A multidisciplinary polycystic ovarian syndrome (PCOS) clinic: a new model for care and research

molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM1) and high sensitivity C-reactive proteins (hsCRP) were also determined. RESULTS: Women with PCOS exhibited significantly higher levels of ET1 (P<0.05), sICAMP-1 (P<0.05), sVCAM-1 (P<0.001) and hsCRP (P<0.001) as compared with age-matched controls, respectively. Positive correlations were evident between ET-1 and FAI (r ¼ 0.41; P<0.01) but ET-1 negatively correlated with SHBG (r ¼ 0.36; P<0.05). sVCAM-1 positively correlated with total T (r ¼ 0.62; 0.001), hsCRP correlated with: BMI (r ¼ 0.73; P<0.001), and HOMA (r ¼ 0.39; P<0.05), respectively. CONCLUSIONS: Women with PCOS exhibited abnormal levels of endothelial and inflammatory markers, which appear to be inter-related to hyperandrogenaemia. Supported by: None. P-235 A MULTIDISCIPLINARY POLYCYSTIC OVARIAN SYNDROME (PCOS) CLINIC: A NEW MODEL FOR CARE AND RESEARCH. J. D. Lamb, W. B. Closshey, H. G. Huddleston, G. Davis, L. T. Zane, M. I. Cedars. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA. OBJECTIVE: To identify and characterize specific phenotypes presenting to a multidisciplinary PCOS clinic. DESIGN: Prospective Cohort. MATERIALS AND METHODS: Our clinic provides multidisciplinary care to patients with suspected PCOS. Referred patients undergo evaluation by a reproductive endocrinologist, dermatologist, psychologist, dietician and genetic counselor. Diagnosis and treatment strategies are developed using a multidisciplinary approach. We prospectively collected data regarding clinical characteristics and biomarkers. All patients were categorized according to the Rotterdam diagnostic criteria (Table 1). A Mann-Whitney test was used for statistical analysis. RESULTS: Thus far, 96 patients presented for evaluation. Data on diagnostic criteria and metabolic parameters were available for 59 patients (61%). Forty-one of these patients (69%) met criteria for PCOS. Patients distributed into the defined phenotypes as follows: I ¼ 57.1%. II ¼ 25.0%, III ¼ 14.2%; IV ¼ 3.6%. Thirty-two percent had categorization deferred due to birth control pill usage or absence of ultrasound at visit. Mean baseline characteristics and metabolic parameters for each phenotype are presented in Table 2. These preliminary data suggest individuals meeting all three Rotterdam criteria have a higher average body mass index (BMI) than those who meet only two (P¼0.003). TABLE 1.

Phenotype

I 3

PCO by Ultrasound (AFC >12 or Vol >10 mm on both ovaries) Hyperandrogenism (Clinical and/or biochemical) Oligoammenorhea/anovulation (<8 cycles/year)

II

X X X

X X

III

IV

X

X X

X

TABLE 2.

Age (years) Body Mass Index (kg/m2) Systolic Blood Pressure (mmHg) Total Cholesterol (mg/dL) Fasting Glucose (mg/dL) 2 hour Glucose Tolerance Test (mg/dL)

I n ¼ 16

II n¼7

III n¼4

IV n¼1

26.9  6.4 35.4  8.1

27.0  3.5 26.2  4.0

24.5  4.0 24.7  6.1

17 32.2

122.3  21.3 118  10.5 117.3  6.4

114

181.4  34.2 170  16.2 201.6  30

156

92.5  12.4 87.4  4.3 101.8  44.3

90  4.8

89  40.6 126.5  16.2

CONCLUSIONS: Currently, PCOS is a broadly defined syndrome affecting 5% of the female population. The establishment of more specifically defined phenotypes may allow for better understanding of long-term health outcomes. Ongoing data collection will enable better delineation of these

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Abstracts

clinical phenotypes and associated biochemical parameters. This multidisciplinary approach enables coordination of care and serves as a useful platform for addressing research questions of complex traits. Supported by: UCSF Mt. Zion Health Fund.

