The Obesity Effect of Arizona's State Immigration Law Among Hispanic Adolescents.

Since 2010, Arizona's immigration law (SB 1070) has produced unintended racial profiling consequences for Hispanics. Earlier empirical evidence establishes its adverse mental health effects on young Hispanics. This study expands the analysis by introducing obesogenic repercussions. Using Youth Risk Behavior Surveillance System data from 2001 to 2017, Synthetic Control Method techniques are employed to isolate the law's health consequences. Results indicate significant post-2010 deviations from indistinguishable pre-2010 trends in health indicators for Arizona and its synthetic states. After 2010, Arizona's Hispanic youths registered relatively significantly higher incidences of mutually reinforcing mental and physical (obesogenic) indicators, even after accounting for nutritional improvements. Our findings do not discredit weight reduction benefits of favorable diet choices, but rather emphasize the stronger offsetting influence of SB 1070-induced obesogenic health behaviors. Thus, there is a need for policy re-evaluation to curb the law's unintended ramifications and launch more targeted youth-oriented health support programs.

Comparison of PCOS phenotypes in adolescent and young adult Mediterranean women with possible PCOS.

PURPOSE: During adolescence, PCOS features are supposed to be in evolution. Because of this, the diagnosis of PCOS in adolescence is often unclear and few studies have compared adolescent and adult PCOS phenotype distribution and features. The aim is to compare phenotypes in adolescents and young adults with PCOS. METHODS: 109 girls aged from 13 to 19 years were retrospectively studied. All patients had a gynecological age > 2 years. 63 patients were adolescents (3-5 years beyond menarche) while 46 patients were young adults (6-9 years beyond menarche). Diagnosis of different PCOS phenotypes (A, B, C, D) was made according to the Rotterdam criteria. Clinical data (menstrual cycles, BMI, presence of hirsutism), androgen circulating levels (total testosterone, androstenedione, dehydroepiandrosterone sulphate) and ovarian morphology by ultrasound were assessed. RESULTS: 109 patients presented PCOS according to the Rotterdam criteria. Phenotype A was by far the most common phenotype (73.4%) followed by phenotype B (21.1%). Only few patients had phenotype C (4.6%) or phenotype D (0.9%). When patients were divided in two groups (adolescent and young adult patients), no significant difference in prevalence and features of the different phenotypes was observed. CONCLUSION: In this cohort of adolescent and young adult women with PCOS, the progression of age does not change the prevalence and the features of main PCOS phenotypes. It suggests that the Rotterdam criteria might be used also in adolescents, at least in those with 2 or more years of gynecological age, for the diagnosis of PCOS.

Long term monitoring of jaguars in the Cockscomb Basin Wildlife Sanctuary, Belize; Implications for camera trap studies of carnivores.

In this study, we estimate life history parameters and abundance for a protected jaguar population using camera-trap data from a 14-year monitoring program (2002-2015) in Belize, Central America. We investigated the dynamics of this jaguar population using 3,075 detection events of 105 individual adult jaguars. Using robust design open population models, we estimated apparent survival and temporary emigration and investigated individual heterogeneity in detection rates across years. Survival probability was high and constant among the years for both sexes (φ = 0.78), and the maximum (conservative) age recorded was 14 years. Temporary emigration rate for the population was random, but constant through time at 0.20 per year. Detection probability varied between sexes, and among years and individuals. Heterogeneity in detection took the form of a dichotomy for males: those with consistently high detection rates, and those with low, sporadic detection rates, suggesting a relatively stable population of 'residents' consistently present and a fluctuating layer of 'transients'. Female detection was always low and sporadic. On average, twice as many males than females were detected per survey, and individual detection rates were significantly higher for males. We attribute sex-based differences in detection to biases resulting from social variation in trail-walking behaviour. The number of individual females detected increased when the survey period was extended from 3 months to a full year. Due to the low detection rates of females and the variable 'transient' male subpopulation, annual abundance estimates based on 3-month surveys had low precision. To estimate survival and monitor population changes in elusive, wide-ranging, low-density species, we recommend repeated surveys over multiple years; and suggest that continuous monitoring over multiple years yields even further insight into population dynamics of elusive predator populations.

