ABSTRACT
Background: Dyslipidemia and insulin resistance [IR], occurring in most infertile women with polycystic ovarian syndrome [PCOS], increase the risk of cardiovascular disease [CVD] and type 2 diabetes. This study aimed to assess the relationships between lipopro-tein ratios and IR in PCOS women
Materials and Methods: Thirty six infertile women with PCOS selected based on Andro-gen Excess Society [AES] criteria and 29 healthy women matched for age were recruited to this case-control study. After physical measurements, fasting serum glucose [Glu], insulin and lipid profile levels [triglycerides [TGs], total cholesterol [TC], low-density lipoprotein-cholesterol [LDL-C] and high-density lipoprotein-cholesterol [HDL-C]] were measured, while lipoprotein ratios [TC/HDL-C, LDL-C/HDL-C, TG/HDL-C] were calculated. IR was also calculated using homeostasis model assessment [HOMA]-IR. The optimal cutoffs of lipoprotein ratios in relation to HOMA-IR were calculated based on the Receiver Operating Characteristics [ROC] curve analysis using the area under curve [AUC]
Results: Waist circumference [WC], insulin levels, HOMA-IR, TG levels, and all lipoprotein ratios were significantly higher, while HDL-C was lower in PCOS group as compared to healthy controls. All lipoprotein ratios, TG levels, and WC are significantly correlated with insulin levels and HOMA-IR. Among lipoprotein ratios, the highest AUC of the ROC belonged to TG/HDL-C ratio with sensitivity of 63.6% and specificity of 84.4% [TG/HDL-O3.19] as a marker of IR in infertile PCOS women
Conclusion: Lipoprotein ratios, particularly TG/HDL-C, are directly correlated with insulin levels and can be used as a marker of IR [HOMA-IR] in infertile PCOS patients