English

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age group with a worldwide prevalence of about 4 to12%1,2. PCOS is seen in up to 25% of the Caucasians and 50% of the South Asian women respectively3,4. It is a heterogeneous disorder of unknown aetiology with a strong genetic element5. PCOS does not exclusively involve the reproductive apparatus; it has a complex number of systemic relevancy symptoms. It leads to Metabolic Syndrome with severe consequences on the cardiovascular system6. The precise cardiovascular disease (CVD) risk in women with PCOS remains unclear because there are no longitudinal studies pertaining to cardiovascular events. There is a paucity of data in regard to cardiovascular event rates and mortality in PCOS hence the present study was aimed to assess cardiovascular disease risk in women with PCOS. Aim: To evaluate cardiovascular disease risk in women with Polycystic ovary syndrome. Materials and Methods: 50 diagnosed cases of PCOS and 50 age matched healthy females were included in this study. Cases were diagnosed based on new Rotterdam criteria formulated by the American Society for Reproductive Medicine (ASRM) and the European Society for Human Reproduction and Embryology (ESHRE). Blood samples were collected after overnight fasting. Serum High sensitivity-C Reactive Protein (hs-CRP), Total Cholesterol(TC), Triglycerides(TG), HDL Cholesterol(HDL-C), VLDL Cholesterol(VLDL-C), LDL Cholesterol (LDL-C) were estimated. Body Mass Index (BMI) was calculated for women in both the groups. Statistical analysis: Results were analyzed using unpaired t-test and p-value was calculated. BMI was correlated with hs-CRP using one way ANOVA test. Statistically non-significant increased levels of serum total cholesterol, Triglycerides, HDL cholesterol, LDL cholesterol, VLDL cholesterol and hs-CRP in PCOS cases as compared with control were observed. BMI was found to be significantly inc

Increased monocyte chemoattractant protein-1 levels indicating early vascular damage in lean young PCOS patients

Polycystic Ovarian Syndrome (PCOS), a prevalent endocrine disorder among women of reproductive age and is frequently accompanied by metabolic disturbances that considerably elevate long-term cardiovascular risk. Among these abnormalities, dyslipidemia is one of the most common and clinically significant; however, evidence from sub-Saharan Africa, particularly Nigeria, remains limited. This study therefore evaluated lipid profile alterations and their clinical significance, with a focus on their contribution to metabolic and cardiovascular disease risk among women with PCOS in Kogi State, Nigeria. A cross-sectional analytical design was employed, involving 110 women diagnosed with PCOS and 40 age-matched controls without PCOS to make a total of 150 samples. Fasting blood samples were obtained for the assessment of lipid parameters, while anthropometric measurements were recorded to calculate cardiometabolic indices, including the Visceral Adiposity Index (VAI) and Lipid Accumulation Product (LAP). Statistical analyses comprised group comparisons and correlation analyses to explore associations between lipid parameters and adiposity-related indices was employed. Women with PCOS exhibited a significantly more atherogenic lipid profile than controls, characterized by elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), alongside significantly reduced high-density lipoprotein cholesterol (HDL-C). Notably, the mean HDL-C level was markedly lower in the PCOS group (1.14 ± 0.39 mmol/L) compared with controls (1.47 ± 0.21 mmol/L; p < 0.001), consistent with the characteristic dyslipidemia which is associated with insulin resistance and hyperandrogenism in PCOS. Correlation analyses revealed that TG levels were moderately and positively associated with both body mass index (BMI) (r = 0.420, p < 0.001) and waist circumference (WC) (r = 0.455, p < 0.001), whereas HDL-C display significant inverse correlations with BMI (r = ?0.315, p = 0.001) and WC (r = ?0.340, p < 0.001). In contrast, LDL-C demonstrated no statistically significant association with BMI or WC. As expected from lipid physiology, total cholesterol showed a strong positive correlation with LDL-C (r = 0.835, p < 0.01), while LDL-C was moderately inversely correlated with HDL-C (r = ?0.548, p < 0.01). BMI also correlated positively with TC (r = 0.413, p < 0.01) and LDL-C (r = 0.546, p < 0.01), and negatively with HDL-C (r = ?0.402, p < 0.01), strengthening the role of adiposity in lipid dysregulation. LAP, an index derived from waist circumference and triglycerides, demonstrated a very strong positive correlation with TG (r = 0.720, p < 0.01), underscoring its sensitivity as a marker of visceral fat–related dyslipidemia. Generally, dyslipidemia particularly elevated TC, LDL-C, and TG was highly prevalent among women with PCOS in Kogi State, Nigeria and was closely associated with indices of visceral adiposity and elevated markers of myocardial injury or stress (cTnI, CK-MB, and myoglobin). These findings indicate a substantial burden of subclinical cardiometabolic risk among women with PCOS in this population. Incorporating simple, non-invasive adiposity indices such as VAI and LAP alongside with conventional lipid profiling may improve early risk categorization. Routine cardiometabolic screening and targeted preventive interventions are therefore recommended to extenuate the progression to expressed cardiovascular disease in women with PCOS.