Jaguar interactions with pumas and prey at the northern edge of jaguars' range.

We present the first study that evaluates jaguar-puma interactions in the arid lands of northern Mexico, where jaguars have their northernmost breeding population and both predators are persecuted for livestock depredation. We tested whether jaguars are the dominant species in this unique ecosystem, where: (1) pumas outnumber jaguars, (2) pumas are better adapted to arid environments, and (3) jaguars and pumas are of similar size. We analyzed four years of data with two approaches; a two species conditional occupancy model and an activity patterns analysis. We used camera location and prey presence as covariates for jaguar and puma detection and presence probabilities. We also explored overlap in activities of predators and prey. Where both species were detected, peccary presence was positively correlated with both jaguar and puma presence, whereas in areas where jaguars were detected but pumas were not, deer presence explained the probability of jaguar presence. We found that both predators were more likely to co-occur together than to be found independently, and so we rejected the hypothesis that jaguars were the dominant species in our study area. Predators were mainly nocturnal and their activity patterns overlapped by 60%. Jaguar, as compared with puma, overlapped more with deer and calves; puma overlapped with calves more than with other prey, suggesting a preference. We believe exploring predator relationships at different scales may help elucidate mechanisms that regulate their coexistence.

Are Private Reserves Effective for Jaguar Conservation?

We present the first study of density and apparent survival for a jaguar (Panthera onca) population in northern Mexico using 13 years of camera trap data from 2000 to 2012. We used the Barker robust design model which combines data from closed sampling periods and resight data between these periods to estimate apparent survival and abundance. We identified 467 jaguar pictures that corresponded to 48 jaguar individuals. We included camera type and field technician as covariates for detection probabilities. We used three covariates to evaluate the effect of reserve on jaguar apparent survival: i) private reserve creation ii) later reserve expansions, and iii) cattle ranches' conservation activities. We found that the use of digital cameras in addition to film cameras increased detection probability by a factor of 6x compared with the use of only film cameras (p = 0.34 ± 0.05 and p = 0.05 ± 0.02 respectively) in the closed period and more than three times in the open period (R = 0.91 ± 0.08 and R = 0.30 ± 0.13 mixed and film cameras respectively). Our availability estimates showed no temporary emigration and a fidelity probability of 1. Despite an increase of apparent survival probability from 0.47 ± 0.15 to 0.56 ± 0.11 after 2007, no single covariate explained the change in these point estimates. Mean jaguar density was 1.87 ± 0.47 jaguars/100 km2. We found that 13 years of jaguar population monitoring with our sampling size were not enough for detecting changes in survival or density. Our results provide a baseline for studies evaluating the effectiveness of protected areas and the inclusion of ranch owners in jaguar conservation programs and long-term population viability.

Emergence of ovulatory cycles with aging in women with polycystic ovary syndrome (PCOS) alters the trajectory of cardiovascular and metabolic risk factors.

