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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The new millennium has brought intense focus of interest on the risk of cardiovascular disease in women. The polycystic ovary syndrome (PCOS) is a common endocrine disorder in women characterised by hyperandrogenism and oligomenorrhoea. Most women with PCOS also exhibit features of the metabolic syndrome, including insulin resistance, obesity and dyslipidaemia. While the association with type 2 diabetes is well established, whether the incidence of cardiovascular disease is increased in women with PCOS remains unclear. Echocardiography, imaging of coronary and carotid arteries, and assessments of both endothelial function and arterial stiffness have recently been employed to address this question. These studies have collectively demonstrated both structural and functional abnormalities of the cardiovascular system in PCOS. These alterations, however, appear to be related to the presence of individual cardiovascular risk factors, particularly insulin resistance, rather than to the presence of PCOS and hyperandrogenaemia per se. However, given the inferential nature of the evidence to date, more rigorous cohort studies of long-term cardiovascular outcomes and clinical trials of risk factor modification are required in women with PCOS.
Atherosclerosis 2006 Apr
PMID:Cardiovascular disease in the polycystic ovary syndrome: new insights and perspectives. 1631 10

The Polycystic Ovary Syndrome (PCOS) affects 6 to 10% of women of childbearing age. Insulin resistance and hyperinsulinemia are present in nearly all PCOS patients and play a central role in the development of both hyperandrogenism and metabolic syndrome (MS). MS occurs in approximately 43% of PCOS patients, raising the cardiovascular risk to up seven fold in these patients. Several serum, functional and structural markers of endothelial dysfunction and subclinical atherosclerosis were described in PCOS patients, even those young and non-obese. However, despite the fact that PCOS adversely affects the cardiovascular profile, long-term studies did not demonstrate a consistent raise in cardiovascular mortality, which seems to be more observed in the post-menopausal period. Recently, oral contraceptives are being substituted for insulin sensitizing agents (metformin and glitazones) in the PCOS treatment, due to their effects on insulin resistance and cardiovascular risk.
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PMID:[Polycystic ovary syndrome, metabolic syndrome, cardiovascular risk and the role of insulin sensitizing agents]. 1793 74

Females with polycystic ovary syndrome (PCOS) are characterized by several metabolic abnormalities that favor the development of atherosclerosis. Atherosclerosis is possibly a chronic inflammatory process, and the markers of the inflammatory state, such as C-reactive protein (CRP) and fibrinogen may be useful to assess the global risk of developing cardiovascular diseases. These proteins might be helpful in finding females with subclinical atherosclerosis. The purpose of this study was to assess the serum CRP and fibrinogen concentrations in young females with PCOS and to clarify the possible correlations between their levels and selected anthropometric, metabolic and hormonal indices. Study assessed a group of 57 females with PCOS (mean age 28.2+/-6.4 years). That group was further divided into two subgroups: the first with body mass index (BMI)</=25 (21 females of mean age 27.4+/-7.0 years) and second with BMI>25 (36 females of mean age 28.6+/-6.0 years). In the control group there were 22 healthy females (mean age 31.6+/-8.5 years). That group was again divided into two subgroups: the first with BMI</=25 (10 females, mean age 30.2+/-8.4 years) and second with BMI>25 (12 females, mean age 31.7+/-8.7 years). Results demonstrated statistically significantly higher CRP concentration in females with PCOS compared to healthy individuals in both BMI subgroups. PCOS females showed also higher plasma insulin levels. There was, however, no statistically significant difference in fibrinogen concentrations. The hormonal profile of females with PCOS seems to influence the concentration of CRP and fibrinogen in different ways. This was evident in the positive correlation between plasma fibrinogen and androstenedione and in the lack of correlation between CRP and androgens and in the positive correlation between CRP and estradiol and the negative correlation between fibrinogen and estradiol. In conclusion, high CRP concentration in females with PCOS probably speaks for a higher risk for cardiovascular diseases.
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PMID:Acute phase proteins: C-reactive protein and fibrinogen in young women with polycystic ovary syndrome. 1705 7

