Download PDF
Exp Clin Endocrinol Diabetes 2018; 126(07): 437-444
DOI: 10.1055/s-0043-121264
Article
© Georg Thieme Verlag KG Stuttgart · New York

The PCOS Patients differ in Lipid Profile According to their Phenotypes

Magdalena Spałkowska
1   Department of Dermatology, Jagiellonian University Medical College in Krakow, Poland
,
Sandra Mrozińska
2   Department of Metabolic Diseases, Jagiellonian University Medical College in Krakow, Poland
,
Anna Gałuszka-Bednarczyk
3   Department of Endocrinological Gynecology, Jagiellonian University Medical College in Krakow, Poland
,
Katarzyna Gosztyła
4   Neurology Department, Medical Centre in Łańcut, Poland
,
Agnieszka Przywara
5   Oncology Department, University Hospital in Krakow, Poland
,
Justyna Guzik
6   Department of Anesthesiology and Intensive Care, Hospital of Saint Raphael in Krakow, Poland
,
Marek Janeczko
7   Department of Gynecology, Hospital of Saint Raphael in Krakow, Poland
,
Tomasz Milewicz
3   Department of Endocrinological Gynecology, Jagiellonian University Medical College in Krakow, Poland
,
Anna Wojas-Pelc
1   Department of Dermatology, Jagiellonian University Medical College in Krakow, Poland
› Author Affiliations
Further Information

Publication History

received 11 August 2017
revised01 October 2017

accepted 05 October 2017

Publication Date:
31 January 2018 (online)

Also available at
    Permissions and Reprints

Abstract

Polycystic ovary syndrome (PCOS) affects 4–18% of women of reproductive age. The number of reports exploring the lipid profiles among PCOS patients and number of studied patients are limited. The aim of our study was to assess the lipid profile separately in lean and non-lean women with polycystic ovary syndrome divided according to hyperandrogenemia, defined as free androgen index (FAI)≥5. The second aim was to compare the lipid profiles among lean and non-lean PCOS patients with respect to hyperandrogenemia and regularity of menstruation cycles. We evaluated 232 patients from Department of Endocrinological Gynecology, Jagiellonian University Medical College in Krakow diagnosed with PCOS. The population consisted of 166 lean and 66 non-lean women. We observed higher levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C) in lean patients with FAI<5 than in lean patients with FAI≥5. There were no differences in lipid profile between non-lean patients with FAI≥5 and non-lean patients with FAI<5. Among lean patients higher total cholesterol levels were observed in those with irregular menstruation cycles and FAI<5 than in patients with FAI≥5 and regular cycles. There were no differences in lipid profiles between four phenotypes among non-lean PCOS patients.

Conclusions The results of our study showed differences in lipid profile between lean PCOS patients according to their phenotype based on androgens’ level. This effect was abandoned by fat tissue mass in non-lean ones. Further studies should be conducted to explore these associations.