STUDY QUESTION: What alters cardiovascular and metabolic risk factors with aging in women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: Lipid parameters, mainly low-density lipoprotein (LDL) cholesterol, increase with aging, but not in women who attain ovulatory cycles. WHAT IS KNOWN ALREADY: Cardiovascular and metabolic parameters tend to increase with aging, but this has not been shown in a prospective longitudinal study in women with PCOS. Correlates of these changes have not been identified. STUDY DESIGN: A prospective cohort of 118 hyperandrogenic women with PCOS who were followed from the age of 20-25 years at 5 year intervals for 20 years. PARTICIPANTS/MATERIALS, SETTING, METHODS: Thirty-five age-matched controls and another 35 age-matched controls in their 40s, 20 years later. Longitudinal measurements of body mass index (BMI), waist circumference, fasting serum steroids, glucose, insulin, lipids, prevalence of metabolic syndrome and ovulatory status. MAIN RESULTS AND THE ROLE OF CHANCE: After 20 years, in the entire group, waist circumference increased as did glucose, total cholesterol (C), high-density lipoprotein-C (HDL-C), LDL-C and non-HDL-C. The prevalence of metabolic syndrome was 7% at the beginning and 6% at the end. Fifty-one women with PCOS were found to be ovulatory and 67 remained anovulatory after 20 years. Anovulatory women had higher insulin, lower QUICKI and higher total C, LDL-C, non-HDL-C and lower HDL-C. In ovulatory women there were no alterations in lipids or glucose and minor changes in insulin and QUICKI compared with controls. None of the parameters were influenced by BMI or waist circumference. LIMITATIONS, REASONS FOR CAUTION: Inability to follow controls for 20 years. Associations observed between ovulatory function and lowered cardiovascular and metabolic risks cannot imply cause and effect. WIDER IMPLICATIONS OF THE FINDINGS: Phenotypic variability, particularly ovulatory function, in women diagnosed to have PCOS appears to influence cardiovascular and metabolic risks. It is unclear if these data pertain to other populations and ethnicities of women. STUDY FUNDING/COMPETING INTERESTS: Self-funded; no conflicts of interest.

Oral contraceptives and cardiovascular risk in women with polycystic ovary syndrome.

Because women affected by polycystic ovary syndrome (PCOS) present an increased cardiovascular risk, the safety of estroprogestin treatment is debated and contrasting data have been reported. However, cardiovascular risk is not the same in all PCOS women and individual cardiovascular risk should be assessed before staring any estroprogestin treatment. The available data show that products containing both 2nd-generation and 3rd-generation progestins (including drospirenone and cyproterone acetate) represent a safe treatment in PCOS patients with regular cardiovascular risk. In PCOS patients with increased cardiovascular risk, a careful choice of estroprogestin product is needed and cardiovascular risk should be monitored during treatment. In obese PCOS patients with normal glucose tolerance and lipid profile, products containing 2nd-generation progestins may be preferred because of lower venous thromboembolism risk. In PCOS patients with altered lipid profile or glucose intolerance, 3rd-generation progestins should be used but, during treatment, cardiovascular risk should be periodically re-assessed. In special situations, metformin or statins may be added to estroprogestin treatment.

PCOS: metabolic impact and long-term management.

Polycystic ovary syndrome (PCOS) is the most frequent endocrinopathy in women, affecting up to 10% of those in reproductive age. Furthermore, PCOS presents a lifetime risk of type II diabetes, cardiovascular diseases and endometrial cancer. Women with PCOS have increased cardiovascular risk; however, the risk is not the same in all patients and it is necessary to assess an individual risk profile. There is a discrepancy between increased cardiovascular risk at young age and postmenopausal number of cardiovascular events, probablu depending on changes in androgen ovarian function after the forties. However, changes with age of metabolic profile in women with PCOS have not been studied yet and many more data are necessary.

Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society.

BACKGROUND: Hirsutism, defined by the presence of excessive terminal hair in androgen-sensitive areas of the female body, is one of the most common disorders in women during reproductive age. METHODS: We conducted a systematic review and critical assessment of the available evidence pertaining to the epidemiology, pathophysiology, diagnosis and management of hirsutism. RESULTS: The prevalence of hirsutism is ~10% in most populations, with the important exception of Far-East Asian women who present hirsutism less frequently. Although usually caused by relatively benign functional conditions, with the polycystic ovary syndrome leading the list of the most frequent etiologies, hirsutism may be the presenting symptom of a life-threatening tumor requiring immediate intervention. CONCLUSIONS: Following evidence-based diagnostic and treatment strategies that address not only the amelioration of hirsutism but also the treatment of the underlying etiology is essential for the proper management of affected women, especially considering that hirsutism is, in most cases, a chronic disorder needing long-term follow-up. Accordingly, we provide evidence-based guidelines for the etiological diagnosis and for the management of this frequent medical complaint.

