Coronary heart disease risk factors in adult premenopausal white women with polycystic ovary syndrome compared with a healthy female population

Glueck, Charles J.; Morrison, John A.; Goldenberg, Naila; Wang, Ping

doi:10.1016/j.metabol.2009.02.005

Cited by 38 publications

(25 citation statements)

References 49 publications

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“…While several studies have shown that women with PCOS are more prone to atherosclerotic issues, [16][17][18][19][20]37 we show here, as Mak and Dokras 22 suggested, that women with PCOS have a higher probability of having VTE compared with women without PCOS. 22 We acknowledge that our findings should be interpreted with caution and the relationship between PCOS and VTE should be evaluated further in prospective studies because our data were obtained from administrative data.…”

Section: Author Manuscriptsupporting

confidence: 58%

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Okoroh

Hooper

Atrash

et al. 2012

American Journal of Obstetrics and Gynecology

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OBJECTIVE-We sought to determine prevalence and likelihood of venous thromboembolism (VTE) among women with and without polycystic ovary syndrome (PCOS). STUDY DESIGN-We performed a cross-sectional analysis using Thomson Reuters MarketScanCommercial databases for the years 2003 through 2008. The association between VTE and PCOS among women aged 18-45 years was assessed using age-stratified multivariable logistic regression models.RESULTS-Prevalence of VTE per 100,000 was 374.2 for PCOS women and 193.8 for women without PCOS. Compared with women without PCOS, those with PCOS were more likely to have VTE (adjusted odds ratio [aOR] 18-24 years, 3.26; 95% confidence interval [CI], 2.61-4.08; aOR 25-34 years, 2.39; 95% CI, 2.12-2.70; aOR 35-45 years, 2.05; 95% CI, 1.84-2.38). A protective association (odds ratio, 0.8; 95% CI, 0.73-0.98) with oral contraceptive use was noted for PCOS women.CONCLUSION-PCOS might be a predisposing condition for VTE, particularly among women aged 18-24 years. Oral contraceptive use might be protective. Keywordspolycystic ovary syndrome; prevalence; venous thromboembolism Venous thromboembolism (VTE) is a chronic condition that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). Initial presentation might be leg pain, tenderness, shortness of breath, or pleuritic chest pain, or there might be no symptoms. 1 VTE is the third most common cardiovascular disease-after myocardial infarction and stroke-among the general population. 2,3 The overall annual incidence of VTE is estimated © 2012 Mosby, Inc. All rights reserved.Reprints: Ekwutosi M. Okoroh, MD, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E64, Atlanta, GA 30333. Eokoroh@cdc.gov. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The authors report no conflict of interest.Presented orally at the 60th Annual Epidemic Intelligence Service Conference, Atlanta, GA, April 11-15, 2011. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript to be 1-2 per 1000 adults per year. [4][5][6][7] These incident estimates, however, might not represent the entire population because VTE incidence differs by age and race, and slightly by sex. VTE is a multifactorial disease with both inherited and acquired risk factors. In 26-47% of first-time VTE cases, the etiology is unknown 4,5,8 ; a possible predisposing condition not yet assessed is polycystic ovary syndrome (PCOS).PCOS is the most common endocrine disorder affecting women of reproductive age. Estimates of its prevalence vary and range from 4-6%. 9-12 Its exact etiology is unknown, but it is characterized by a heterogeneous presentation of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. 13 PCOS is also associated with insulin-induced elevations of plasminogen activator inhibitor (P...

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Section: Author Manuscriptsupporting

confidence: 58%

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Okoroh

Hooper

Atrash

et al. 2012

American Journal of Obstetrics and Gynecology

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“…The exact mechanisms involved in the pathophysiology of PCOS are still unclear, but high levels of androgens are considered to play a crucial role in the etiology. PCOS patients suffer from dyslipidemia, obesity and metabolic syndrome (Wild 2002, Glueck et al 2009), resulting in an increased risk for type 2 diabetes mellitus and cardiovascular diseases including hypertension and atherosclerosis (Charitidou et al 2008, Wild et al 2010, Goodarzi et al 2011, de Groot et al 2011). This predisposition is further aggravated by the associated endothelial dysfunction (Lakhani et al 2005, Hudecova et al 2010.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the vascular responses in a murine model of polycystic ovary syndrome

