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Lipids and lipoprotein subfractions in women with PCOS: relationship to metabolic and endocrine parameters

OBJECTIVE Women with polycystic ovary syndrome (PCOS) exhibit an abnormal lipoprotein profile, characterized by raised concentrations of plasma triglyceride, marginally elevated low density lipoprotein (LDL)‐cholesterol, and reduced high density lipoprotein (HDL)‐cholesterol. However, a normal LDL‐cholesterol level may be misleading since LDL exists as subpopulations of particles differing in size and atherogenic potential. Smaller LDL particles are more atherogenic and high concentrations often occur in association with elevated circulating triglyceride concentrations (but frequently normal total LDL‐cholesterol), increased hepatic lipase activity (HL) and insulin resistance. Information on LDL subclasses and HL activity in women with PCOS is sparse. The aim of this study was to determine the concentrations of small, dense LDL (LDL‐III) in women with PCOS relative to body mass index (BMI)‐matched controls. We also examined the association of lipoprotein subfraction concentrations with endogenous sex hormone concentrations, since existing literature suggested that androgens up‐regulate and oestrogens down‐regulate HL activity, a key determinant of LDL subfraction distribution.