P-236 ASSOCIATION BETWEEN THE SINGLE NUCLEOTIDE POLYMORPHISM OF THE SORBIN AND SH3-DOMAIN-CONTAINIG-1 (SORBS1) GENE AND POLYCYSTIC OVARY SYNDROME (PCOS) IN A KOREAN POPULATION. S.-W. Choi, J.-M. Park, E.-J. Lee, B.H. Gu, K.-H. Baek. Phillips Exeter Academy, Exeter, NH; Graduate School of Life Science and Biotechnology, Cell and Gene Therapy Research Institute, Pochon CHA University, Seoul, Korea. OBJECTIVE: To evaluate SNP association between the SORBS1 gene and PCOS patients in a Korean population. DESIGN: Prospective randomized study. MATERIALS AND METHODS: To assess the association between the single nucleotide polymorphism of the SORBS1 gene and polycystic ovary syndrome (PCOS) in a Korean population, we carried out genotyping of SNP in the exon 7 of SORBS1 gene by RFLP analysis. In this study, 233 Korean patients with PCOS and 105 healthy Korean women were included. HapAnalyzer was used for the association study. RESULTS: The frequencies of three genotypes for SNP were found in exon 7 of SORBS1. The frequency of G allele was slightly higher in a patient group (n ¼ 233) than in a control group (n ¼ 105). However, statistically significant relationship was not found between the SNP in exon 7 of SORBS1 gene and PCOS in a Korean population. CONCLUSIONS: The polymorphism in exon 7 of the SORBS1 gene is not associated with susceptibility of PCOS in a Korean population, indicating the variance among different ethnical backgrounds. Supported by: This study was supported by a grant from Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (01-PJ10PG6–01GN13–0002).

P-237 ENHANCED LEVELS OF F11R RECEPTOR (F11R/JAM-1/JAM-A) IN PCOS PATIENTS. O. Muneyyirci-Delale, A. Babinska, V. L. Nacharaju, M. Dalloul, E. Kornecki. Obstetrics and Gynecology, SUNY Downstate Medical Center, Brooklyn, NY; Obstetrics and Gynecology, Kings County Hospital Center, Brooklyn, NY; Anatomy and Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY; Anatomy, CSI/CUNY Staten Island, Staten Island, NY. OBJECTIVE: Our recent studies have revealed a critical involvement of F11R in the adhesion of platelets to cytokine-inflamed endothelial cells, and thus the development of thrombosis and atherosclerosis in non-denuded blood vessels, triggered by inflammatory process. During the past decade, women with PCOS have been observed to have an increased prevalence of diabetes and increased risk factors for cardiovascular disease (CVD). Specifically, many women with PCOS are similar to those with the cardiometabolic syndrome (CMS), a clustering of hyperinsulinemia, glucose intolerance, increased waist circumference, dyslipidemia, and hypertension. As PCOS condition is thought to be associated with increased risk of cardiovascular factors, we determined F11R levels in normal and PCOS patients to see the possible role of this receptor. DESIGN: Case control study. MATERIALS AND METHODS: Serum specimens obtained after signing IRB approved consent from 12 normal cycling women and 13 PCOS patients were used to determine F11R levels utilizing a sensitive F11R ELISA, the primary antibody M.Ab.F11R and secondary F11R specific antibodies. F11R values are expressed as pg/ml  SD. Comparison of values between the two groups was done by student’s t test. RESULTS: The F11R value in normal women (12) was 101.1  68.4, range being 20.2 to 250.5. In PCOS patients the range was 20.1 to 2461.7. The F11R levels were compared between normal female and PCOS patients after eliminating outliers differing  2 SD from PCOS patient group. The PCOS patients (9) show significantly high F11R level, 223.8  149.9 (P¼0.04) when compared with normal women. CONCLUSIONS: The higher level of F11R in PCOS women suggests a possible risk to PCOS patients of early heart disease and other cardiovascular risk factors. These results suggest that the determination of F11R levels may provide valuable information in the assessment of cardiovascular risk. Supported by: None.

Vol. 88, Suppl 1, September 2007