title: Varying patterns of brachial artery flow-mediated dilatation in women with polycystic ovary syndrome and controls: An application of the group-based trajectory modeling.
abstract: OBJECTIVE
  To identify changing patterns of absolute change in brachial artery lumen diameter (LD) after reactive hyperemia in women with polycystic ovary syndrome (PCOS) and controls and to quantify the association of PCOS status and participants' factors with these patterns.
  
  
  METHODS
  Brachial flow-mediated dilation was measured in 128 women with PCOS and 148 controls aged 30-60 years. Group-based trajectory modeling was used to investigate absolute change in LD every 30 seconds for 2 minutes after occluding cuff deflation. Multinomial logistic regression was used to identify factors associated with trajectories.
  
  
  RESULTS
  Three patterns emerged, namely nondilators (42.2%), dilators (44.6%), and enhanced dilators (13.0%). The proportion of women with PCOS did not differ across groups. Independently of age and PCOS status, larger baseline LD (odds ratio; 95% confidence interval: 2.51; 1.29, 4.89) and lower insulin levels (0.70; 0.52, 0.93) were associated with nondilators rather than with dilators. Higher total cholesterol was associated with dilators in women with PCOS but with nondilators in controls.
  
  
  CONCLUSIONS
  Trajectory modeling identified distinct patterns of change in LD and factors associated with the endothelial response. This method may be a useful tool to understand the brachial flow-mediated vasodilator response.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Meyer
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Ping G
authors.initials: PG
authors.lastname: Tepper
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Emma
authors.initials: E
authors.lastname: Barinas-Mitchell
authors.affiliation: Division of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Korytkowski
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Evelyn O
authors.initials: EO
authors.lastname: Talbott
mesh_terms: D000328:Adult; D001916:Brachial Artery; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D008954:Models, Biological; D009929:Organ Size; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging*; D012015:Reference Standards; D012044:Regression Analysis; D014664:Vasodilation
chemical_list: D002784:Cholesterol
keywords: endothelial dysfunction; flow-mediated dilation; group-based trajectory modeling; polycystic ovary syndrome; subclinical cardiovascular disease