Dyslipidemia and Oxidative Stress in PCOS

Abstract

Polycystic ovary syndrome (PCOS) is a common metabolic and reproductive disorder in women. An increased cardiovascular risk has to be anticipated in PCOS as it is a metabolically unstable condition. Among cardiovascular risk factors, dyslipidemia is certainly the most persistent and highly prevalent. Predominant observation is an elevation of LDL cholesterol in all PCOS patients. Decreased concentrations of HDL cholesterol are found in obese PCOS from the third decade of life onwards while triglycerides start to rise from the second decade of life. PCOS is associated with oxidative stress, namely increased production of free radicals followed by decreased serum antioxidant levels and antioxidant enzyme activity. Broad range of endocrine and metabolic disturbances like obesity, hyperinsulinemia as well as dyslipidemia might be responsible for PCOS-associated oxidative stress. Therapeutic interventions in PCOS women based on lifestyle modification as well as use of insulin sensitizers did not show significant effect on dyslipidemia. Statins are considered to be a group of promising agents that are safe and effective in improving total cholesterol, LDL cholesterol and triglycerides, and possess antioxidant activity. Supplementation with omega-3 fatty acids, α-lipoic acid and N-acetylcysteine is considered to have an anti-inflammatory and antioxidant effect and to improve dyslipidemia and insulin sensitivity in PCOS women.

The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

“…34,35 An interesting issue is the finding that supplementation with omega-3, α-lipoic acid and N-acetyl cysteine results in an antioxidant, anti-inflammatory effect, improves insulin sensitivity and the lipid profile of women with PCOS. 36 Salehpour et al demonstrated that N-acetyl cysteine lowers levels of testosterone, reduces androgen response to gonadotropin stimulation, improves ovulation rates and long-term health after 6 months of treatment. 37 In recent years, attention has also been paid to the role of increased activity of the sympathetic nervous system in the pathogenesis, progression and treatment of PCOS.…”

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

“…Whether HbA1c is superior to OGTT regarding long-term metabolic and cardiovascular risk in PCOS must be established in prospective studies. It was estimated that 70% newly diagnosed women with PCOS had borderline or high lipid levels (33), including increased total cholesterol, TG, LDL or decreased HDL levels (34,35). In a Danish study population with median BMI 27 kg/m 2 , 41% patients with PCOS had HDL <1.29 mmol/L and 21% patients had TG >1.68 mmol/L (36).…”

Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome

“…In addition, due to increased production of free radicals and reactive oxygen species (ROS) [4], elevated circulating protein carbonyls, tumor necrosis factor-α (TNF-α), and decreased insulin signaling [5,6], it is associated with increased biomarkers of inflammation and oxidative stress. Increased inflammatory factors and biomarkers of oxidative stress among patients with PCOS may predict the development of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) [7][8][9].…”