BJOG : an international journal of obstetrics and gynaecology · 2010
Metabolic syndrome in young women with the polycystic ovary syndrome: revisiting the threshold for an abnormally decreased high-density lipoprotein cholesterol serum level.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Dewailly D, Contestin M, Gallo C, Catteau-Jonard S
Аннотация
OBJECTIVE: 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).
DESIGN: Retrospective analysis of a database.
SETTING: Academic Hospital.
POPULATION: A total of 854 women aged 16-40 years having PCOS according to Rotterdam criteria.
METHODS: 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.
MAIN OUTCOMES MEASURES: Prevalence of MetS.
RESULTS: 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.
CONCLUSIONS: 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.
DESIGN: Retrospective analysis of a database.
SETTING: Academic Hospital.
POPULATION: A total of 854 women aged 16-40 years having PCOS according to Rotterdam criteria.
METHODS: 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.
MAIN OUTCOMES MEASURES: Prevalence of MetS.
RESULTS: 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.
CONCLUSIONS: 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.