Atherogenic lipid indices and metabolic syndrome in polycystic ovary syndrome: a comparative cross-sectional study

Polycystic Ovary Syndrome (PCOS) is one of the causes of infertility in females. It is also associated with hyperandrogenism and hyperinsulinemia. With these hormonal imbalances, there can be an equally important risk of cardiometabolic consequences as a result of altered atherogenic lipid indices and metabolic syndrome which has not been much explored in context of Nepal. The purpose of this study was to delve into different lipid profile parameters to calculate atherogenic lipid indices to identify the metabolic syndrome (MetS) and cardiovascular risk in PCOS. We enrolled 70 PCOS and 60 age-matched non-PCOS females visiting the Infertility Clinic at the Department of Obstetrics and Gynecology at Tribhuvan University Teaching Hospital. After written informed consent, anthropometric measurements as well as a blood samples were taken and biochemical analysis of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were measured in Abbott ARCHITECT ci4100 autoanalyzer. Based on the examined variables, various formulas to assess atherogenic risk and metabolic syndrome [Castelli’s risk index I & II (CRI-I, CRI-II), atherogenic coefficient (AC), atherogenic index of plasma (AIP), lipoprotein combined index (LCI), lipid accumulation product (LAP)] were applied. Descriptive and inferential analysis was carried in SPSS version 23.0. A p-value ≤ 0.05 was considered as significant. The PCOS group had higher atherogenic lipid indices (CRI-I, CRI-II, AIP, AC, LCI and LAP) compared to their non-PCOS counterparts. The prevalence of metabolic syndrome (MetS) was also higher in the PCOS (81.4%, n = 57) compared to non-PCOS (30%, n = 18). The LAP score was found to be an efficient indicator of MetS in the PCOS patients with an AUC of 0.829 ( p < 0.001), with the sensitivity and specificity of 80% and 94.5% respectively. Our study showed a higher frequency of MetS and cardiovascular risk in PCOS as determined by higher atherogenic lipid indices than non PCOS. LAP score was the most efficient indicator of MetS.