Heart risks linked to infertility syndrome

From Toronto at the annual meeting of the Endocrine Society

In women with polycystic ovary syndrome, immature eggs distend the ovaries, leading to infertility. Such women also exhibit many classic risk factors for cardiovascular disease, such as high cholesterol, increased abdominal fat, and diabetes. So far, however, studies have not demonstrated that these women are at higher-than-normal risk of developing heart disease.

Some of the first direct evidence for such a link comes from a study of 31 women with polycystic ovary syndrome and 53 healthy women matched for age, weight, and waist-to-hip ratio. All were 30 to 45 years old. About 15 percent of the healthy women had detectable amounts of calcium in the arteries of their hearts, compared with 36 percent of the women with the syndrome, reports Rose C. Christian of the Mayo Clinic in Rochester, Minn. Such calcium deposits are early signs of fatty plaques in blood vessels, which can lead to high blood pressure and heart attacks.

Overall, in this Minnesota community, about 10 percent of women in their 40s and 33 percent of men the same age have detectable amounts of calcium in their arteries, Christian says.

While premenopausal women are generally at lower risk for heart disease than men of the same age are, she says, “polycystic ovary syndrome erases the gender protection.” The syndrome tends to run in families. Besides suffering from infertility, many women with polycystic ovary syndrome develop facial hair because they have higher-than-normal concentrations of male hormones, or androgens, in their blood. Many women with the syndrome are resistant to insulin, the hormone that helps cells absorb sugar from the bloodstream.

Other researchers at the meeting reported that mutations linked to polycystic ovary syndrome lie in the neighborhood of a gene for the cell-surface protein that recognizes insulin.

Although it still isn’t clear whether the mutated gene is the insulin receptor itself, says Yaron Tomer of the Mount Sinai School of Medicine in New York, his findings fit with other research suggesting that insulin can stimulate the ovaries to produce androgens.