Assessing cardiovascular risk in Mediterranean women with polycystic ovary syndrome.

BACKGROUND: Although dyslipidemia is common in the polycystic ovary syndrome (PCOS), current diagnostic guidelines suggest to evaluate only plasma HDL-cholesterol and triglyceride concentrations, assuming that, in this disorder, cardiovascular risk is mainly due to the presence of the metabolic syndrome (MS). In the US, MS has been found in up to 50% of PCOS, but in other countries its prevalence is lower. METHODS: We compared the prevalence of MS with that of increased LDL- and non-HDL-cholesterol levels in 350 Mediterranean PCOS women (244 anovulatory and 106 ovulatory), and 95 normo-weight and 90 body mass index (BMI)- matched controls. RESULTS: The prevalence of MS was 7.1% in PCOS, higher than normoweight and BMI-matched controls (2.4% and 3.5%, respectively, p < 0.05 for both). The prevalence of elevated LDL- and non-HDL-cholesterol levels in PCOS was respectively, 14.9% and 8.6%, higher than normoweight (2.1% and 1.0%, respectively, p < 0.01 for both) and BMI-matched controls (4.4% and 2.2%, respectively, p<0.05 for both). In PCOS, increased LDL-cholesterol was twice more prevalent than MS or non-HDL-cholesterol. Only a minority of PCOS with MS had increased LDL-cholesterol while increased non-HDL-cholesterol was generally associated to increased LDL-cholesterol. CONCLUSIONS: We have found that in Mediterranean PCOS the prevalence of MS is relatively low while elevated LDL-cholesterol levels are more prevalent. Therefore, beyond MS, a more comprehensive lipid evaluation, including LDL-cholesterol, is needed for a more effective assessment of cardiovascular risk in PCOS.

Cardiovascular risk and events in polycystic ovary syndrome.

Young women with polycystic ovary syndrome (PCOS) present a high risk for cardiovascular disease because of the presence of abdominal obesity, insulin resistance and androgen excess. In addition, they present with endothelial dysfunction and early signs of atherosclerosis (increased carotid intima-media thickness and increased coronary calcium). However, the evidence of increased cardiovascular events during the postmenopausal age is relatively small, although some recent studies have indicated a slight increase in the severity of cardiovascular disease in women who had PCOS during their fertile age. The discrepancy between cardiovascular risk in young age and postmenopausal cardiovascular events may depend on changes in the risk that happen during the late fertile age or on overestimation of early atherosclerotic signs.

Correlates of increased lean muscle mass in women with polycystic ovary syndrome.

OBJECTIVE: Muscle mass plays an important role in determining cardiovascular and metabolic risks in polycystic ovary syndrome (PCOS). In addition, whether lean mass influences carotid intima-media thickness (IMT) in PCOS has not been assessed. DESIGN: Prospective investigation. METHODS: Ninety-five women with PCOS were age- and weight-matched to 90 ovulatory controls. All women had dual X-ray absorptiometry for lean, fat and bone mass, and bone mass density (BMD). Serum testosterone, sex hormone-binding globulin, insulin, and glucose and carotid IMT were determined. Free androgen index (FAI) and insulin resistance (by QUICKI) were calculated. RESULTS: In PCOS, waist circumference and insulin were higher and QUICKI lower than in controls (P<0.01). Trunk fat mass, % trunk fat, and lean mass were higher in PCOS compared to controls (P<0.01), while total bone mass and BMD were similar. IMT was increased in PCOS (P<0.01) but only 15% of PCOS patients had abnormal (> or = 0.9 mm) values. Lean mass correlated with fat parameters, insulin, QUICKI, and FAI, but not with total testosterone; and after adjustments for insulin and QUICKI, lean mass still correlated with fat mass (P<0.01) but not FAI. Lean mass correlated with IMT (P<0.01), but this was dependent on insulin. However, excluding those patients with abnormal IMT values, IMT correlated with lean mass independently of insulin. Bone mass correlated with lean and fat mass, but not with insulin or androgen. PCOS patients with 'pathological' IMT values had higher % trunk fat, lean mass, and insulin, lower QUICKI, and higher testosterone and FAI compared with those with normal IMT. CONCLUSION: Lean mass is increased in PCOS, while bone mass is similar to that of matched controls. The major correlates of lean mass are fat mass and insulin but not androgen. Lean mass also correlated with IMT, and although influenced by insulin, small changes in IMT may partially reflect changes in muscle mass, while clearly abnormal values relate to more severe abnormalities of PCOS.