Objective To explore the relationship among thyroid stimulating hormone level and sex hormone level, blood lipid level and insulin resistance in patients with polycystic ovary syndrome. Methods From February 2014 to February 2017, eighty cases with polycystic ovary treated in the People's Hospital of Longhua, Shenzhen were selected as the research object.The clinical data of all patients were collected to check the indexes of thyroid function, lipid metabolism, glucose metabolism, and sex hormone related indexes, and the insulin resistance index (HOMA-IR) was calculated according to the related indexes of glucose metabolism.The patients were divided into group according to the level of thyrotropin, group A (thyrotropin 4.0mIU / L). According to the patient's insulin resistance index, the patients were divided into IR group and non IR group.According to the blood lipid metabolism index, the patients were divided into abnormal blood lipid group and non lipid abnormality group.The levels of thyrotropin and sex hormone related indexes were compared in different groups, and the correlation between thyrotropin level and various indexes was analyzed. Results The differences in body mass index ((23.3±4.2) kg/m2 vs.(23.8±3.5) kg/m2 vs.(25.6±5.2) kg/m2), luteinizing hormone((11.9±1.1)U/L vs.(11.7±1.2)U/L vs.(9.5±1.0)U/L), low density lipoprotein cholesterol ((2.4±0.9) mmol/L vs.(2.7±0.7) mmol/L vs.(2.9±0.8) mmol/L), high-density lipoprotein cholesterol ((1.5±0.4) mmol/L vs.(1.5±0.5) mmol/L vs.(1.3±0.2) mmol/L), triglyceride ((1.1±0.8) mmol/L vs.(1.5±0.9) mmol/L vs.(1.8±0.7) mmol/L), and apolipoprotein A ((1.8±0.5) mg/L vs.(1.7±0.4) mg/L vs.(1.5±0.3) mg/L) among group A, B and C were statistically significant (F=8.456, 9.587, 11.245, 10.784, 10.847, 10.214, P<0.05). The serum TSH concentration in group IR was significantly higher than that in non IR group ((3.1±1.1) mU/L vs.(2.3±0.8) mU/L) (t=3.551, P<0.05). The serum LH concentration in group IR was significantly lower than that in non IR group((9.4±1.1)U/L vs.(11.2±2.1)U/L) (t=3.739, P<0.05). The level of TSH in dyslipidemia group was significantly higher than that of non dyslipidemia group((3.2±1.3) mU/L vs.(2.4±1.1) mU/L) (t=3.551, P<0.05), and the level of LH in dyslipidemia group was significantly lower than that of non dyslipidemia group((9.3±1.6)U/L vs.(11.6±2.4)U/L) (t=4.709, P<0.05). The TSH level in patients with polycystic ovary syndrome was positively correlated with body mass index, three acylglycerol, low density lipoprotein cholesterol and insulin resistance index(r=0.272, 0.317, 0.364, 0.227)( P=0.015, 0.004, 0.003, 0.043), and there was a negative correlation with luteinizing hormone and high-density lipoprotein cholesterol(r=-0.616, -0.254) (P=0.000, 0.034). Conclusion Hyperthyroidism in patients with polycystic ovary syndrome is associated with abnormal blood lipid, abnormal sex hormone levels, and insulin resistance. Key words: Polycystic ovary syndrome; thyroid stimulating hormone; sex hormones; blood lipids; insulin resistance