Polycystic ovary syndrome (PCOS) is probably the most common endocrinopathy of reproductive age. PCOS represents a disorder that not only enhances the risk for type 2 diabetes (T2D) but is also associated with an increased number of cardiovascular risk factors known to facilitate atherogenesis. On the other hand, inflammation is thought to play an important role in the progression and development of complications of atherosclerosis. Evidence of low-grade chronic inflammation in PCOS is indicated by the presence of elevated C-reactive protein (CRP) levels, inflammatory cytokines (i.e., IL-6 and IL-18), and increased leucocyte count. CRP, a nonspecific marker of inflammation, has been proven to be one of the strongest predictors of the risk of cardiovascular events in patients with or without cardiovascular disease. The levels of the adhesion molecules (AM), sIVAM-1, sVCAM-1, and sE-selectin in serum reflect low-grade chronic inflammation of the endothelium and independently predict coronary heart disease (CHD) and T2D. In a recent study in a large number of PCOS women we demonstrated elevated levels of sIVAM-1 and sE-selectin and we further substantiated the existence of a low-grade chronic inflammatory process in PCOS. However, it remains to be assessed with long-term studies whether the early presence of markers of chronic inflammation in young women with this syndrome has clinical significance.
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PMID:Indices of low-grade inflammation in polycystic ovary syndrome. 1730 43

The present study was designed in order to: (a) compare ET-1 and ADMA levels, between women with PCOS (n=106) and healthy controls (n=30); (b) determine the effects of treatment with estrogens and anti-androgens on the hormonal features of PCOS, insulin resistance, ET-1 and ADMA levels. Women with PCOS were randomized in five therapeutic protocols: (I) 17beta-estradiol+cyproterone acetate 50mg; (II) conjugated estrogen+CA 50 mg; (III) ethinyl estradiole+CA 2mg; (IV) EE+CA 52 mg; (V) EE+desogestrel. In all women, gonadotropin, PRL, androgen, SHBG, insulin, glucose, ET-1 and ADMA levels were determined; in women with PCOS, testosterone, SHBG, ET-1 and ADMA levels were measured again after 3, 6, 12 months of treatment and insulin and glucose levels after 12 months. ET-1 and ADMA concentrations were higher in women with PCOS, and they were positively correlated with each other. ADMA levels were decreased and IR was increased with treatment. Treatment with synthetic estrogens (EE) resulted in a more pronounced increase in SHBG and a more pronounced decrease in FAI, compared to natural estrogens. Conclusively, PCOS is associated with endothelial dysfunction, which is ameliorated by the administration of estrogens and anti-androgens, independent of IR.
Atherosclerosis 2008 Feb
PMID:The administration of estrogens, combined with anti-androgens, has beneficial effects on the hormonal features and asymmetric dimethyl-arginine levels, in women with the polycystic ovary syndrome. 1741 49

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that has received an immense amount of attention in the recent years due to the possible associated risk of cardiovascular disease. Women with PCOS demonstrate an adverse cardiovascular profile characteristic of the cardiometabolic syndrome and an established risk of progression to type 2 diabetes. Despite the presence of cardiovascular risk factors and increased surrogate markers of cardiovascular disease, it is unclear if they develop accelerated atherosclerosis. This article summarized the recent development and findings of cardiovascular risk in women with PCOS, and finally the therapeutic options will be discussed.
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PMID:Cardiovascular risk in women with polycystic ovary syndrome. 1809 63

Polycystic ovary syndrome (PCOS) is a common endocrinopathy associated with an increasing number of cardiovascular comorbidities. The relationship between insulin resistance and PCOS was described more than 3 decades ago. Women with PCOS also have an increased prevalence of several established cardiovascular risk factors such as diabetes, hypertension, and dyslipidemia. These factors contribute to the increased risk of endothelial dysfunction, increased carotid artery intima media thickness, and coronary artery calcification noted in women with PCOS compared with controls. Although truncal obesity is very prevalent in PCOS, these surrogate markers of atherosclerosis have been shown to be independent of body weight in young, asymptomatic subjects. Metabolic syndrome is a cluster of risk factors that also confer an increased risk of cardiovascular disease. Women with PCOS have also been shown to have a significantly higher prevalence of metabolic syndrome compared with age-matched controls. Currently, there are no longitudinal studies confirming increased cardiovascular morbidity and/or mortality in women with PCOS. However, the early presence of traditional and other cardiovascular risk factors underscores the need to screen and aggressively counsel and treat these women to prevent future symptomatic cardiovascular disease.
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PMID:Cardiovascular disease risk factors in polycystic ovary syndrome. 1818 Oct 81

