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Polycystic Ovaries and Coronary Artery Disease
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Birdsall and colleagues [1] recently discussed the association of polycystic ovaries and the extent of coronary artery disease in women having cardiac catheterization. They stated that anovulation with reduced estradiol production may be associated with coronary artery disease. However, elevated testosterone production seems to be one of the atherogenic influences in polycystic ovaries. As shown in their Table 2, the free testosterone values in women with polycystic ovaries were significantly greater than those in women with normal ovaries. This finding would also explain the diminished high-density lipoprotein cholesterol values found in women with polycystic ovaries. Estradiol levels were not measured during the study or addressed in the review of patients. Many women with polycystic ovaries exceed their ideal body weight and therefore tend to have normal circulating levels of estrogen, often as estrone [2, 3].
I wholeheartedly agree with Birdsall and colleagues' suggestion that further studies must be undertaken to investigate the natural history and current treatments for polycystic ovaries-not only to alleviate the physical symptoms of androgen excess (which are devastating to many women) but also to reduce the occurrence of long-term complications and even death.
Polycystic ovaries may be one variant of syndrome X-just the “female influence.” If so, we should evaluate the influence of pregnancies and use of oral contraceptives on the risk for developing cardiac disease. The role of insulin resistance and the association of polycystic ovaries independent of androgen excess is another possible atherogenic risk factor in these women [4, 5].
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
