Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder among women in the United States. Women with PCOS experience acne, excessive hair, weight gain and irregular periods. Unfortunately, these women also have cardiovascular disease (CVD) risk factors including obesity, inflammation and type 2 diabetes. It is challenging to determine when and if atherosclerosis is accelerated in women with PCOS compared to controls as many studies investigate subclinical atherosclerosis in young women and are limited by small sample sizes. The purpose of this dissertation is to investigate markers for subclinical atherosclerosis in women with PCOS and non-PCOS controls.
The meta-analysis on carotid intima-media thickness (CIMT) showed that women with PCOS have greater CIMT compared to controls. The summary estimates of the difference are comparable to a seven year progression in CIMT. This analysis also revealed CIMT estimates were more constant across studies with higher quality assessments of CIMT.
The investigation of serum complement protein C3 (C3) suggested C3 may be an inflammatory risk marker for CVD in women with PCOS and controls. C3 was associated with traditional CVD risk factors in women with PCOS and controls, and was associated with coronary artery calcium (CAC) after adjusting for case control status, age, and either insulin or BMI. In the fully adjusted model with African American race, C3 was significantly associated with the presence of CAC.
The trajectory analysis of flow-mediated dilation in women with PCOS and controls identified three patterns of change in lumen diameter that were labeled as non-dilators, dilators and enhanced dilators. Baseline lumen diameter, insulin and HDLc were associated with group membership, and an interactive effect between PCOS status and total cholesterol on group membership was detected.
The findings from this dissertation clarify the mechanisms of subclinical atherosclerosis in women with PCOS and controls. This is of public health importance because many women with PCOS may not realize they are at risk for CVD. It is critical to evaluate factors that put these women at an increased risk of CVD so researchers can monitor risk factors and develop interventions to prevent atherosclerosis in this high risk population.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04012011-084022 |
| Date | 29 June 2011 |
| Creators | Meyer, Michelle |
| Contributors | Maria Mori Brooks, PhD, Mary Korytkowski, MD, Kim Sutton-Tyrrell, DrPH, Evelyn O. Talbott, DrPH |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04012011-084022/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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