Abstract P454: Impact of Air Pollution on Subclinical Atherosclerosis Risk in Middle Aged Women With and Without Polycystic Ovary Syndrome

Abstract

Objective: To study the association of ambient air pollution and subclinical atherosclerosis (SCA) risk in middle aged women with and without a history polycystic ovary syndrome (PCOS). Background: The harmful impact of air pollution relates to the increased risk in cardiovascular disease (CVD), a leading cause of mortality in the US. Atherosclerosis measured by coronary artery calcification (CAC) is highly correlated with the degree of atherosclerosis. Fine particulate matter (particles ≤ 2.5 μm in aerodynamic diameter [PM 2.5 ]), is known to affect cardiovascular health, but no study has focused on the impact in middle aged women with PCOS, a heterogeneous disorder involving altered ovarian function and often with higher risk of CVD. Methods: We evaluated 310 women (at first visit: age 47.7 ± 6.3 years; BMI 30.1 ± 7.6; 46.4% PCOS) from the Cardiovascular Health and Risk Measurement III study, who had data on SCA measured by CAC Agaston score, PCOS measures and PM 2.5 levels. Logistic regression models were used to estimate the association between PM 2.5 exposures (categorized into quartiles) and CAC (categorized into a binary variable, where CAC Agaston score ≤ 10 as reference group), adjusting for age, BMI, and PCOS status. Subgroup analyses were conducted to test associations between PM 2.5 and CAC among the vulnerable population of women with PCOS. Results: Annual mean PM 2.5 levels were 16.8 ± 1.1 and 16.6 ± 1.3 μg/m 3 , respectively, among women with CAC Agaston score > 10 and ≤ 10 (N=76 vs. 234). In addition, women with PCOS had an annual mean PM 2.5 levels of 16.5 ± 1.3 μg/m 3 , and women without PCOS had an annual mean PM 2.5 levels of 16.8 ± 1.1 μg/m 3 (N=143 for PCOS cases vs. 165 for controls). In adjusted analysis, the odds ratio of CAC risk was 1.32 (95% CI: 0.54, 3.28) for the highest quartile of PM 2.5 vs. the lowest one (Q4: 17.5-18.9 VS. Q1: 12.7-16.0 μg/m 3 ). Within the PCOS group, the likelihood of CAC was 4.78 times higher (95% CI: 1.37, 16.76) in the highest quartile of PM 2.5 levels, compared to the lowest. Conclusions: Women with PCOS appear to be at higher risk for the impact of PM2.5 exposure on SCA, compared to those without PCOS in this middle aged group. Replication of this work in other groups of women with PCOS would be of a high priority.