PCOS Forum

Research in Polycystic Ovary Syndrome Today and Tomorrow

Renato Pasquali; Elisabet Stener-Victorin; Bulent O. Yildiz; Antoni J. Duleba; Kathleen Hoeger; Helen Mason; Roy Homburg; Theresa Hickey; Steve Franks; Juha S. Tapanainen; Adam Balen; David H. Abbott; Evanthia Diamanti-Kandarakis; Richard S. Legro

Disclosures

Clin Endocrinol. 2011;74(4):424-433. 

In This Article

Dyslipidaemia in PCOS

Polycystic ovary syndrome is frequently associated with various patterns of dyslipidaemia including low high-density lipoprotein cholesterol (HDL-C), high levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol (LDL-C).[54–56] Although the data from large series suggest that the mean values for circulating lipids in women with PCOS are in normal limits, up to 70% of patients have at least one abnormal lipid level according to NCEP-ATPIII criteria.[57] Body fat amount and distribution, presence and degree of insulin resistance, and androgen excess appear to have independent and interrelated effects on the type and extent of lipid abnormalities in PCOS.[58] Prevalence rates of dyslipidaemia show significant variability in different studies. Several factors including age, race, glucose intolerance and diagnostic criteria used to define PCOS might have an influence on this variation. Nevertheless, most of the studies assessing dyslipidaemia in PCOS have certain limitations, including (but not limited to) small sample size and lack of information on environmental modulators of serum lipid levels such as diet, physical activity, smoking and alcohol consumption.

Large-scale follow-up studies are warranted to investigate lipid alterations in PCOS as well as to determine the impact of commonly used long-term therapeutic interventions in the syndrome. There is debate at what age to institute therapy for dyslipidaemia, as the treatment, for example with statins, does include slight risk of a serious adverse side effect including rhabdomyolysis, whereas events are unlikely in younger women with PCOS. Further, there is concern that treatment with these agents will improved reproductive aspects and result in increased and unexpected ovulation and potential undesired foetal exposure. Many of these drugs are given a categorical teratogenic designation because they interfere with cholesterol synthesis or metabolism, and LDL-C remains the primary precursor for sex steroid synthesis in the placenta.

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