Antioxidant properties of high-density lipoproteins are impaired in women with polycystic ovary syndrome

Objective: To determine the relationships among the inflammatory index, intrinsic oxidation levels, lipid and apolipoprotein (apo)A-I concentrations of high-density lipoprotein (HDL), and polycystic ovary syndrome (PCOS).

Design: Cross-sectional study.

Setting: University hospital.

Patient(s): A total of 425 patients with PCOS and 441 control women were included.

Intervention(s): None.

Main outcome measure(s): The HDL inflammatory index (HII) was determined using a cell-free fluorometric assay. Intrinsic HDL oxidation levels, HDL-free cholesterol, HDL-cholesterol ester, HDL-triglyceride, serum apoA-I, and malondialdehyde levels were also measured.

Result(s): The mean HII value and the frequency of HII ≥1 were significantly higher in the PCOS group (0.77 ± 0.54, 27.1%) than in the control group (0.53 ± 0.37, 8.4%). These values were also higher in each of the 4 PCOS phenotypes based on the Rotterdam criteria than in the controls, and higher in patients with hyperandrogenism (HA) + oligo- and/or anovulation (OA) phenotype than in those with OA + polycystic ovary (PCO) phenotype. Furthermore, patients with PCOS with OA + PCO had lower malondialdehyde and intrinsic HDL oxidation levels compared with those with HA. Multivariate regression analysis demonstrated that PCOS, HDL-cholesterol ester, and E2 levels were the main predictors of HII value.

Conclusion(s): The impairment of HDL antioxidant/anti-inflammatory function in PCOS is related to HA status, increased oxidative stress, and abnormalities in HDL components and thus may contribute to PCOS pathogenesis and increase the risks of future cardiovascular diseases.