Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder associated with cardiovascular disease (CVD) risk factors and metabolic disturbances. This systematic review and meta-analysis was conducted to determine whether carotid intima-media thickness (CIMT), a marker of subclinical atherosclerosis, is higher in women with PCOS compared with women without PCOS. Primary articles reporting the mean CIMT in women with PCOS and controls were identified using Ovid MEDLINE, EMBASE and PUBMED. We performed a random-effects meta-analysis and created forest plots of the mean difference in CIMT and conducted tests for heterogeneity and publication bias. Studies were grouped by quality, defined by reporting reproducibility of CIMT and averaging both common carotid arteries versus one side for CIMT. From the 36 eligible full-text studies, 8 studies were included in the systematic review and 19 studies were included in the meta-analysis (total n= 1123 women with PCOS, n= 923 controls). The summary mean difference in CIMT among women with PCOS compared with controls was 0.072 mm [95% confidence interval (CI) 0.040, 0.105, P < 0.0001] for highest quality studies, 0.084 mm (95% CI 0.042, 0.126, P = 0.0001) for good quality studies, 0.041 (95% CI −0.038, 0.120, P = 0.310) for fair-quality studies and 0.045 (95% CI −0.020, 0.111, P = 0.173) for lower quality studies. Larger studies with a well-defined PCOS population using rigorous methodology may be required to draw a more robust conclusion. However, these results suggest women with PCOS are at a greater risk of premature atherosclerosis, which emphasizes the importance of screening and monitoring CVD risk factors in women with PCOS.

Consumption of sugar-sweetened beverages (SSBs) increases total caloric intake, is linked to cardiometabolic outcomes as well as dental caries, and sugar in SSBs is associated with mortality and frailty among adults. We describe energy and total sugar intake trends among the United States (US) population from SSBs, soft drinks, other beverage groups, and the total diet based on the first 24-h recall data from the National Health and Nutrition Examination Survey (NHANES) cycles (2003–2004 through 2015–2016). SSBs included soft drinks, sports drinks, energy drinks, and fruit drinks, but excluded sports beverages with protein and sweetened teas/coffees. Among the total population (age ≥2 years: 57,026), energy intake from SSBs declined significantly from 183.9 ± 6.9 mean kcal/d (±SE) in 2003–2004 to 95.0 ± 3.5 in 2015–2016, while total sugar intake declined from 43.6 ± 1.7 mean g/d to 22.3 ± 0.8 (p-trend < 0.0001). Decreases were found for energy and total sugar intake, as well as percentage of energy and total sugar intake from SSBs, soft drinks, and all beverages for all age groups examined (≥2, 2–19, ≥20 years) (p-trend < 0.0001). From 2003 to 2016, energy and sugar intake from all beverages, SSBs, soft drinks, and the total diet decreased among the total population, children, and adults.

Background/Aims: Environmental and occupational exposures are implicated as risk factors for amyotrophic lateral sclerosis (ALS), the etiology of which is largely unknown, although no causal relationships have been established. Objective: The aim of the study was to evaluate the associations of personal risk factors and self-reported environmental and occupational exposures with risk of ALS. Methods: The cases involved ALS patients (n = 66) identified from major neurological centers in Pittsburgh and Philadelphia, Pa., USA, from 2008 to 2010. The age-, race- and sex-matched controls included outpatient hospital and population-based controls (n = 66). A detailed questionnaire obtaining data on occupation, vocational and avocational exposure as well as personal lifestyle factors was administered. Results: Occupational exposure to metals (odds ratio, OR = 3.65; 95% CI: 1.15, 11.60) and pesticides (OR = 6.50; 95% CI: 1.78, 23.77) was related to increased risk of ALS after controlling for smoking and education. No associations were found for occupational exposure to organic or aromatic solvents. Conclusion: Workers exposed to metals and pesticides may be at greater risk of ALS. Future research should involve more accurate exposure assessment through the use of job exposure matrices, confirmation of occupation and biomarkers.

Background: Pre‐pregnancy hypertension and hypertensive disorders of pregnancy (HDP; preeclampsia, eclampsia, gestational hypertension) are major health risks for maternal morbidity and mortality. However, it is unknown if racial/ethnic differences exist. We aimed to determine the impact of HDP and pre‐pregnancy hypertension on maternal coronary heart disease, stroke, and mortality risk ≤1, 3, and 5 years post‐delivery and by race/ethnicity ≤5 years. Methods and Results: This retrospective cohort study included women aged 12 to 49 years with a live, singleton birth between 2004 to 2016 (n=254 491 non‐Hispanic White; n=137 784 non‐Hispanic Black; n=41 155 Hispanic). Birth and death certificates and International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification ( ICD‐9‐CM and ICD‐10‐CM ) diagnosis codes in hospitalization/emergency department visit data defined HDP, pre‐pregnancy hypertension, incident coronary heart disease and stroke, and all‐cause mortality. During at least 1 pregnancy of the 433 430 women, 2.3% had pre‐pregnancy hypertension with superimposed HDP, 15.7% had no pre‐pregnancy hypertension with HDP, and 0.4% had pre‐pregnancy hypertension without superimposed HDP, whereas 81.6% had neither condition. Maternal deaths from coronary heart disease, stroke, and all causes totaled 2136. Within 5 years of delivery, pre‐pregnancy hypertension, and HDP were associated with all‐cause mortality (hazard ratio [HR], 2.21; 95% CI, 1.61–3.03), incident coronary heart disease (HR, 3.79; 95% CI, 3.09–4.65), and incident stroke (HR, 3.10; 95% CI, 2.09–4.60). HDP alone was related to all outcomes. Race/ethnic differences were observed for non‐Hispanic Black and non‐Hispanic White women, respectively, in the associations of pre‐pregnancy hypertension and HDP with all‐cause mortality within 5 years of delivery (HR, 2.34 [95% CI, 1.58–3.47]; HR, 2.11 [95% CI, 1.23–3.65]; P interaction=0.001). Conclusions: Maternal cardiovascular outcomes including mortality were increased ≤5 years post‐delivery in HDP, pre‐pregnancy hypertension, or pre‐pregnancy hypertension with superimposed HDP. The race/ethnic interaction for all‐cause mortality ≤5 years of delivery warrants further research.