Key words

polycystic ovary syndrome - HDL - cholesterol
 

  • References

  • 1 Teede H, Deeks A, Moran L. Polycystic ovary syndrome: A complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8: 41
    CrossrefPubMedGoogle Scholar
  • 2 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81: 19-25
    CrossrefPubMedGoogle Scholar
  • 3 Thathapudi S, Kodati V, Erukkambattu J. et al. Anthropometric and biochemical characteristics of polycystic ovarian syndrome in South Indian women using AES-2006 criteria. Int J Endocrinol Metab 2014; 12: e12470
    PubMedGoogle Scholar
  • 4 Moran LJ, Norman RJ. Teede Hj. Metabolic risk in PCOS: phenotype and adiposity impact. Trends Endocrinol Metab. 2015; 26: 136-143
    CrossrefPubMedGoogle Scholar
  • 5 Ebrahimi-Mamaghani M, Saghafi-Asl M, Pirouzpanah S. et al. Association of insulin resistance with lipid profile, metabolic syndrome, and hormonal aberrations in overweight or obese women with polycystic ovary syndrome. J Health Popul Nutr. 2015; 33: 157-167
    PubMedGoogle Scholar
  • 6 Essah PA, Nestler JE, Carmina E. Differences in dyslipidemia between American and Italian women with Polycystic ovary syndrome. J Endocrinol Invest. 2008; 31: 35-41
    CrossrefPubMedGoogle Scholar
  • 7 Kim JJ, Choi YM. Dyslipidemia in women with polycystic ovary syndrome. Obstet Gynecol Sci 2013; 56: 137-142
    CrossrefPubMedGoogle Scholar
  • 8 Wild RA, Carmina E, Diamanti-Kandarakis E. et al. Assesment of cardiovascular risk and prevention of cardiovascular disease in women with polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab 2010; 95: 2038-2049
    CrossrefPubMedGoogle Scholar
  • 9 Badimon L, Volahur G. LDL-cholesterol versus HDL-cholesterol in the atherosclerotic plaque: inflammatory resolution versus thrombotic chaos. Ann N Y Acad Sci 2012; 1254: 18-32
    CrossrefPubMedGoogle Scholar
  • 10 Alexander CJ, Tangchitnob EP, Lepor NE. Polycystic ovary syndrome: A major unrecognized cardiovascular risk factor in women. Rev Obstet Gynecol 2009; 2: 232-239
    Google Scholar
  • 11 Diamanti-Kndarakis E, Papavassiliou AG, Kandarakis SA. et al. Pathopysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab. 2007; 18: 280-285
    CrossrefPubMedGoogle Scholar
  • 12 Shelley JM, Green A, Smith AM. et al. Relationship of endogenous sex hormones to lipids and blood pressure in mid-aged women. Ann Epidemiol. 1998; 8: 39-45
    CrossrefPubMedGoogle Scholar
  • 13 Berneis K, Rizzo M, Lazzarini V. et al. Atherogenic lipoprotein phenotype and low-density lipoproteins size and subclasses in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007; 92: 186-189
    CrossrefPubMedGoogle Scholar
  • 14 Zhang J, Fan P, Liu H. et al. Apolipoprotein A-I and B levels, dyslipidemia and metabolic syndrome in south-west Chinese women with PCOS. Hum Reprod. 2012; 27: 2484-2493
    CrossrefPubMedGoogle Scholar
  • 15 Hernández-Mijares A, Bañuls C, Gómez-Balaguer M. et al. Influence of obesity on atherogenic dyslipidemia in women with polycystic ovary syndrome. Eur J Clin Invest. 2013; 43: 549-556
    CrossrefPubMedGoogle Scholar
  • 16 Castelo-Branco C, Steinvarcel F, Osorio A. et al. Atherogenic metabolic profile in PCOS patients: role of obesity and hyperandrogenism. Gynecol Endocrinol. 2010; 26: 736-742
    CrossrefPubMedGoogle Scholar
  • 17 Sahin S, Eroglu M, Selcuk S. et al. Intrinsic factors rather than vitamin D deficiency are related to insulin resistance in lean women with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2014; 18: 2851-2856
    PubMedGoogle Scholar
  • 18 Rajkhowa M, Neary RH, Kumpatla P. et al. Altered composition of high density lipoproteins in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1997; 82: 3389-3394
    PubMedGoogle Scholar
  • 19 Welt CK, Gudmundsson JA, Arason G. et al. Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features. J Clin Metab 2006; 91: 4842-4848
