Serum lipid profile and insulin resistance in women with polycystic ovary syndrome (PCOS)

For the first time in 1935, the classic form of polycystic ovary syndrome (PCOS) was described by Stein and Levental. They reported the association between polycystic ovaries and amenorrhea, hirsutism and obesity.1 Polycystic ovary syndrome encompasses a spectrum of diseases that are associated with the following features: cutaneous hyperandrogenism (such as hirsutism, acne resistant to treatment, or male or female pattern baldness (androgenetic baldness), irregular menstruation (such as oligomenorrhea or amenorrhea, or irregular bleeding), polycystic ovaries (one or two), obesity and insulin resistance.2 Polycystic ovary syndrome is the most common endocrine disorder in women with a prevalence of 6-10% of women in reproductive age and also is the main leading cause of infertility due to lack of ovulation.3,4 There is evidence that PCOS is may be the result of metabolic disorders including insulin resistance. Hyperinsulinemia and early incidence of type 2 diabetes in patients with this syndrome is higher than the normal population.2 Given the role of insulin resistance in polycystic ovary, lowering medications are used to treat insulin resistance.5–7 Dyslipidemia pattern in insulin resistance, low levels of HDL and high triglyceride levels pattern are common in women with polycystic ovary syndrome. Hyperinsulinemia inhibits lipolysis and thus increase esterified acids. High levels of nonesterified fatty acids (NEFA) may increase triglyceride and decrease HDL level.8 Dyslipidemia is a common metabolic disorder in women with polycystic ovary syndrome, although in different geographic regions and ethnic groups has been reported different.9 Abnormal situation of lipoproteins is common in this syndrome, these disorders include: Increased level of total cholesterol, triglycerides, LDL (lowdensity lipoprotein), reduced high-density lipoprotein and apoprotein A1.9 Abdominal obesity is positively associated with increased LDL and VLDL and has inverse proportion with amount of HDL.10