Atherogenic forms of dyslipidaemia in women with polycystic ovary syndrome.

OBJECTIVE: Dyslipidaemia is very common in patients with polycystic ovary syndrome (PCOS) but, beyond plasma lipids, atherogenic lipoprotein (Lp) and apolipoprotein (apo) alterations are still ill defined. DESIGN: We measured concentrations of apoB, Lp(a) and small, dense low-density lipoprotein (LDL) in 42 patients with PCOS [age: 28 +/- 7 years, body mass index (BMI): 27 +/- 5 kg/m(2)] vs. 37 age- and BMI-matched healthy controls. METHODS: Elevated Lp(a) levels considered were those > 30 mg/dl while elevated apoB concentrations were those > 100 g/l. RESULTS: Polycystic ovary syndrome showed increased triglycerides levels (p = 0.0011) and lower high-density lipoprotein (HDL)-cholesterol concentrations (p = 0.0131) while total- and LDL cholesterol were similar. PCOS also showed smaller LDL size (p = 0.0005), higher levels of total small, dense LDL (p < 0.0001), higher concentrations of Lp(a), as considered as absolute values (p = 0.0143) and log-transformed (p = 0.0014), while no differences were found in apoB levels. Elevated Lp(a) concentrations were found in 24% of PCOS, while elevated apoB levels were relatively uncommon (14%). Spearman correlation analysis revealed that Lp(a) concentrations were weakly correlated only with HDL-cholesterol levels (r = -0.378, p = 0.0431). In addition, 36% of patients with PCOS with normal plasma lipid profile showed elevated levels of Lp(a), apoB or small, dense LDL. CONCLUSIONS: Atherogenic Lp abnormalities may be found in one-third of women with PCOS who have a normal lipid pattern. Future prospective studies are needed to test to which extent such atherogenic forms of dyslipidaemia may contribute to the increased cardiovascular risk in young women with PCOS.

Differences in dyslipidemia between American and Italian women with polycystic ovary syndrome.

BACKGROUND: Dyslipidemia is a common metabolic complication in polycystic ovary syndrome (PCOS). The aim of this study was to determine if differences exist in dyslipidemia in women with PCOS from different ethnic and geographical backgrounds. METHODS: This retrospective study evaluated the serum fasting lipid profiles of 106 women with PCOS from the United States and 108 women with PCOS from Italy evaluated at endocrinology clinics. RESULTS: American women had higher mean body mass index than Italian women (36.1+/-8.6 vs 28.1+/-5.8 kg/m2, p<0.01). Low HDL-cholesterol was the most prevalent lipid abnormality in both populations. U.S. women had higher mean levels of serum total cholesterol, LDL-cholesterol, and triglycerides, and lower mean serum HDL-cholesterol. Most of these differences were due to differences in weight. After controlling for differences in weight and age, fasting serum triglycerides remained higher in U.S. women compared with Italian women [131.1 mg/dl, SE=7.8, 95% confidence interval =(115.7, 146.5) vs 99.3, SE=8.4, 95% confidence interval =(82.9, 115.8)]. CONCLUSIONS: Variations in body weight alone do not fully explain differences in dyslipidemia in women of diverse ethnic and geographical backgrounds. Genetic and environmental factors, such as diet and activity level, likely contribute to these differences.

