Endocrine Abstracts

Women with polycystic ovary syndrome (PCOS) have an increased prevalence of cardiovascular risk factors. Insulin resistance (IR) is believed to be an important factor in the pathogenesis of both PCOS and cardiovascular disease and thus provides a plausible link between these two conditions. An exaggerated post-prandial triglyceride (TG) response is thought to be one of the mechanisms through which IR is associated with atherosclerosis. The aim of this study was to compare fasting and post-prandial lipids in women with PCOS and healthy control subjects, and to interpret results in relation to BMI and IR.

Following local ethics committee approval, 24 women with PCOS (age 30±1; BMI 38±1:mean±S.E.M.) and 23 normal subjects (age 33±2; BMI 28±1) were studied before and up to 8 hours following a standard test meal. The TG response was calculated as the area under the curve (AUC-TG) and IR (HOMA-IR) was calculated using the HOMA model.

Fasting TG (FTG) and AUC-TG were greater and HDL-cholesterol (HDL-C) lower in PCOS subjects (see table). Total and LDL-cholesterol did not differ between the groups. HOMA-IR correlated (P<0.01) with FTG (R=0.59) and AUC-TG (R=0.61) and using multiple regression analysis was the strongest predictor of these variables. HDL correlated inversely (P<0.01) with BMI (R=−0.66), HOMA-IR (R=−0.36) and AUC-TG (R=−0.57) but also with androstenedione (R=−0.5). Using multiple regression analysis, androstenedione was the strongest predictor of HDL-C.

In summary, PCOS women have increased fasting and post-prandial TG, and reduced HDL-C. IR explains hypertriglyceridaemia, but hyperandrogenaemia also contributes to low HDL-C. Attention to cardiovascular risk profile should be part of PCOS management.