Lipid and apolipoprotein abnormalities in hirsute women. I. The association with insulin resistance.

OBJECTIVE

We attempted to evaluate apolipoprotein lipid levels in hirsute hyperandrogenic women and to clarify the influence of insulin resistance versus endogenous sex steroids on these profiles.

STUDY

DESIGN

Forty-seven women seen for evaluation of hirsutism in the Reproductive Endocrine Clinic were contrasted with 15 normal women. Thirty-one patients were treated with the gonadotropin-releasing hormone analog, leuprolide acetate, 7.5 mg intramuscularly monthly for 3 months. Insulin resistance was assessed before and after GnRH analog administration. Mean concentrations were compared with the Student t test and analysis of variance.

RESULTS

Hirsute women were heavier and had higher systolic and diastolic blood pressures, more menstrual irregularities (all p less than 0.01), and higher waist/hip ratios (p less than 0.05). They had higher triglyceride, very-low-density lipoprotein C-III levels and lower high-density lipoprotein cholesterol concentrations (all p less than 0.01). They had lower apolipoprotein A-I/A-II ratios (p less than 0.01). After administration of GnRH analog, androgen and estrogens were suppressed and insulin resistance was unaltered. Insulin correlated with apolipoprotein lipid abnormalities.

CONCLUSION

Lipid and apolipoprotein abnormalities in these hirsute women seem to be associated more with insulin resistance than with endogenous androgens or estrogens.