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 Ն30 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 Ն3 compared with 0.7% (1 of 142) of similarly aged controls (Pϭ0.05). 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 Ն45 years, PCOS cases had significantly greater mean IMT than did control women (0.78Ϯ0.03 versus 0.70Ϯ0.01 mm, Pϭ0.005). This difference remained significant after adjustment for age and BMI (PϽ0.05). 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 Ⅲ polycystic ovary syndrome Ⅲ subclinical atherosclerosis Ⅲ carotid intima-media wall thickness Ⅲ B-mode duplex ultrasonography P olycystic ovary syndrome (PCOS), a reproductive endocrine disorder characterized by chronic anovulation, hyperandrogenism, hyperinsulinemia, and obesity, may represent one of the largest unique groups of women at high risk for the development of early onset coronary heart disease. 1 PCOS affects Ϸ5% of all women. 2 Over the past decade, it has been reported that women with PCOS exhibit an increase in coronary heart disease risk factors, including decreased levels of HDL cholesterol (HDLc), elevated levels of LDL cholesterol (LDLc) and triglycerides, increased prevalence of hypertension and insulin resistance, and abnormalities in the coagulation and fibrinolytic pathways. [3][4][5][6][7][8][9][10][11][12][13][14] This profile is similar to the metabolic cardiovascular syndrome (syndrome X), which represents a clustering within an individual of hyperinsulinemia, mild glucose intolerance, dyslipidemia, and hypertension. 15 Epidemiological studies in middle-aged and elderly populations have demonstrated greater carotid...

Body composition during puberty is a marker of metabolic changes that occur during this period of growth and maturation, and, thus, holds key information regarding current and future health. During puberty, the main components of body composition (total body fat, lean body mass, bone mineral content) all increase, but considerable sexual dimorphism exists. Methods for measuring body composition (e.g. densitometry and dual-energy X-ray absorptiometry) and degree of maturity will be discussed in this review. Components of body composition show age-to-age correlations (i.e. ‘tracking’), especially from adolescence onwards. Furthermore, adipose tissue is endocrinologically active and is centrally involved in the interaction between adipocytokines, insulin and sex-steroid hormones, and thus influences cardiovascular and metabolic disease processes. In conclusion, pubertal body composition is important, not only for the assessment of contemporaneous nutritional status, but also for being linked directly to the possible onset of chronic disease later in life and is, therefore, useful for disease risk assessment and intervention early in life.

The purpose of this study was to evaluate the influence of menarcheal age on changes in insulin, glucose, lipids, and blood pressure during adolescence and to assess whether body composition modifies this relationship. We examined 391 girls, a subset of Fels Longitudinal Study female participants (8-21 yr of age). Self-reported menarcheal age was classified based on the National Health and Nutrition Examination Survey III distribution, in which early menarche was at the 25th percentile or less (11.9 yr). Age at menarche was examined in relation to measures of body composition [e.g. fat-free mass (FFM) and percent body fat (PBF)], insulin resistance, blood pressure, and lipid profile. The effects of menarcheal age and body composition on cardiovascular disease risk factor changes were analyzed with serial data mixed models. Median menarcheal age was 12.7 yr (range, 9.8-17.0 yr), with 91 girls (23%) classified as early menarche. Girls with early menarche had more deleterious changes in insulin, glucose, blood pressure, FFM, and PBF levels than girls with average or late menarche. Menarcheal age adversely affected cardiovascular disease risk factor changes independent of age and changes in FFM or PBF. Girls with early menarche exhibited elevated blood pressure and glucose intolerance compared with later maturing girls, independent of body composition.