Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity.
OBJECTIVE
To assess the role of insulin resistance, independent of obesity, in determining cardiovascular risk among women with the polycystic ovarian syndrome (PCOS).


METHODS
Cross-sectional study examining the relationships between hyperinsulinemia, composite cardiovascular risk scores, and prevalence of individual risk factors among lean and obese women with PCOS and healthy controls.


METHODS
University-based tertiary care outpatient endocrinology clinic.


METHODS
57 women with clinically defined PCOS and 45 unselected healthy age-matched controls.


METHODS
Clinical and anthropomorphic measurements and laboratory determinations of insulin and lipid levels.


METHODS
Fasting serum insulin and a cardiovascular risk score.


RESULTS
Hyperinsulinemic women with PCOS carried more cardiovascular risk than their normoinsulinemic counterparts, who in turn had more risk than the control women (P=.004 by analysis of covariance). In addition to the lipid changes expected with insulin resistance (high triglyceride and low HDL cholesterol levels), there was an excess of LDL cholesterol among the women with PCOS (P=.006 by analysis of covariance). Across the range of body mass index, women with PCOS had greater insulin resistance than controls, suggesting that PCOS itself and body mass index both contribute to the observed insulin resistance.


CONCLUSIONS
Our data support the hypothesis that insulin resistance in PCOS is a determinant of overall cardiovascular risk independent of obesity. The mechanism of this relationship remains uncertain and is the subject of ongoing research.
Mather
K J
KJ
Division of Endocrinology, Faculty of Medicine, University of Calgary, Alberta, Canada.
Kwan
F
F
Corenblum
B
B
D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D014280:Triglycerides