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P29 PCOS is a reproductive endocrine disorder, characterized by  chronic anovulation, androgen excess, and insulin resistance, affecting  approximately 5% of the female population. PCOS is associated with an  increase in CHD risk factors, including LDL cholesterol,triglycerides,  obesity,and hypertension. Endothelial dysfunction has been implicated  in the development and progression of atherosclerosis and has been  shown to be adversely affected in males with high free testosterone  levels and in men and women with increased insulin resistance. We  recruited 83 women with PCOS (42.3 ± 5.8 years) from our  Pittsburgh cohort and 91 controls of similar age (43.4 ± 5.4  years) to evaluate endothelium-dependent vascular function using  brachial artery ultrasonography. Women on hormone replacement or oral  contraceptives were excluded from the analysis. The mean BMI ± SD  was 31.7 ± 8.7 and 27.1 ± 6.4 kg/m 2 in cases  and controls, respectively. The groups were also similar with respect  to smoking status. No difference was observed in BMI-adjusted flow  mediated vasodilation (FMD) between PCOS cases and controls (p=.630).  However, baseline brachial lumen diameter (LD) was significantly higher  among women with PCOS compared to controls (Mean ± SE =  3.30 ± .06 vs. 3.12 ± .05) after adjustment(p=.023).  Further adjustment for LDLc, HDLc, triglycerides, systolic blood  pressure (SBP), or insulin did not alter the PCOS-brachial lumen  diameter association. Independently of case status and BMI, HDLc was  significantly associated with baseline LD(p=.001); DBP was of  borderline significance(p=.099). These findings suggested that PCOS may  be associated with a compensatory enlargement of the arteries in  response to accelerated arterial wall thickening and/or arterial  stiffening. Further analyses within PCOS cases suggested that  testosterone and insulin may mediate endothelial function (FMD). Future  studies are needed to futher explore vascular changes and the  implication for cardio- and cerebrovascular events in this high risk  population.

circulation

Evidence of an Increase in Baseline Brachial Artery Lumen Diameter Independent of Body Mass Index (BMI) among Women with Polycystic Ovary Syndrome (PCOS)Compared to Age-Matched Control Women