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Lipoprotein subclasses compensate the classic atherogenic lipid profile of women with polycystic ovary syndrome, but common antiandrogenic treatments worsen their lipidome

Luque-Ramírez M, Martínez-García MÁ, Insenser M, Quintero-Tobar A, de Lope Quiñones S, Nattero-Chávez L, Escobar-Morreale HF

European journal of endocrinology, 2025

340 participants · 1 citation

Abstract

OBJECTIVES: Patterns of circulating inflammatory glycoproteins and lipoprotein subclasses are not well-defined in polycystic ovary syndrome (PCOS). We aimed to describe these profiles and effects of drug intervention on those parameters.

DESIGN: Cross-sectional and longitudinal interventional prospective studies.

METHODS: The cross-sectional study included 340 patients with PCOS and 92 non-hyperandrogenic women. Glycoprotein and lipoprotein profiles were measured by proton-nuclear magnetic resonance spectroscopy. We also analyzed their changes after treatment with metformin, an oral contraceptive, or an oral contraceptive plus spironolactone in 13, 20, and 16 women with PCOS, respectively.

RESULTS: Circulating glycoproteins were increased in obese women, regardless of PCOS. PCOS-associated increased VLDL-cholesterol and VLDL-triglycerides, but reduced HDL-cholesterol, HDL-triglycerides, IDL-triglycerides, LDL-cholesterol, and LDL-triglycerides, compared with controls. Regarding lipoprotein particles (P), PCOS patients had higher large and medium VLDL-P and, accordingly, larger VLDL sizes than controls. Interestingly, women with PCOS also showed larger HDL-P and HDL sizes than controls, a pattern that is not associated with cardiovascular disease. However, large and medium LDL-P were reduced in patients. Circulating glycoproteins increased with all treatments. Antiandrogenic regimens induced a larger increase in HDL-cholesterol, HDL-triglycerides, IDL-triglycerides,…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 340 participants or records.

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