Androgen excess and cardiovascular risk.

Cardiovascular diseases represent the major cause of death in most of developed countries and ultimately kill as many men as women. Both genders are exposed to the same risk factors but their rates of cardiovascular morbidity and mortality are very different until old age. This represents a crucial point; in fact, only at age 75 and over cardiovascular rates of women approximate those of men. It has been suggested that differences in hormonal status and mainly in androgen levels may explain such gender disparity. Consistently with this hypothesis, it has been shown that women with polycystic ovary syndrome (PCOS) have elevated cardiovascular risk despite their young age. However, the possibility that androgens may increase cardiovascular risk remains controversial. Hyperandrogenism, as isolated androgen excess, has not been clearly recognised so far as a risk factor for cardiovascular diseases. In addition, the risk of premature cardiovascular diseases in PCOS is at present uncertain. Long-term studies examining the prevalence of cardiovascular diseases among women with PCOS did not demonstrate a clear increased risk for cardiovascular morbidity and mortality. Thus, it seems that androgens have a limited role in inducing cardiovascular risk; the altered risk factors found in women with PCOS are mainly dependent on the metabolic components of this syndrome as well as on insulin resistance and reduced adiponectin secretion.

Prevalence and metabolic characteristics of adrenal androgen excess in hyperandrogenic women with different phenotypes.

BACKGROUND: Serum DHEAS has been found to be elevated in some women with polycystic ovary syndrome (PCOS). We wished to determine whether this prevalence is different in women with androgen excess who have different phenotypes and to correlate these findings with various cardiovascular and metabolic parameters. METHODS: Two hundred and thirty-eight young hyperandrogenic women categorized into various diagnostic groups were evaluated for elevations in serum DHEAS, testosterone, glucose, insulin, quantitative insulin-sensitivity check index (QUICKI), cholesterol, HDL-C, LDL-C, triglycerides and C-reactive protein (CRP). Data were stratified based on elevations in DHEAS. RESULTS: Serum DHEAS was elevated in 39.5% for the entire group [36.7% in PCOS and 48.3% in idiopathic hyperandrogenism (IHA)]. In classic (C)-PCOS, the prevalence was 39.6% and in ovulatory (OV) PCOS it was 29.1%. These differences were not statistically significant. Women with elevated DHEAS had higher testosterone but lower insulin, higher QUICKI, lower total and LDL-cholesterol and higher HDL-cholesterol, p<0.01. Triglycerides and CRP were not different. This trend was greatest in women with C-PCOS. CONCLUSIONS: The prevalence of adrenal hyperandrogenism, as determined by elevations in DHEAS, appears to be statistically similar in IHA, C-PCOS and compared to OV-PCOS. Metabolic and cardiovascular parameters were noted to be more favorable in those women who have higher DHEAS levels.

Reproductive outcome of women with 21-hydroxylase-deficient nonclassic adrenal hyperplasia.

