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RESEARCH PRODUCT
How should we manage atherogenic dyslipidemia in women with polycystic ovary syndrome?
Kaspar BerneisRizzo ManfrediEnrico CarminaGiovam Battista Rinisubject
Adultmedicine.medical_specialtySettore MED/09 - Medicina Interna10265 Clinic for Endocrinology and Diabetology610 Medicine & healthRisk AssessmentSeverity of Illness IndexSettore MED/13 - Endocrinologiachemistry.chemical_compoundWeight lossInternal medicinemedicineHumansatherosclerosis high-density lipoprotein cholesterol polycystic ovary syndrome small and dense low-density lipoprotein triglyceridesDyslipidemiasTriglyceridebusiness.industryCholesterolCholesterol HDLnutritional and metabolic diseasesObstetrics and Gynecology2729 Obstetrics and GynecologyCholesterol LDLmedicine.diseaseAtherosclerosisPrognosisPolycystic ovaryMetforminEndocrinologyTreatment OutcomechemistryCardiovascular Diseaseslipids (amino acids peptides and proteins)Drug Therapy CombinationFemaleControlled Clinical Trials as Topicmedicine.symptomHydroxymethylglutaryl-CoA Reductase InhibitorsbusinessPioglitazoneDyslipidemiamedicine.drugLipoproteinPolycystic Ovary Syndromedescription
Despite their young age, women with polycystic ovary syndrome (PCOS) have increased cardiovascular risk. Besides normal concentrations of low-density lipoprotein (LDL) cholesterol, dyslipidemia is very common and includes elevated triglyceride levels and low high-density lipoprotein cholesterol concentrations. Recent findings also showed that women with PCOS have qualitative LDL alterations, with increased levels of atherogenic small, dense LDL particles. Such lipid abnormalities constitute a common form of dyslipidemia, the so-called atherogenic lipoprotein phenotype (ALP), associated with a greater cardiovascular risk. Weight reduction and increased physical activity may constitute first-line therapy for ALP in PCOS, and lipid lowering drugs, particularly nicotinic acid and fibrates, should be used in patients with severe dyslipidemia. Statins have usually a lower impact on ALP, and their beneficial effect is often moderate. Insulin-sensitizing medications favorably alter each component of ALP and combined therapy with these agents remains an option; in particular, the combination pioglitazone plus metformin seems to be particularly beneficial.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2007-05-07 |