Lipoprotein particles in adolescents and young women with PCOS provide insights into their cardiovascular risk

Abstract

Context: Adult women with polycystic ovarian syndrome (PCOS) have an increased risk for cardiovascular disease, but the evidence for this is controversial in adolescents and youngwomenwith PCOS. Measurement of low-density lipoprotein (LDL) particle number, measured by nuclear magnetic resonance spectroscopy is a novel technology to assess cardiovascular risk. Objective: The objective of the study was to evaluate lipoprotein particle number and size in young women with PCOS and its relationship with insulin resistance and hyperandrogenism. Design: This was a cross-sectional case control study. Setting: The study was conducted at a clinical research center. Participants: Women with PCOS (n = 35) and normal controls (n = 20) participated in the study. Interventions: Blood samples and anthropometric measures were obtained. Main Outcome Measures: LDL particle size and number were measured using nuclear magnetic resonance spectroscopy. A secondary outcome was to investigate the correlation of LDL particle number with high-sensitivity C-reactive protein, waist to hip ratio, hyperandrogenism, insulin resistance, and adiponectin. Results: Women with PCOS had higher LDL particle number when compared with healthy controls (935 ± 412 vs 735 ± 264, P = .032); LDL particle number correlated strongly with high-sensitivity C-reactive protein (r=0.37, P=.006) and waist-to-hip (r=0.57, P=.0003). The higher LDL particle number was driven mainly due to differences in the small LDL particle number (sLDLp), with PCOS patients having more sLDLp (348 ± 305 vs 178 ± 195, P = .015). The sLDLp correlated with the Matsuda index (r=-0.51, P=.0001), homeostasis model assessment index of insulin resistance (r- 0.41, P = .002), and adiponectin (r =-0.46, P = .0004) but not with T. Conclusion: Adolescent and young women with PCOS have an atherogenic lipoprotein profile suggestive of increased cardiovascular risk that appears to be driven by the degree of visceral adiposity and insulin resistance.