Inclusion and exclusion criteria.
For both cohorts, patients with PCOS (aged 16-45 years) were recruited
from a departmental database or from outpatients attending the
University Hospital of Wales. A diagnosis of PCOS was made according to
the Rotterdam criteria, with congenital adrenal hyperplasia,
androgen-secreting tumours, Cushing’s syndrome, thyroid disease and
hyperprolactinaemia excluded by biochemical testing. Subjects were also
excluded if they were pregnant, breastfeeding or had a history of
hypertension, hyperlipidaemia or diabetes, or current or previous
(within 3 months) use of glucocorticoids, lipid-lowering agents,
anti-hypertensives, anti-diabetics or anti-obesity drugs. Healthy
volunteers were recruited by advertisement in the local press, and among
students and staff within our Institution. Healthy volunteers had
regular menstrual cycles (every 27–32 days) and their healthy state was
established by history, physical examination and hormonal evaluation
(thyroid function, prolactin, testosterone and 17-hydroxyprogesterone);
those with features of hirsutism or a family history of PCOS were
excluded. For cohort 1, in the PCOS group there were 15 current smokers
and 12 ex-smokers (32.1%) compared with 11 current smokers and 19
ex-smokers among the healthy volunteers (31.6%). Nineteen subjects with
PCOS (22.6%) were taking a combined oral contraceptive pill compared
with 28 (29.5%) healthy volunteers. For cohort 2, in the PCOS group
there were 2 current smokers and 1 ex-smoker (15%) compared with 1
current smoker and 2 ex-smokers among the healthy volunteers (15%). Of
the PCOS group, 8 (40%) were taking a combined oral contraceptive pill
compared with 7 (35%) healthy volunteers.