Metabolic syndrome in young women with the polycystic ovary syndrome: revisiting the threshold for an abnormally decreased high-density lipoprotein cholesterol serum level.

Abstract

To verify whether the adult threshold for an abnormally decreased high-density lipoprotein cholesterol (HDL-C) serum level (0.5 g/l) is appropriate in young women with polycystic ovary syndrome (PCOS). Retrospective analysis of a database. Academic Hospital. A total of 854 women aged 16-40 years having PCOS according to Rotterdam criteria. Criteria defining the metabolic syndrome (MetS) (increased waist circumference, systolic and/or diastolic blood pressure, triglycerides, fasting glycaemia and decreased HDL-C) were separately analysed and compared in three different subgroups (16-20 years, 20-30 years and 30-40 years). The prevalence of the MetS was calculated using two different thresholds (0.5 and 0.4 g/l) for HDL-C in the 16-20 years group. Prevalence of MetS. The prevalence of an abnormal HDL-C (<0.5 g/l) was higher in the youngest women (60%), whereas frequencies of abnormal waist circumference, systolic and/or diastolic blood pressure, triglycerides and fasting glycaemia were lower than in the two other groups. The prevalence of an abnormal HDL-C dropped to 27% when using a threshold of 0.4 g/l in the 16-20 years subgroup. The prevalence of the MetS in the 16-20 years subgroup was 11%, whatever the threshold, because HDL-C was <0.4 g/l in all women once they scored 3 or more. The adult threshold for HDL-C overestimates the prevalence of abnormal HDL-C in young women with PCOS. Until normative data about HDL-C in adult women under 20 years is available, we suggest using a threshold of 0.4 g/l or ignoring this criterion.