Incidence of dyslipidemia and hyperinsulinemia in women diagnosed with polycystic ovary syndrome (PCOS).

Abstract

Objective: To determine the incidence of dyslipidemia and hyperinsulinemia in patients diagnosed with PCOS. Elevated lipid and insulin levels are associated with increased morbidity due to cardiovascular disease and type II diabetes. The literature reports that a PCOS woman can expect a 70% incidence of dyslipidemia and up to a 60% chance of developing type II diabetes. Both these abnormalities increase the risk of developing cardiovascular disease. The reproductive endocrinology setting has a chance to screen for these abnormalities in young PCOS patients and initiate preventative medical, dietary and exercise counseling to ameliorate the long-term consequences of elevated lipid and insulin levels. Design: Descriptive chart review. Materials/Methods: A chart review of all patients who presented to a western reproductive endocrinology practice from 8/00-2/01 was conducted. If a patient met one or more of the following criteria: oligoovulation, symptoms of hyperandrogenism or ultrasound findings of multiple follicular cysts, a diagnosis of PCOS was assigned. Fasting serum cholesterol, triglyceride and insulin levels were examined. Results: Fifty patients who presented for treatment from 8/00-2/01, and who were diagnosed with PCOS were screened for the incidence of dyslipidemia and hyperinsulinemia. Serum cholesterol and triglyceride levels were available for 35 of these patients. Fifteen (43%) had either fasting serum cholesterol or fasting serum triglyceride levels greater than 200 mg/dl. The incidence of hypercholesterolemia and hypertriglyceridemia was 80% and 47% respectively. The average Body Mass Index (BMI) was 35.6, with a range from 22.5–53.1. Fasting insulin levels were available for 32 patients. Sixteen (50%) had levels greater than 19 mcU/ml. Of the fifteen patients with hyperlipidemia, a sub group of seven (47%) also had hyperinsulinemia. The average age and BMI of the subgroup was 28 and 35.4 respectively. Conclusions: Almost half (24/50) of the screened PCOS women already exhibited hyperinsulinemia or hyperlipidemia or both. A reproductive endocrinology setting has a unique opportunity to screen PCOS patients and initiate preventative interventions before long-term health consequences appear. The clinical significance of this study is that identifying at risk PCOS women allows early treatment of predisposing abnormalities which may help to reduce or prevent the future morbidity of cardiovascular disease and diabetes.