 0.7% (1 of 142) of
similarly aged controls (P=0.05). Overall and in the
group aged 30 to 44 years, no difference was noted in mean carotid IMT
between PCOS cases and controls. Among women aged 45 years, PCOS
cases had significantly greater mean IMT than did control women
(0.78±0.03 versus 0.70±0.01 mm, P=0.005). This
difference remained significant after adjustment for age and BMI
(P<0.05). These results suggest that (1) lifelong
exposure to an adverse cardiovascular risk profile in
women with PCOS may lead to premature atherosclerosis,
and (2) the PCOS-IMT association is explained in part by weight and fat
distribution and associated risk factors. There may be an independent
effect of PCOS unexplained by the above variables that is related
to the hormonal dysregulation of this condition.
Key Words: cardiovascular risk factors • polycystic ovary syndrome • subclinical atherosclerosis • carotid intima-media wall thickness • B-mode duplex ultrasonography
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