Labruijere

Houten

Vries

et al. 2013

Journal of Endocrinology

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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of the reproductive age, but the exact pathophysiological mechanisms involved remain unclear. Cardiovascular disease risk is increased in PCOS patients and endothelial damage has been observed. We recently developed a mouse model of PCOS with reproductive and metabolic characteristics resembling those observed in women with PCOS. In this model we studied vascular function with particular emphasis on markers of vascular endothelial function. Animals were treated for 90 days with dihydrotestosterone (DHT; 27.5 mg/day) or placebo using subcutaneous continuous-release pellets. Aortas were isolated for isometric force recordings in organ baths to investigate endothelial and vascular smooth muscle characteristics. Lungs were used to analyze endothelial nitric oxide synthase (eNOS) expression and phosphorylation. Asymmetric dimethylarginine (ADMA) levels were investigated in serum to assess endothelial damage. Expression of androgen receptor (Ar) mRNA was studied in aortas. DHT treatment (compared with placebo) induced i) a significant decrease in acetylcholine-induced aortic relaxations, with no change in calcitonin generelated peptide-or sodium nitroprusside-induced relaxations, as well as 5-hydroxytryptamine-induced contractions; ii) no change in eNOS expression/phosphorylation in lungs or in plasma ADMA levels; and iii) a twofold increase in aortic AR expression. Our results suggest that, in DHT-exposed mice, hyperandrogenemia specifically decreases endotheliumdependent vasorelaxation without deterioration of smooth muscle function. This study may initiate further investigations to elucidate underlying mechanism for the phenotype that is present in these animals, as well as in PCOS patients.

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“…Obesity is present in 40-60% of the women with this pathology and 50-70% of the subjects with PCOS, either obese or of normal weight, have evidence of resistance to insulin [1]. Moreover, it has been suggested that PCOS represents a female subtype of metabolic syndrome, carrying a high risk for developing type 2 diabetes mellitus and atherosclerosis with a higher probability for coronary and cerebrovascular events [2]. Endothelial dysfunction and carotid intima-media thickness (CIMT) have been regarded as early features of atherosclerosis, and their assessment, as well as the evaluation of inflammatory markers, can be regarded as useful prognostic tools for the detection of pre-clinical cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

The polycystic ovary syndrome (pcos) status and cardiovascular risk in young women

Ilie¹,

Pepene²,

Marian³

et al. 2010

Open Medicine

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AbstractThe study investigated the presence of early vascular damage and chronic inflammation, and their relationships with hormonal and metabolic parameters in 45 young women with PCOS in comparison with thirty-two healthy age-matched controls. Hormonal and metabolic profiles, high sensitivity C-reactive protein (hsCRP), tumoral necrosis factor-alpha (TNF-α), endothelin-1 (ET-1), brachial flow-mediated vasodilation (FMD) and carotid intima-media thickness (CIMT) were determined in both groups. Compared with the controls, women with PCOS had significantly lower FMD and respectively higher ET-1 levels (p=0.001). No differences were observed between the groups in terms of CIMT or inflammatory markers. In the PCOS group, ET-1 levels were significantly correlated with only testosterone concentrations (r = 0.31, p = 0.037), whereas the hsCRP levels were independently predicted only by body mass index (BMI). Within the total group, the PCOS status was the sole significant predictor of ET-1 levels and the only independent predictor of FMD. In conclusion, there is evidence of endothelial dysfunction associated with increased levels of androgen hormones in young women with PCOS. The combination of endothelial dysfunction and coexistent obesity promoting inflammation contributes to the progression of atherogenesis in PCOS. The PCOS status should be regarded as a predictor marker of cardiovascular risk, along with well-known cardiovascular risk factors.

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Coronary heart disease risk factors in adult premenopausal white women with polycystic ovary syndrome compared with a healthy female population

Cited by 38 publications

References 49 publications

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Analysis of the vascular responses in a murine model of polycystic ovary syndrome

The polycystic ovary syndrome (pcos) status and cardiovascular risk in young women

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