Meyer, Michelle
(2011)
Markers for Subclinical Atherosclerosis in Women with Polycystic Ovary Syndrome and Controls.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
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.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
29 June 2011 |
| Date Type: |
Completion |
| Defense Date: |
11 April 2011 |
| Approval Date: |
29 June 2011 |
| Submission Date: |
1 April 2011 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
polycystic ovary syndrome; cardiovascular disease; PCOS; subclinical atherosclerosis |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-04012011-084022/, etd-04012011-084022 |
| Date Deposited: |
10 Nov 2011 19:33 |
| Last Modified: |
15 Nov 2016 13:38 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/6693 |
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