Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis

Objective To quantify the magnitude and pattern of low-density lipoprotein (LDL) cholesterol and nonhigh-density lipoprotein (HDL) cholesterol levels in women with polycystic ovary syndrome (PCOS) versus control women. Design Systematic review and meta-analysis of lipid levels in published cross-sectional studies worldwide where PCOS women and controls were examined and sampled. Main Outcome Measure(s) Differences in plasma lipids (including triglycerides, HDL-cholesterol, LDL-cholesterol, and nonHDL-cholesterol) in PCOS versus control subjects were calculated. Comparisons were made with and without body mass index (BMI) matching. Result(s) Triglyceride levels were 26 mg/dL (95% confidence interval [CI] 17–35) higher and HDL-cholesterol concentrations 6 mg/dL (95% CI 4–9) lower in women with PCOS. Also, LDL-cholesterol and nonHDL-cholesterol concentrations were higher in PCOS: by 12 mg/dL (95% CI 10–16) and 19 mg/dL (95% CI 16–22), respectively. With BMI matching, LDL-cholesterol and nonHDL-cholesterol were still higher in PCOS: by 9 mg/dL (95% CI 6–12) and 16 mg/dL (95% CI 14–19), respectively. LDL-cholesterol and nonHDL-cholesterol differences were greater with National Institutes of Health criteria [15 mg/dL (95% CI 13–17) and 21 mg/dL (95% CI 16–25), respectively] versus Rotterdam criteria [8 mg/dL (95% CI 5–12) and 17 (95% CI 13–22), respectively]. Conclusion(s) Dyslipidemia is common in PCOS. Beyond known alterations in triglycerides and HDL-cholesterol, women with PCOS have higher LDL-cholesterol and nonHDL-cholesterol, regardless of BMI. We recommend that all women with PCOS be screened for dyslipidemia, including LDL-cholesterol and nonHDL-cholesterol determinations, for effective cardiovascular risk prevention.