Polycystic Ovary Syndrome Is Associated With Atherogenic Changes in Lipoprotein Particle Number and Size Independent of Body Weight

The study, involving 50 premenopausal women—25 with polycystic ovary syndrome (PCOS) and 25 without—demonstrated that PCOS is associated with atherogenic changes in lipoprotein particle number and size, which are independent of body weight. Women with PCOS had increased numbers of very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) size, and borderline decreased LDL size. These changes persisted after adjusting for ethnicity, alcohol and tobacco use, and exercise. Bioavailable testosterone was identified as the only predictor of LDL cholesterol, triglycerides, VLDL, and LDL particle number, while sex hormone-binding globulin (SHBG) predicted LDL and HDL size. The study concluded that PCOS contributes to an increased cardiovascular disease risk through lipoprotein profile changes more closely related to androgens than to fasting insulin levels.