Should we individualize lipid profiling in women with polycystic ovary syndrome?
Is it necessary to monitor lipid profiles in all young women with polycystic ovary syndrome (PCOS)?



Lipid profiling is required when women with PCOS develop type 2 diabetes (T2D) or hypertension, but rarely changes clinical care before the age of 35 years.



PCOS consensus statements and guidelines recommend that women with PCOS should be screened for dyslipidaemia every second year or annually.



Women from Denmark, Norway, Finland and Sweden, who had participated in research projects or clinical trials or in whom lipid profiles had been determined routinely as part of clinical care since 2000 were included.



One thousand three hundred and twenty-seven women with PCOS (Rotterdam criteria) were included. Based on individual cardiovascular risk score and lipid levels, treatment level was guided by the European Society of Cardiology and the European Atherosclerosis Society Task Force for the management of dyslipidaemias. Change in clinical care was defined as need to (i) immediately start statin treatment or (ii) consider statin treatment if life-style intervention fails.



All in all, 74 (5.6%) women with PCOS should immediately start statin treatment, and statin treatment should be considered in 33 women (2.5%). Among women with T2D, 27/28 (96.4%) should initiate statin treatment and the corresponding number for women with hypertension was 42/57 (73.7%). In PCOS women who had not yet developed T2D or hypertension, lipid profiling only changed clinical care in 28 (2.3%). This number was further reduced to 12 (1.2%) in women below the age of 35 years, and to zero in normal-weight women below the age of 35 years.



Findings can only be generalized to countries with low cardiovascular mortality rates.



Lipid profiling is required when women with PCOS develop T2D or hypertension. However, lipid profiling rarely changes the clinical care of low risk PCOS patients before the age of 35, especially in the normal-weight women.



The Academy of Finland, Sigrid Juselius Foundation and the Nordic Federation of Obstetrics and Gynecology. There are no conflicts of interest to be declared.
Department of Women's and Children's Health, Uppsala University, 75185 Uppsala, Sweden Inger.sundstrom@kbh.uu.se.
Inger
I
Sundström Poromaa
Section for Reproductive Medicine, Department of Gynaecology, Women's Division, Oslo University Hospital, 0027 Oslo, Norway.
Jan Roar
JR
Mellembakken
Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Kajaanintie 50, FI-90029 Oulu, Finland.|PEDEGO Research Unit, Medical Research Centre, FI-90029 Oulu, Finland.
Laure
L
Morin-Papunen
Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Kajaanintie 50, FI-90029 Oulu, Finland.|PEDEGO Research Unit, Medical Research Centre, FI-90029 Oulu, Finland.
Terhi
T
Piltonen
Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Kajaanintie 50, FI-90029 Oulu, Finland.|PEDEGO Research Unit, Medical Research Centre, FI-90029 Oulu, Finland.
Johanna
J
Puurunen
Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Kajaanintie 50, FI-90029 Oulu, Finland.|PEDEGO Research Unit, Medical Research Centre, FI-90029 Oulu, Finland.|Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, Helsinki 00290, Finland.
Juha S
JS
Tapanainen
Department of Physiology and Pharmacology, Karolinska Institutet, 17177 Stockholm, Sweden.
Elisabet
E
Stener-Victorin
Department of Women's and Children's Health, Karolinska Institutet, 17176 Stockholm, Sweden.
Angelica Lindén
AL
Hirschberg
Department of Obstetrics and Gynaecology, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway.|Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
Eszter
E
Vanky
Department of Gynaecology and Obstetrics, Odense University Hospital, 5000 Odense, Denmark.
Pernille
P
Ravn
Department of Endocrinology, Odense University Hospital, 5000 Odense, Denmark.
Dorte
D
Glintborg
Department of Endocrinology, Odense University Hospital, 5000 Odense, Denmark.
Marianne
M
Andersen
D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications; D012307:Risk Factors; D055815:Young Adult
D008055:Lipids
PCOS; cholesterol; lipid; polycystic ovary syndrome; statin treatment