    CrossrefPubMedGoogle Scholar
  • 20 Dewailly D, Catteau-Jonard S, Reyss A-C. et al. Oligoanovulation with polycystic ovaries but not overt hyperandrogenism. J Clin Endocrinol Metab. 2006; 91: 3922-3927
    CrossrefPubMedGoogle Scholar
  • 21 Barber TM, Wass JA, McCarthy MI. et al. Metabolic charcteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2007; 66: 513-517
    PubMedGoogle Scholar
  • 22 Norman RJ, Hague WM, Masters SC. et al. Subjects with polycystic ovaries without hyperandrogenaemia exhibit similar disturbances in insulin and lipid profiles as those with polycystic ovary syndrome. Hum Reprod. 1995; 10: 2258-2261
    CrossrefPubMedGoogle Scholar
  • 23 Svendsen PF, Nilas L, Norgaard K. et al. Obesity, body composition and metabolic disturbances in polycystic ovary syndrome. Hum Reprod. 2008; 23: 2113-2121
    CrossrefPubMedGoogle Scholar
  • 24 Lord J, Thomas R, Fox B. et al. The central tissue? Visceral fat mass is good marker of insulin resistance and metabolic disturbance in women with polycystic ovary syndrome. BJOG 2006; 113: 1203-1209
    CrossrefPubMedGoogle Scholar
  • 25 Aydin K, Cinar N, Aksoy DY. et al. Body composition in lean women with polycystic ovary syndrome: effect of ethinyl estradiol and drospirenone combination. Contraception 2013; 87: 358-362
    CrossrefPubMedGoogle Scholar
  • 26 Chang RJ. The reproductive phenotype in polycystic ovary syndrome. Nat Clin Pract Endocrinol Metab 2007; 3: 688-695
    CrossrefPubMedGoogle Scholar
  • 27 Kirchengast S, Huber J. Body composition characteristics and fat distribution patterns in young infertile women. Fertil Steril. 2004; 81: 539-544
    CrossrefPubMedGoogle Scholar
  • 28 Kirchengast S, Huber J. Body composition characteristics and body fat distribution in lean women with polycystic ovary syndrome. Hum Reprod 2001; 16: 1255-1260
    CrossrefPubMedGoogle Scholar
  • 29 Yucel A, Noyan V, Sagsoz N. The association of serum androgens and insulin resistance with fat distribution in polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2006; 126: 81-86
    CrossrefPubMedGoogle Scholar
  • 30 Good C, Tulchinsky M, Mauger D. et al. Bone mineral density and body composition in lean women with polycystic ovary syndrome. Fertil Steril. 1999; 72: 21-25
    CrossrefPubMedGoogle Scholar
  • 31 Saxena P, Prakash A, Nigam A. et al. Polycystic ovary syndrome: Is obesity a sine qua non? A clinical, hormonal, and metabolic assesment in relation to body mass index. Indian J Endocrinol Metab 2012; 16: 996-999
    CrossrefPubMedGoogle Scholar
  • 32 Dunaif A, Segal KR, Futterweit W. et al. Profound peripheral insulin resistance, independent of obesity, in polycytic ovary syndrome. Diabetes 1989; 38: 1165-1174
    CrossrefPubMedGoogle Scholar
  • 33 Wild RA, Rizzo M, Clifton S. et al. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011; 95: 1073-1079
    CrossrefPubMedGoogle Scholar
  • 34 Valkenburg O, Steegers-Theunissen RP, Smedts HP. et al. A more atherogenic serum lipoprotein profile is present in women with polycystic ovary syndrome: a case-control study. J Clin Endocrinol Metab. 2008; 93: 470-476
    CrossrefPubMedGoogle Scholar
  • 35 Moghetti P, Tosi F, Bonin C. et al. Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2013; 98: E628-E637
    CrossrefPubMedGoogle Scholar
  • 36 Guastella E, Longo RA, Carmina E. Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes. Fertil Steril. 2010; 94: 2197-2201
    CrossrefPubMedGoogle Scholar
  • 37 Dilbaz B, Ozkaya E, Cinar M. et al. Cardiovascular disease risk characteristics of the main polycystic ovary syndrome phenotypes. Endocrine 2011; 39: 272-277
    CrossrefPubMedGoogle Scholar
  • 38 Wiltgen D, Spritzer PM. Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes. Fertil Steril. 2010; 94: 2493-2496
    CrossrefPubMedGoogle Scholar