Pattern of dyslipidemia among adult women with polycystic ovary syndrome in Port Harcourt, Nigeria
Keywords:Dyslipidemia, Nigeria, Polycystic ovary syndrome, PCOS
Background: Dyslipidemia is adjudged the most common metabolic disorder observed among women with polycystic ovary syndrome (PCOS). However, there is paucity of data to support this hypothesis in our region. Therefore, this study was structured to evaluate the pattern of dyslipidemia among women with PCOS in Port Harcourt, Nigeria.
Methods: This was a retrospective study of 226 adult women with PCOS who had visited the Department of Chemical Pathology and Metabolic Medicine of a tertiary hospital in Nigeria over a 10-year period (1st January 2008 to 31st December 2017), aimed to evaluate the pattern of dyslipidemia in these women. Records on age, total cholesterol (Tc), triglycerides (Tg), high-density lipoprotein (HDL-c), and low-density lipoprotein (LDL-c) were collected and analyzed using Shapiro-Wilk, descriptive, chi-square, and Fisher’s exact statistics. Statistical significance was set at 0.05.
Results: The mean age of the study population was 28.40 ± 5.75 and ranged from 18 - 42 years. Most of the study population (55.3%) were within the age group of 20 – 30 years. The most common lipid abnormalities observed among the study population were increased triglycerides (75.7%) and decreased HDL-c (61.1%) concentrations while the least was increased total cholesterol (17.7%) and LDL-c (14.5%). Dyslipidemia was observed in 80.1% of the study population and more frequent (51.9%) within the age group of 20-30 years.
Conclusions: Dyslipidemia is common among young adult women with PCOS. Regular assessment for dyslipidemia should be mandatory in PCOS to mitigate the long-term consequences of its complications.
Alsadi B. Polycystic Ovarian Syndrome: Pathophysiology and Infertility. World J Lap Surg. 2014;7(1):23-27.
Moharaj S, Amod A. Polycystic ovary syndrome. J Endocrinol Metab S Afr. 2009;14(2): 86-95.
Stein IF, Leventhal ML. Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181-91.
Lavie O. Benign disorders of the ovaries and oviducts. In: Alan HD, Lauren N, Ashley SR, editors. Current Obstetrics and Gynaecologic Diagnosis and Treatment. 11th ed. New York: Lange Medical Publication; 2013. pp. 661-70.
Omokanye LO, Ibiwoye-Jaiyeola OA, Olatiowo AWO, Abdul IF, Durowade KA, et al. Polycystic ovary syndrome. Analysis of management outcomes among women at a public health institution in Nigeria. Niger J Gen Pract. 2015;13(2):44-8.
Ugwu GO, Iyoke CA, Onah HE, Mba SG. Prevalence, presentation and management of polycystic ovary syndrome in Enugu, South-east Nigeria. Niger J Med. 2013;22(4):313-6.
Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS et al: Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057.
Goodarz MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: etiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 2011;7(4):219-31.
Joe-Kechebelu NN, Mbamara SU, Ikechebelu JI. Familial trend in polycystic ovarian syndrome. Ann Afr Med. 2013;12(3):132-4.
Zawadic JK, Danif A. Diagnostic criteria for polycystic ovarian syndrome: towards a rational approach. In: Polycystic Ovary Syndrome, Dunaif A, Givens JR, Haseltine F (Eds.). Cambridge, England: Blackwell Science, 1992. pp. 377–84.
Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006; 91(11):4237-45.
Rotterdam, ESHRE/ASRM-Sponsored, PCOS, Consensus, Workshop, Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1):19-25.
Churchill SJ, Wang ET, Pisarska MD. Metabolic consequences of polycystic ovary syndrome. Minerva Ginecol. 2015;67(5):545-55.
Berneis K, Rizzo M, Hersberger M, Rini GB, Di Fede G, Pepe I, et al. Atherogenic forms of dyslipidemia in women with polycystic ovary syndrome. Int J Clin Pract. 2009;63(1):56-63.
Wild RA, Rizzo M, Clifton S, Carmina E. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011;95(3): 1073-9.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6):499-502.
Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285(19):2486-97.
Legro RS, Kunselman AR, Dunaif A. Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. AM J Med. 2001;111(8):607-13.
Hussain A, Alam JM. Dyslipidemia in women with polycystic ovary syndrome: A case control study in tertiary care hospital of Karachi. J Pak Med Asso. 2014;64(90):1049-52.
Rocha MP, Marcondes JA, Barcellos CR. Dyslipidemia in women with polycystic ovary syndrome: incidence, pattern and predictors. Gynecol Endocrinol. 2011;27(10):814-9.
Nisa SUN, Nisa SSUN, Nasreen S. Frequency of dyslipidemia in patients of polycystic ovarian syndrome (PCOS) in BV hospital, Bahawalpur. Pak J Med Health Sci. 2014;8(2):489-91.
Kim JJ, Choi YM. Dyslipidemia in women with polycystic ovary syndrome. Obs Gynecol Sci. 2013; 56(3):137-42.
Wild RA, Painter PC, Coulson PB, Carruth KB, Ranny GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1985;61(5): 946-51.
Carmina E. Cardiovascular risk and events in polycystic ovary syndrome. Climacteric. 2009;12 (suppl 1):22–5.
Shoaib OM, Mustafa SM, Nourein IH. Serum lipid profile of polycystic ovary syndrome in Sudanese women. Int J Med Sci Public health. 2015;4(11): 1605-10.
Robinson S, Henderson AD, Gelding SV, Kiddy D, Niththyananthan R, Bush A, et al. Dyslipidaemia is associated with insulin resistance in women with polycystic ovaries. Clin Endocrinol (Oxf). 1996; 44(3):277-84.
Meirow D, Raz I, Yossepowitch O, Brzezinski A, Rosler A, Schenker JG, et al. Dyslipidaemia in polycystic ovarian syndrome: different groups, different aetiologies? Hum Reprod. 1996;11(9):1848-53.
Essah PA, Nestler JE, Carmina E. Differences in dyslipidemia between American and Italian women with polycystic ovary syndrome. J Endocrinol Invest. 2008;31(1):35-41.
Guzick DS1, Talbott EO, Sutton-Tyrrell K, Herzog HC, Kuller LH, Wolfson SK Jr. Carotid atherosclerosis in women with polycystic ovary syndrome: initial results from a case-control study. Am J Obstet Gynecol. 1996;174(4):1224-9.
Dahlgren E1, Janson PO, Johansson S, Lapidus L, Oden A. Ovary syndrome and risk for myocardial infarction. Evaluated from a risk factor model based on a prospective population study. Acta Obstet Gynecol Scand. 1992;71(8):559-604.
Wild RA; Long-term health consequences of PCOS. Hum Reprod Update. 2002;8(3):231-41
American College of Obstetricians and Gynecologist committee on practice bulletins – Gynecology. ACOG practice bulletin no. 108: polycystic ovary syndrome. Obstet Gynecol. 2009;114:936-49.