Low density lipoproteins (LDL) size seems to be an important predictor of cardiovascular events and progression of coronary artery disease and the predominance of small dense LDL have been accepted as an emerging cardiovascular risk factor by the National Cholesterol Education Program Adult Treatment Panel III. We recently showed increased LDL size or higher levels of small, dense LDL in different categories of patients at higher cardiovascular risk, such as those with coronary (including acute myocardial infarction) and non-coronary (including carotid disease, abdominal aortic aneurysm and peripheral arterial disease) forms of atherosclerosis or metabolic diseases (including type-II diabetes, polycystic ovary syndrome and growth hormone deficiency). Screening for the presence of small, dense LDL may potentially identify those with even higher risk and may contribute in directing specific treatments in order to prevent new cardiovascular events. This seems particularly true for statins and fibrates. Promising data are available for rosuvastatin, the latest statin molecule introduced in the market, and ezetimibe, a cholesterol absorption inhibitor. The most recent patents regarding these two hypolipidemic agents include the antiinflammatory, antithrombotic and antiplatelet activity (EP1626716B1 and CN1794987A for rosuvastatin) and the potential use for treatment of cholesterol-associated benign and malignant tumors and diabetes (US7098198 and US7071181 for ezetimibe).
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PMID:An update on the role of the quality of LDL in cardiovascular risk: the contribution of the universities of Palermo and Zurich. 1822 Nov 6

We examined the relationship between endocrine, clinical and metabolic parameters in 35 women (mean age 27.3 years) with polycystic ovary syndrome (PCOS) and 30 age- and body mass index-matched normal ovulatory women. In PCOS women, serum leptin, homocysteine, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3 levels and the insulin resistance index (HOMA-IR) were significantly higher, while sex hormone-binding globulin and high-density lipoprotein cholesterol levels were lower compared with healthy women. Serum luteinizing hormone (LH), estradiol (E(2)), androstenedione, testosterone and dehydroepiandrosterone sulphate levels were found to be significantly higher in PCOS women compared with healthy women. The levels of E(2), LH and testosterone were positively correlated with leptin levels in PCOS women. Similarly, androstenedione levels and HOMA-IR were positively correlated with homocysteine levels and insulin levels were positively correlated with LH. We conclude that increased homocysteine levels, hyperandrogenaemia, insulin resistance and impaired lipid metabolism contribute to the risk of premature atherosclerosis in PCOS women.
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PMID:Serum levels of leptin and homocysteine in women with polycystic ovary syndrome and its relationship to endocrine, clinical and metabolic parameters. 1823 Feb 73

There is a little information in literature about circulating asymmetric dimethylarginine (ADMA) concentrations in polycystic ovary syndrome (PCOS) and the results reported are discrepant. In this study, therefore, we aimed (1) to determine the circulating ADMA concentrations in 44 women with PCOS and 22 age- and BMI-matched healthy controls, (2) to evaluate its correlations with insulin resistance, gonadotrophins, and androgen secretion, and (3) to compare effects of metformin and ethinyl estradiol-cyproterone acetate (EE/CPA) treatments on circulating ADMA concentrations. In conclusion, our data indicate that circulating ADMA concentrations in non-obese, non-hypertensive and young women with PCOS are significantly higher than healthy controls and they improved by a 3-month course of metformin and oral contraceptive treatments.
Atherosclerosis 2008 Oct
PMID:Metformin and oral contraceptive treatments reduced circulating asymmetric dimethylarginine (ADMA) levels in patients with polycystic ovary syndrome (PCOS). 1828 Oct 49


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