title: Milder forms of atherogenic dyslipidemia in ovulatory versus anovulatory polycystic ovary syndrome phenotype.
abstract: BACKGROUND
  Dyslipidemia is common in women with polycystic ovary syndrome (PCOS) but its prevalence in different PCOS phenotypes is still largely unknown.
  
  
  METHODS
  We measured plasma lipids and lipoproteins in 35 anovulatory PCOS (age: 25 +/- 6 years, BMI: 28 +/- 6 kg/m(2)), 15 ovulatory PCOS (age: 30 +/- 6 years, BMI: 25 +/- 3 kg/m(2)) and 27 healthy women (controls) age- and BMI-matched with ovulatory PCOS. PCOS was diagnosed by the presence of clinical or biologic hyperandrogenism associated with chronic anovulation and/or polycystic ovaries at ultrasound. In women with normal menses chronic anovulation was indicated by low serum progesterone levels (<9.54 nmol/l) during midluteal phase (days 21-24) in two consecutive menstrual cycles.
  
  
  RESULTS
  Total cholesterol, triglycerides and low-density lipoprotein (LDL)-cholesterol levels increased and high-density lipoprotein (HDL)-cholesterol decreased from controls to ovulatory and then to anovulatory PCOS (all P < 0.05). Levels of lipoprotein(a) (Lp(a)) and small, dense LDL increased (P < 0.0001 for both) and LDL size reduced (P < 0.005) between groups. Insulin resistance (by HOMA) showed a positive correlation with triglycerides and small, dense LDL and an inverse correlation with HDL-cholesterol and LDL size (P < 0.05 for all) in both PCOS phenotypes. No significant correlations were found with testosterone levels. At multivariate analysis, insulin resistance was independently associated with HDL-cholesterol and small, dense LDL in both PCOS phenotypes and with triglyceride concentrations in ovulatory PCOS only.
  
  
  CONCLUSIONS
  Women with ovulatory PCOS showed milder forms of atherogenic dyslipidemia than anovulatory PCOS and this seemed to be related to the extent of insulin resistance. Future prospective studies are needed to assess the relative contribution of such alterations on cardiovascular risk.
authors.affiliation: Department of Internal Medicine and Emerging Diseases, University of Palermo, Via del Vespro, 141, 90127 Palermo, Italy.
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.forename: Kaspar
authors.initials: K
authors.lastname: Berneis
authors.forename: Martin
authors.initials: M
authors.lastname: Hersberger
authors.forename: Ilenia
authors.initials: I
authors.lastname: Pepe
authors.forename: Gaetana
authors.initials: G
authors.lastname: Di Fede
authors.forename: Giovam Battista
authors.initials: GB
authors.lastname: Rini
authors.forename: Giatgen A
authors.initials: GA
authors.lastname: Spinas
authors.forename: Enrico
authors.initials: E
authors.lastname: Carmina
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000209:etiology*; D005260:Female; D006801:Humans; D010060:Ovulation; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol