Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome

BACKGROUND: Dyslipidemia, diabetes and obesity are all potent cardiovascular risk factors that tend to cluster in women with polycystic ovary syndrome (PCOS). Metabolic disorders in patients with PCOS cannot be explained solely by the presence of obesity.
OBJECTIVE: To study the correlation between insulin resistance and serum lipid profile in Indian women with PCOS.
SETTING: Gynecology clinic of a tertiary care hospital.
MATERIALS AND METHODS: In this prospective study done from April 2004 to December 2004, 65 women with PCOS had their body mass index (BMI) and waist hip ratio calculated. Fasting glucose, insulin and lipid profiles were also estimated in each case. Insulin resistance was defined by fasting glucose-to-insulin ratio ≤ 4.5. The association of obesity markers and insulin resistance with lipid parameters was then studied. Statistical analysis using student ′t′ and Mann Whitney U tests was done as indicated.
RESULTS: Insulin resistance was seen in 50 of the 65 PCOS women. There was no correlation seen between markers of obesity such as BMI and waist/hip ratio with various lipid parameters. But in PCOS women with insulin resistance, the lipid profile was significantly different [high triglycerides, total cholesterol and lower high-density lipoprotein (HDL)] compared to insulin-sensitive women. The difference between the two groups for total cholesterol (P = 0.002), triglycerides (P = < 0.001) and HDL (P ≤ 0.001) was statistically significant but that for low-density lipoprotein (LDL) (P ≤ 0.07) was not statistically significant.
CONCLUSION: Insulin resistance is associated with dyslipidemia in women with PCOS, independent of obesity.

Keywords
Dyslipidemia, insulin resistance, lipid profile, polycystic ovarian syndrome