Lipid Accumulation Product as a Marker of Cardiovascular Disease Risk among Women with Polycystic Ovarian Syndrome- A Hospital Based Case-control Study

Abstract

Introduction: Polycystic Ovarian Syndrome (PCOS) is the most frequent gynaecological endocrinopathy characterised mainly by anovulation and hyperandrogenism. Women with PCOS are at higher risk of developing Cardiovascular Disease (CVD) due to a number of risk factors associated with this disease. Obesity, especially central adipose tissue accumulation, plays a major role in the pathophysiology of this disease. Lipid Accumulation Product (LAP) is a simple, inexpensive index to estimate cardiovascular risk and is based on fasting triglyceride and Waist Circumference (WC). Aim: To find out the association between LAP and cardiovascular risk factors in women with PCOS. Materials and Methods: This case-control study was conducted in the Department of Biochemistry and Department of Gynaecology, Government Medical College, Thiruvananthapuram, Kerala, India. Study subjects included 48 women with PCOS and 48 age and Body Mass Index (BMI) matched controls. Clinical and demographic data and medical history were evaluated. Duration of the study was six months. Anthropometric measurements, Blood Pressure (BP) and biochemical parameters like Fasting Plasma Glucose (FPG), lipid profile were recorded. LAP was calculated using the formula-Female LAP= {waist (cm) -58} × Triglyceride (TG) concentration (mmol/L). The quantitative variables were expressed as mean and standard deviation. Comparison of continuous variables between two groups was analysed by unpaired t-test. Categorical variables were analysed by Chi-square test. Correlations between continuous variables were tested using the Pearson correlation or Spearman correlation coefficient (r) analysis. The p-value <0.05 was considered as statistically significant. Variables which were statistically significant in univariate analysis were subjected to multivariate analysis. Results: The results of this study showed that the PCOS group had significantly higher WC than BMI matched control group. PCOS group had significantly higher mean TG level (p<0.05), mean FPG level (p<0.05) and lower mean High Density Lipoprotein (HDL) level (p<0.05) than the control group. LAP value (p<0.001) was significantly higher in PCOS group compared to control group. The prevalence of Metabolic Syndrome (MetS) was higher in women with PCOS. LAP values too were significantly higher in PCOS women with MetS. All CVD risk parameters except age showed a significant relationship with LAP values. Multiple linear regression model was done and LAP (p<0.001) was found to be an independent risk factor for CVD, adjusting for other factors. Conclusion: The study results shows that there is a significant association between LAP and cardiovascular risk markers. High LAP index is associated with cardiovascular risk markers in PCOS women irrespective of obesity.