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Lipid Abnormalities in Polycystic Ovary Syndrome

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Insulin Resistance and Polycystic Ovarian Syndrome

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Polycystic ovary syndrome (PCOS) is a complex reproductive disorder with the consequent clinical and metabolic derangements. In the natural disease course, an increased cardiovascular risk has to be anticipated in a metabolically unstable condition.

Among risk factors, dyslipidemia is certainly the most persistent with high prevalence. Consequently, it is reasonable to conclude that women with PCOS may indeed be at significantly increased risk for developing coronary heart disease. The effect of aging on the pattern of dyslipidemia in PCOS, with increase of total cholesterol and low-density lipoprotein (LDL)-cholesterol, is causing almost stable cardiovascular risk over a lifetime. Predominant observation of the most studies in women with PCOS was an elevation of LDL-cholesterol in both lean and obese patients. Decreased concentrations of total high-density lipoprotein (HDL) was found in obese patients with PCOS from the third decade of life onward, whereas triglycerides start to rise from the second decade of life in both younger and older subgroups. Prevalence of metabolic syndrome was 43–46% in women with PCOS, with lipid abnormalities as the most frequent component of the syndrome.

Women with PCOS have 7.4-fold relative risk for myocardial infarction. Different surrogate tools could be of clinical importance in evaluation of the cardiovascular derangement. Therapeutic interventions, including dietary regiments and exercise, led to amelioration of dyslipidemia, whereas some therapeutic agents, such as metformin, troglitazone, and antiobesity drugs as adjuvant therapy, did not succeed in improvement of the lipid profile. Novel intervention modalities with confirmation in longitudinal studies are needed in prospect for more specific and efficacious amelioration of lipid profile in women with PCOS.

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Authors and Affiliations

  1. Institute of Endocrinology, Diabetes and Diseases of Metabolism, Belgrade, Serbia

    Djuro Macut MD, PhD

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Editors and Affiliations

  1. Endocrine Section of First Department of Internal Medicine, Athens University School of Medicine, Athens, Greece

    Evanthia Diamanti-Kandarakis MD, PhD

  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA

    John E. Nestler MD

  3. Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Dimitrios Panidis MD, PhD

  4. Endocrinology Unit, Department of Internal Medicine and Gastroenterology and C.R.B.A., S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy

    Renato Pasquali MD

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Macut, D. (2007). Lipid Abnormalities in Polycystic Ovary Syndrome. In: Diamanti-Kandarakis, E., Nestler, J.E., Panidis, D., Pasquali, R. (eds) Insulin Resistance and Polycystic Ovarian Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-310-3_7

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