Molly Uren | ALES Graduate Seminar

Date(s) - 20/04/2021
3:00 pm - 4:00 pm

A graduate exam seminar is a presentation of the student’s final research project for their degree.
This is an ALES MSc course-based seminar by Molly Uren. This seminar is open to the general public to attend.

Meeting ID: 974 3328 4463 Passcode: 471034

Project Topic: Detection of early cardiovascular disease in high-risk women with and without polycystic ovary syndrome

MSc with Dr. Donna Vine

Seminar Abstract:

Background: Polycystic Ovary Syndrome (PCOS), an endocrine-metabolic disorder that affects up to 20% of women. Diagnosis includes the presence of at least two of the following: elevated testosterone, oligo/anovulation, and polycystic ovaries. Women with PCOS are at increased risk of cardiovascular disease (CVD), including cardiac dysfunction, end-stage ischemic disease, and atherosclerosis. PCOS women have an increased incidence of cardiometabolic risk factors including metabolic syndrome; obesity, insulin resistance, atherogenic dyslipidaemia, and increased risk for Type-2 Diabetes. These risk factors and elevated testosterone levels are proposed to increase the risk of early subclinical atherosclerotic CVD (ACVD) and cardiac dysfunction in women with PCOS. Currently, there is a need to investigate early screening of CVD in high-risk women with and without PCOS to effectively assess, manage, and prevent long term morbidity and mortality from CVD.

Objective: This pilot study aims to provide evidence-based research that will aid assessment guidelines for early detection of dyslipidaemia, cardiac dysfunction and subclinical atherosclerosis in women with and without PCOS.

Design, Setting, participants: A case-control pilot study in high cardiometabolic risk women with and without PCOS matched for age and body mass index. Participants aged 25 to 45 years are recruited from Edmonton and the greater area in Alberta, Canada.

Main outcome measures: ACVD is measured using carotid intima-media thickness (cIMT) and cardiac function using ultrasound and 2D/3D echocardiography. Plasma insulin, glucose apolipoprotein (apo)-B lipoproteins, triglycerides (TGs), LDL-cholesterol (C), HDL-C, and non-HDL-C are measured in the fasted state. Anthropometry and body composition are measured using BOD POD and dietary intake is assessed using 24-hour recall questionnaire. Results: Preliminary data (n= 14 PCOS, and n=2 control) shows PCOS women have decreased Left ventricular (LV) ejection fraction (EF) (59.86±2.48) compared to controls (64±1.41), indicating early systolic dysfunction. Those with PCOS tend to have increased LV mass (24.4%), cIMT (19.9%), and impaired LV Global Longitudinal Strain (GLS) (1.4%) compared to those without PCOS. No significant difference in fasting plasma lipids and apoB- lipoproteins are observed in those with and without PCOS. Insulin is higher in PCOS women (113±60.28pmol/l) compared to controls (47.5±30.41).

Conclusion: Our preliminary data shows no significant differences in fasting atherogenic dyslipidaemia in high-risk control and PCOS groups.  Preliminary data suggests women with PCOS have early impairment in systolic and global LV function compared to controls. The expected outcomes of this study are to provide data on early CVD; atherogenic dyslipidaemia, ACVD, and cardiac function in women with and without PCOS. This data can then be used for guidelines in early CVD assessment in high-risk women. A larger and longer-term trial is needed to determine the relationship between atherogenic dyslipidaemia, early markers of CVD, and long-term morbidity and mortality in high-risk women with and without PCOS.