Lipoprotein subclass patterns in women with polycystic ovary syndrome (PCOS) compared with equally insulin-resistant women without PCOS.
OBJECTIVE
Women with polycystic ovary syndrome (PCOS) are more insulin resistant and display an atherogenic lipid profile compared with normal women of similar body mass index (BMI). Insulin resistance (IR) at least partially underlies the dyslipidemia of PCOS, but it is unclear whether PCOS status per se confers additional risk.


METHODS
Using a case-control design, we compared plasma lipids and lipoprotein subclasses (using polyacrylamide gel tube electrophoresis) in 70 women with PCOS (National Institutes of Health criteria) and 70 normal women pair matched for age, BMI, and IR (homeostasis model assessment-IR, quantitative insulin sensitivity check index, and the Avignon Index). Subjects were identified as having a (less atherogenic) type A pattern consisting predominantly of large low-density lipoprotein (LDL) subfractions or a (more atherogenic) non-A pattern consisting predominantly of small-dense LDL subfractions.


RESULTS
Total, high-density lipoprotein, or LDL cholesterol, or triacylglycerol did not differ between the groups, but very low-density lipoprotein levels (P<0.05) were greater in women with PCOS, whereas a non-A LDL profile was seen in 12.9% compared with 2.9% of controls (P<0.05, chi2). Multiple regression analysis revealed homeostasis model assessment-IR and waist circumference to be independent predictors of very low-density lipoprotein together explaining 40.2% of the overall variance. Logistic regression revealed PCOS status to be the only independent determinant of a non-A LDL pattern (odds ratio 5.48 (95% confidence interval 1.082-27.77; P<0.05).


CONCLUSIONS
Compared with women matched for BMI and IR, women with PCOS have potentially important differences in lipid profile with greater very low-density lipoprotein levels and increased rates of a more atherogenic non-A LDL pattern.
Department of Endocrinology and Diabetes, Adelaide and Meath Hospital, and School of Public Health and Population Science, University College Dublin, Dublin 24, Ireland.
N
N
Phelan
A
A
O'Connor
T
T
Kyaw-Tun
N
N
Correia
G
G
Boran
H M
HM
Roche
J
J
Gibney
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007118:Immunoassay; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008074:Lipoproteins / Q000097:blood* / Q000145:classification; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D012044:Regression Analysis
D007328:Insulin; D008074:Lipoproteins; D002784:Cholesterol