Comparison of cardiovascular risk markers in patients with complete androgen insensitivity (CAIS) and premature ovarian failure (POF)
Puja Ayrton & Gerard Conway
Objectives: The syndrome of CAIS is the result of loss of function mutations of the androgen receptor. Women with CAIS present with primary amenorrhea, absent uterus and 46XY karyotype. Little is known about the long term natural history of this condition, in particular the risk of heart disease in adults. Here we report on biochemical risk markers in a group of women with CAIS compared to a control group with ovarian failure who were matched for their use of exogenous oestrogen.
Methods: 20 subjects with CAIS and 31 subjects with POF were recruited. Fasting lipid profile, glucose and insulin was measured.
Waist: Hip ratio and body mass index were calculated. Local ethical committee approval was obtained.
Results: The mean age of the CAIS group was 37 years and the POF group was 33 years. 15% of the POF patients and 10% of the CAIS patients were not on oestrogen replacement. Women with CAIS were taller and heavier than those with POF but there was no significant difference when BMI was compared. Similarly, waist and hip measurements were greater in CAIS there was no significant difference in the WHR. Results of significance are tabulated. There were no significant differences in the other lipid parameters (total cholesterol, triglycerides and LDL cholesterol).
Conclusions: Women with CAIS have a low risk cardiovascular profile based on higher HDL concentrations and good insulin sensitivity. This data supports the notion that androgens confer an adverse cardiovascular risk that may contribute to the excess in heart disease observed in men compared to women.