Effects of oral fat and glucose tolerance test on serum lipid profile, apolipoprotein, and CRP concentration, and insulin resistance in patients with polycystic ovary syndrome.

OBJECTIVE

To evaluate serum lipid responses and insulin resistance to a high-fat content meal in patients with polycystic ovary syndrome (PCOS).

DESIGN

Controlled clinical study.

SETTING

Healthy volunteers and patients with PCOS in clincial research.

PATIENT(S): Twenty women with PCOS (22.7 +/- 4 years, body mass index [BMI]: 23.5 +/- 2.6 kg/m(2)) and 20 age- and BMI-matched control women (22.8 +/- 4, BMI: 23.1 +/- 3.1 kg/m(2)) were included in the study. Waist circumference, BMI, fat mass, fat percent, and fat-free mass were measured.

INTERVENTION(S): A standard oral glucose tolerance test (75 g of glucose, 2 hours) was performed, and the area under the curve-glucose (AUC(glu)) and homeostasis model assessment of insulin resistance (HOMA-IR) were used for insulin resistance. An oral fat tolerance test (OFTT) with 500 mL standard fat meal (1493 kcal) was performed. With OFTT, both timely (at 0, second, fourth, sixth, and eighth hours) and AUC(triglyceride), AUC(total-cholesterol), AUC(VLDL-cholesterol), AUC(HDL-cholesterol), AUC(LDL-cholesterol), AUC(insulin), AUC(glucose), AUC(hs-CRP), AUC(LP(a)), AUC(ApoA1), and AUC(ApoB) responses were evaluated.

MAIN OUTCOME MEASURE(S): Plasma lipid, insulin, and C-reactive protein levels.

RESULT(S): Waist circumference, fat percent, and HOMA-IR values of PCOS patients were higher than those of control subjects. AUC(glu) values were also higher in patients with PCOS. After OFTT, AUC(triglyceride), AUC(total cholesterol), and AUC(VLDL) values were higher in patients with PCOS.

CONCLUSION(S): Patients with PCOS have insulin resistance and prolonged lipid response to OFTT. These exaggerated responses may cause early atherogenesis in these patients.