CONTEXT: Because many women with 21-hydroxylase (21-OH)-deficient nonclassic adrenal hyperplasia (NCAH) carry at least one allele affected by a severe mutation of CYP21, they are at risk for giving birth to infants with classic adrenal hyperplasia (CAH). OBJECTIVE: Our objective was to determine the frequency of CAH and NCAH infants born to mothers with 21-OH-deficient NCAH. DESIGN AND SETTING: We conducted an international multicenter retrospective/prospective study. PATIENTS AND METHODS: The outcome of 203 pregnancies among 101 women with 21-OH-deficient NCAH was reviewed. The diagnosis of 21-OH-deficient NCAH was established by a basal or post-ACTH-stimulation 17-hydroxyprogesterone level of more than 10 ng/ml (30.3 nmol/liter). When possible, genotype analyses were performed to confirm CAH or NCAH in the offspring. RESULTS: Of the 203 pregnancies, 138 (68%) occurred before the mother's diagnosis of NCAH and 65 (32%) after the diagnosis. Spontaneous miscarriages occurred in 35 of 138 pregnancies (25.4%) before the maternal diagnosis of NCAH, and in only four of 65 pregnancies (6.2%) after the diagnosis (P < 0.002). Four (2.5%; 95% confidence interval, 0.7-6.2%) of the 162 live births were diagnosed with CAH. To date, 24 (14.8%; 95% confidence interval, 9.0-20.6%) children, 13 girls and 11 boys, have been diagnosed with NCAH. The distribution of NCAH children and their mothers varied significantly by ethnicity (P < 0.0001, for both). CONCLUSIONS: The risk of a mother with 21-OH-deficient NCAH for giving birth to a child affected with CAH is 2.5%; at least 14.8% of children born to these mothers have NCAH.

Metabolic syndrome in polycystic ovary syndrome.

Because insulin resistance and visceral obesity are important features of polycystic ovary syndrome (PCOS), metabolic syndrome is much more common in women with PCOS than in the general female population of similar age. It has been reported that in the USA almost 50% of women with PCOS present the metabolic syndrome. In Italy, where women with PCOS have a lower mean body weight and less frequently increased serum triglycerides than US PCOS, metabolic syndrome is less common but still 4 times more frequent in PCOS patients than in the general female population of similar age. Patients with mild PCOS phenotype (ovulatory PCOS) have a lower prevalence of metabolic syndrome but, in these patients too, metabolic syndrome is 2 times more frequent than in the normal population. These data suggest that PCOS is the most common cause of increased cardiovascular risk in young adult women. All obese and overweight women with PCOS should be screened for metabolic syndrome and, when the syndrome is not found, the screening should be repeated every 2 or 3 years. Treatment consists in lifestyle intervention. Pharmacological therapies should be used only when lifestyle fails to normalize cardiovascular risk factors.

Endothelial dysfunction in PCOS: role of obesity and adipose hormones.

PURPOSE: Polycystic ovary syndrome (PCOS) is an extremely prevalent disorder in which elevated blood markers of cardiovascular risk and altered endothelial function have been found. This study was designed to determine if abnormal carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD) in young women with PCOS may be explained by insulin resistance and elevated adipocytokines. METHODS: A prospective study in 50 young women with PCOS (age: 25.2 +/- 1 years; body mass index [BMI]: 28.7 +/- 0.8) and 50 matched ovulatory controls (age: 25.1 +/- 0.7 years; BMI: 28.5 +/- 0.5) was performed. Carotid IMT, brachial FMD, and blood for fasting glucose, insulin, leptin, adiponectin and resistin were measured. RESULTS: PCOS, IMT was increased (P <.01), FMD was decreased (P <.01), fasting insulin was increased (P <.01), QUICKI (a marker of insulin resistance) was decreased (P <.01), and adiponectin was lower (P <.05), whereas leptin and resistin were not different compared with matched controls. Whereas BMI or waist/hip ratios did not correlate with IMT or FMD, insulin and QUICKI correlated positively and negatively with IMT (P <.01). There was a significant negative correlation between adiponectin and IMT (P <.05). These correlations were unchanged when adjusting for BMI and the correlation between IMT and adiponectin was unaffected by insulin resistance parameters. CONCLUSIONS: These data suggest that young women with PCOS have evidence for altered endothelial function. Adverse endothelial parameters were correlated with insulin resistance and lower adiponectin. Both insulin resistance and adiponectin appear to be important parameters. It is hypothesized that the type of fat distribution may influence these factors.