To examine the relationship between adiponectin and metabolic variables in the offspring of patients with type 2 diabetes mellitus. Fasting blood samples and anthropometric indices were taken from 34 subjects, offspring of patients with type 2 diabetes, and 24 healthy control subjects without any immediate family history of diabetes. Plasma glucose and serum adiponectin, insulin, triglycerides, total cholesterol, HDL and LDL cholesterol levels were measured, and insulin resistance (IR) was calculated based on the homeostasis model assessment (HOMA) method. Offspring and control subjects were sex-matched, but the offspring were older and had higher body mass index and waist circumference than the control subjects (p < 0.05). The offspring had significantly higher mean fasting plasma glucose concentrations; however, their mean serum insulin, adiponectin, triglyceride, total cholesterol, HDL and LDL cholesterol and HOMA-derived IR levels did not significantly differ from those of the control subjects (p > 0.05). While the negative correlation between serum adiponectin and HDL cholesterol levels in the offspring remained statistically significant after adjusting for the effect of age, sex and BMI (r = -0.37, p < 0.05), the negative correlation between adiponectin and serum triglyceride, LDL cholesterol or IR levels became non-significant after controlling for the above variables (p > 0.05 in all cases). The correlation between adiponectin and some known biochemical risk factors for developing diabetes and cardiovascular disease in the offspring of patients with diabetes warrants further study to evaluate its potential in assessing the risk of developing these disorders.

VI. Drug Therapy

BackgroundWomen with polycystic ovary syndrome (PCOS) often have insulin resistance (IR) which may be worsened by obesity. The roles of dietary intake and activity are unclear. Our objectives were to determine whether (a) high caloric intake or inactivity explains obesity in PCOS, and (b) dietary composition is associated with PCOS phenotypes.MethodsEighty‐seven women with PCOS and 50 women without PCOS participated in this cohort study at a reproductive medicine center. Data collected included 3‐day food and physical activity records, anthropometrics, and metabolic and hormonal assays.ResultsWomen with PCOS had increased body mass index (BMI) but similar caloric intake and activity to women without PCOS. There were no differences in protein, carbohydrates, fat, or glycemic load consumption, but women with PCOS consumed less fiber (medians: 19.6 vs. 24.7 g) and less magnesium (medians: 238.9 vs. 273.9 mg). In women with PCOS, those with IR consumed less fiber, less magnesium, and greater glycemic load than those without IR (medians: 18.2 vs. 22.1 g, 208.4 vs. 264.5 mg, 89.6 vs. 83.5). Fiber intake of women with PCOS was negatively correlated with IR, fasting insulin, glucose tolerance, testosterone, and dehydroepiandrosterone sulfate. Magnesium intake was negatively correlated with IR, C‐reactive protein, and testosterone, but positively correlated with HDL cholesterol. Fiber intake and BMI accounted for 54.0% of the variance observed in IR.ConclusionsObesity in women with PCOS could not be explained by overeating or inactivity. Increasing dietary fiber and magnesium intakes may assist in reducing IR and hyperandrogenemia in women with PCOS.

Background: Polycystic ovarian syndrome is characterized by chronic anovulation, hyperandrogenism and ovarian polycystic changes on ultrasonogram. PCOS is often accompanied by obesity and insulin resistance. Leptin is produced mainly by the adipocytes. Debatable reports of relationship between leptin and insulin resistance exist. The objectives of study were to assess serum leptin and insulin level in PCOS subjects and to find out the correlation between serum leptin level and BMI in PCOS subjects and controls.Methodology: The study was carried out in 30 PCOS subjects between the age group of 18- 35 years and 30 age and BMI matched healthy women with normal menstrual cycle as controls.Fasting blood samples were collected. Serum leptin and serum insulin were estimated by ELISA and ECLIA methods respectively. Insulin resistance was calculated by HOMA. FBS, blood urea and serum creatinine were also measured.Results: Serum Insulin and HOMA-IR were significantly high (p < 0.001) in PCOS subjects compared to controls. Higher mean serum leptin, mean BMI and mean FBS were observed in the PCOS subjects compared to controls but the difference between the two groups were not statistically significant. Leptin showed a significant positive correlation with BMI in the PCOS subjects and controls.Conclusion: PCOS is associated with insulin resistance and places the subject at a higher risk of metabolic syndrome. Elevated serum leptin in PCOS women appears to be due to the positive correlation between leptin and BMI. Thus follow-up of these subjects with regard to metabolic syndrome may be beneficial.

Women with polycystic ovary syndrome (PCOS) have a high prevalence of cardiovascular disease (CVD) risk factors including dyslipidemia. Lipoproteins are heterogeneous, and measurement of serum lipids provides only the size of the pool and does not predict their function or composition. Recently, high-density lipoprotein cholesterol (HDL-C) function, as determined by cholesterol efflux capacity from macrophages, has been shown to be an independent predictor of subclinical CVD. The aim of the study was to comprehensively evaluate lipoprotein profile including lipid particle size and number and cholesterol efflux capacity in PCOS to better define CVD risk. A case control study was performed at an academic PCOS center. Women with PCOS (n = 124) and geographically matched controls (n = 67) were included in the study. The primary outcome was to measure HDL-C efflux capacity by an ex vivo system involving the incubation of macrophages with apolipoprotein (Apo) B-depleted serum from subjects, and the secondary outcome was to measure lipid particle size and number using nuclear magnetic resonance spectroscopy. Women with PCOS had significantly higher body mass index and blood pressure but similar HDL-C and low-density lipoprotein cholesterol levels compared to controls. The mean ApoA1 levels were lower, and the ApoB/ApoA1 ratio was higher in PCOS subjects compared to controls (P < .01). There were no differences in ApoB levels. Women with PCOS had an 7% decrease in normalized cholesterol efflux capacity compared to controls (P < .003). Cholesterol efflux capacity in PCOS correlated with body mass index, ApoA1, HDL-C, and the presence of metabolic syndrome. In a multivariable regression model, PCOS was significantly associated with diminished cholesterol efflux. PCOS was also associated with an atherogenic profile including an increase in large very low-density lipoprotein particles, very low-density lipoprotein (VLDL) size, and small low-density lipoprotein cholesterol particles (P < .01). Our novel findings of decreased cholesterol efflux and an atherogenic lipid particle number and size pattern in women with PCOS, independent of obesity, further substantiate the increased risk of CVD in this population.

There are so many studies that suggest the changes in lipid profiles and lipoprotein (a) [Lp(a)] are associated with early atherosclerosis in rheumatoid arthritis (RA). But there are some opposite studies also. Because of marked ethnicity differences in the distribution of Lp(a), we aimed to investigate the associations of Lp(a) levels and lipid changes in Turkish RA patients. There were 30 women and 20 men, a total of 50 patients with RA (mean age 47.6 +/- 13.2 years), included and 21 healthy women and 14 healthy men (mean age 45.7 +/- 14.5 years) were recruited as a control (C) group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) levels were analysed for each group. Analysis of six different studies was performed. In the RA and C groups, mean serum Lp(a) levels were 39.7 +/- 64.4 and 10.5 +/- 13.4 mg/dl, respectively (P=0.001). Mean TC levels were 189.2 +/- 142.5 and 174.0 +/- 29.3 mg/dl (P=0.294), mean TG levels were 121.4 +/- 65.4 and 106.5 +/- 80.0 mg/dl (P=0.030), mean HDL-C levels were 44.5 +/- 10.0 and 47.7 +/- 4.8 mg/dl (P=0.014) and mean LDL-C levels were 94.3 +/- 35.3 and 102.0 +/- 24.6 mg/dl (P=0.98), respectively. Analysis of the six studies showed Lp(a) level was higher and HDL level was lower in RA patients than in healthy controls. Patients with RA may have altered lipid profiles from one country to another one. Especially in Turkey, higher serum Lp(a), lower HDL-C and higher TG levels may be found in RA patients instead of some findings of other countries showing different results. Ethnicity may be a reason for these findings.

