HONOLULU, April 26 - Women with polycystic ovary syndrome (PCOS) are at risk for premature calcification in their coronary arteries - an early indication of cardiovascular disease - according to Evelyn O. Talbott, Dr.P.H., professor of epidemiology at the University of Pittsburgh Graduate School of Public Health. However, controlling weight and insulin sensitivity may reduce the risk.
PCOS, characterized by menstrual irregularities, chronic anovulation, excess hair growth and infertility, is a common reproductive endocrine disorder affecting five percent of the female population. Women with PCOS also experience several metabolic abnormalities, including insulin resistance, increased circulating insulin levels, abnormal blood lipid levels and increased central obesity ("apple body shape"). Until recently, PCOS was not recognized as a single, multi-dimensional disorder. Women suffering from it were instead treated for individual symptoms, particularly irregular menstrual periods and infertility.
"Preliminary results from our study suggest an association between the metabolic abnormalities experienced by women with PCOS, collectively termed metabolic Syndrome X or metabolic cardiovascular syndrome, and premature atherosclerosis in the coronary arteries," said Dr. Talbott. Coronary calcium deposits are an indicator of early, subclinical cardiovascular disease.
In the study, researchers used electron beam computed tomography (EBCT) to scan coronary arteries of 41 women with PCOS, and 43 controls. Their average age was 47. Scans showed an increased prevalence of coronary artery calcification among women with PCOS, with 65.9 percent of women with PCOS showing coronary calcium deposits, compared with 34.9 percent of women in the control group.
The excess calcification among women with PCOS was shown to be related to increased circulating insulin concentrations, low HDL cholesterol levels (the "good" cholesterol) and increased waist circumference. These results suggest to Dr. Talbott that women with PCOS may be able to reduce their risk of coronary artery disease by addressing specific components of the metabolic cardiovascular syndrome.
"These results highlight the need to reduce central obesity and improve insulin sensitivity in young women with PCOS. Dietary intervention and exercise in the teens and 20s, coupled with the use of insulin-sensitizing agents in select individuals, may help to prevent adverse cardiovascular outcomes, such as angina and heart attack, in later life," said Dr. Talbott.