Polycystic Ovaries Research Today is a free monthly online journal that collates and summarizes the latest research about Polycystic Ovaries, including details on treatment, symptoms, polycystic ovary syndrome, infertility.

How should we manage atherogenic dyslipidemia in women with polycystic ovary syndrome?

Rizzo M, Berneis K, Carmina E, Rini GB

Department of Clinical Medicine and Emerging Diseases, University of Palermo, Palermo, Italy. mrizzo@unipa.it

Despite their young age, women with polycystic ovary syndrome (PCOS) have increased cardiovascular risk. Besides normal concentrations of low-density lipoprotein (LDL) cholesterol, dyslipidemia is very common and includes elevated triglyceride levels and low high-density lipoprotein cholesterol concentrations. Recent findings also showed that women with PCOS have qualitative LDL alterations, with increased levels of atherogenic small, dense LDL particles. Such lipid abnormalities constitute a common form of dyslipidemia, the so-called atherogenic lipoprotein phenotype (ALP), associated with a greater cardiovascular risk. Weight reduction and increased physical activity may constitute first-line therapy for ALP in PCOS, and lipid lowering drugs, particularly nicotinic acid and fibrates, should be used in patients with severe dyslipidemia. Statins have usually a lower impact on ALP, and their beneficial effect is often moderate. Insulin-sensitizing medications favorably alter each component of ALP and combined therapy with these agents remains an option; in particular, the combination pioglitazone plus metformin seems to be particularly beneficial.

Published 1 January 2008 in Am J Obstet Gynecol, 198(1): 28.e1-5.
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