Disclosure: S. Sahu: None. T. Jain: None. A.J. Augustine: None. G. Palaniswamy: None. T. Mareedu: None. P.R. Patel: None. B. Padamati: None. N. Koduri: None. A. Dixit: None. Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among reproductive-age women, characterized by hormonal imbalance, insulin resistance, and metabolic dysfunction. Despite growing evidence linking PCOS to cardiovascular risk factors such as hypertension, dyslipidemia, and chronic inflammation, longitudinal studies examining the direct association between PCOS and cardiovascular disease (CVD) remain limited. Women under 40 with PCOS face an elevated risk of cardiovascular disease due to metabolic and hormonal imbalances. Key risk factors include insulin resistance, obesity, and hypertension. Lifestyle interventions and management of weight and diabetes are essential strategies to reduce this risk. While PCOS is associated with increased cardiovascular risk, further research is needed to fully understand the independent effects of PCOS on CVD. This study aims to evaluate the long-term cardiovascular risk in women diagnosed with PCOS through a retrospective cohort analysis and address this research gap.Methods: A retrospective analysis was conducted using a dataset comprising 1,000 women aged 18-40, with 500 diagnosed with PCOS and 500 age-matched controls without PCOS. Key cardiovascular risk markers, including systolic and diastolic blood pressure (BP), lipid profile (LDL, HDL, triglycerides), fasting glucose, insulin resistance (HOMA-IR), and inflammatory marker C-reactive protein (CRP), were compared between groups. T-tests were used for continuous variables, and a chi-square test was performed to assess the association between PCOS and CVD. Additionally, logistic regression was conducted to evaluate PCOS as an independent predictor of CVD after adjusting for confounders such as BMI, smoking status, and physical activity.Results: Women with PCOS exhibited significantly higher systolic BP (p &amp;lt; 0.01), LDL cholesterol (p &amp;lt; 0.001), triglycerides (p &amp;lt; 0.001), fasting glucose (p &amp;lt; 0.01), and CRP (p &amp;lt; 0.001) compared to controls. The prevalence of CVD was markedly elevated in the PCOS group (chi-square test, χ² = 26.24, p &amp;lt; 0.0001), suggesting a strong association between PCOS and cardiovascular risk. Logistic regression confirmed that PCOS remained an independent predictor of CVD (OR: 2.45, 95% CI: 1.78–3.42, p &amp;lt; 0.001) even after adjusting for confounders.Conclusion: This study provides compelling evidence that PCOS is a significant risk factor for cardiovascular disease, independent of BMI and lifestyle factors. The elevated levels of atherogenic lipids, blood pressure, and inflammatory markers in PCOS patients underscore the urgent need for early cardiovascular screening and risk management in this population. Future research should focus on long-term interventions to mitigate CVD risk in women with PCOS and further clarify the independent role of PCOS in cardiovascular outcomes. Presentation: Saturday, July 12, 2025

In order to investigate the possible causes and effects of obesity in polycystic ovary syndrome resting energy expenditure, postprandial thermogenesis and insulin resistance were measured in 14 polycystic ovary syndrome subjects and in 14 controls. A cross-sectional study of a selected group of patients was performed. Seven of the PCOS subjects were obese and seven lean. Controls were individually matched for age, race, weight, body mass index (BMI) lean body mass and percentage fat. The obese, but not lean, polycystic ovary syndrome subjects had a greater waist:hip ratio than controls (median (range) obese PCOS 0.865 (0.823-0.960) vs obese control 0.804 (0.823-0.940), P less than 0.025). Metabolic rate was measured by continuous indirect calorimetry and insulin sensitivity was assessed by a short insulin tolerance test. The resting energy expenditure (REE) was similar in PCOS subjects and controls (median (range), 6796 (5489-7774) vs 6833 (4893-8492) kJ/day). REE correlated with LBM in the PCOS group (r = 0.83, P less than 0.00) and the control group (r = 0.82, P less than 0.001). Postprandial thermogenesis was reduced in polycystic ovary syndrome (obese: median 45.4 (range 33.6-100.0) vs 86.5 (67.2-109.2) kJ (P less than 0.05); lean: 79.4 (73.5-108.4) vs 89.9 (76.0-109.2) kJ (P less than 0.05). Fasting insulin (9.7 +/- 3.6 vs 4.4 +/- 0.8 mU/l, P less than 0.05) and postprandial incremental insulin rise (163 +/- 31 vs 116 +/- 15 mU/l, P less than 0.025) were higher in polycystic ovary syndrome. Insulin sensitivity was reduced in polycystic ovary syndrome (obese: median 136 (range 92-169) vs 173 (109-225) mumol/l/min (P less than 0.05); lean: 161 (138-225) vs 194 (161-253) mumol/l/min (P less than 0.05)). The reduction in insulin sensitivity correlated with the reduced postprandial thermogenesis in the polycystic ovary syndrome group (r = 0.75, P less than 0.01). These results confirm previous reports of hyperinsulinaemia and insulin resistance in polycystic ovary syndrome. Furthermore, polycystic ovary syndrome subjects have a reduced postprandial thermogenesis which is related statistically to the reduced insulin sensitivity. The decreased postprandial thermogenesis may predispose women with polycystic ovary syndrome to weight gain.

Anti-Müllerian hormone (AMH) is a biomarker that predicts the number of antral follicles and is involved in follicle arrest for women with polycystic ovary syndrome (PCOS). We investigated the association between the characteristic hyperandrogenemia, insulin resistance (IR), AMH, and the morphology and size of ovaries for women with PCOS. A total of 99 Taiwanese women with PCOS who were willing to undergo vaginal ultrasonography were enrolled in this cross-sectional study. The number of antral follicles and the ovarian volume showed a significant correlation with AMH, total testosterone and the free androgen index, but not with age, body mass index (BMI) or the homeostasis model assessment of insulin resistance (HOMA-IR). AMH had a significant negative association with both BMI and HOMA-IR. Multiple stepwise regression analysis demonstrated that AMH, BMI and total testosterone were independently related to the number of antral follicles. AMH and total testosterone were the main determinants for ovarian volume in a stepwise regression model. Our results suggest that not only the AMH level, but also obesity, IR and elevated androgen levels may relate to the development of the large size of antral follicle pool and ovarian volume in women with PCOS. Obesity and IR may enhance the follicular excess through the dysregulation of AMH or through the pathway of hyperandrogenemia. These findings might partly explain why adequate body weight management and improvement in IR can improve the ovulatory function for women with PCOS.

In 791 women with polycystic ovary syndrome (PCOS), we assessed the success of metformin-diet (MET-D) in reducing weight, triglycerides (TG), LDL cholesterol (LDLC), and blood pressure (SBP, DBP), while elevating...

Background: The lipid profile among women with polycystic ovary syndrome (PCOS) is influenced by both insulin resistance and hyperandrogenism. The association of lipid profiles in metabolic phenotype-predominant women with PCOS was not adequately evaluated. Objective: To assess the association of lipid profiles among metabolic phenotypes [body mass index (BMI) and insulin resistance (IR)] between women with and without PCOS. Methods: This case-control study included 287 reproductive-aged females with PCOS and 190 age-matched controls conveniently sampled from the PCOS clinic, Department of Endocrinology of a University hospital, between September 2020 and August 2022. The fasting glucose, insulin, and lipid profiles were analyzed using glucose oxidase, chemiluminescence immunoassay, and glycerol phosphate dehydrogenase peroxidase methods. LDL cholesterol was calculated from Friedwald’s formula or measured directly. The National Cholesterol Education Program’s risk categories for different lipid fractions in Adult Treatment Panel III were used. Participants were divided into lean (&lt;23 kg/m2), overweight (23 – 27.4 kg/m2), and obese (≥27.5 kg/m2) by BMI, and IR by homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.6. Results: Approximately 70.7% of women with PCOS had at least one abnormality in their lipid profile. Among all lipid fraction classifications, only the high-risk LDL-cholesterol category showed a significant association with PCOS after adjustment for BMI and HOMA-IR status [OR=9.2, p=0.041]. Different lipid fractions differed between the study groups only in the lean-overweight and insulin-sensitive groups. However, none of the diagnostic features, including phenotypes, had significant associations with lipid fraction categories. Conclusions: Only LDL cholesterol had an independent association with PCOS. An association between lipid fractions and PCOS was observed among women without obesity or IR. [J Assoc Clin Endocrinol Diabetol Bangladesh, January 2026; 5(1): 12-20]