Atherogenic forms of dyslipidaemia in women with polycystic ovary syndrome

Summary Objective:  Dyslipidaemia is very common in patients with polycystic ovary syndrome (PCOS) but, beyond plasma lipids, atherogenic lipoprotein (Lp) and apolipoprotein (apo) alterations are still ill defined. Design:  We measured concentrations of apoB, Lp(a) and small, dense low‐density lipoprotein (LDL) in 42 patients with PCOS [age: 28 ± 7 years, body mass index (BMI): 27 ± 5 kg/m 2 ] vs. 37 age‐ and BMI‐matched healthy controls. Methods:  Elevated Lp(a) levels considered were those > 30 mg/dl while elevated apoB concentrations were those > 100 g/l. Results:  Polycystic ovary syndrome showed increased triglycerides levels (p = 0.0011) and lower high‐density lipoprotein (HDL)‐cholesterol concentrations (p = 0.0131) while total‐ and LDL cholesterol were similar. PCOS also showed smaller LDL size (p = 0.0005), higher levels of total small, dense LDL (p < 0.0001), higher concentrations of Lp(a), as considered as absolute values (p = 0.0143) and log‐transformed (p = 0.0014), while no differences were found in apoB levels. Elevated Lp(a) concentrations were found in 24% of PCOS, while elevated apoB levels were relatively uncommon (14%). Spearman correlation analysis revealed that Lp(a) concentrations were weakly correlated only with HDL‐cholesterol levels (r = −0.378, p = 0.0431). In addition, 36% of patients with PCOS with normal plasma lipid profile showed elevated levels of Lp(a), apoB or small, dense LDL. Conclusions:  Atherogenic Lp abnormalities may be found in one‐third of women with PCOS who have a normal lipid pattern. Future prospective studies are needed to test to which extent such atherogenic forms of dyslipidaemia may contribute to the increased cardiovascular risk in young women with PCOS.