Diagnostic value of four serum lipoprotein ratios in patients with polycystic ovary syndrome for metabolic syndrome

doi:10.3969/j.issn.1006-7795.2015.04.009

Abstract

Abstract:

Objective To investigate and compare predictive diagnostic value of the low density lipoprotein-cholesterol(LDL-C)/high density lipoprotein-cholesterol(HDL-C), apolipoprotein(Apo)B/ApoAI, triglyceride(TG)/HDL-C, total cholesterol(TC)/HDL-C ratios for metabolic syndrome(MS) in patients with polycystic ovary syndrome(PCOS). Methods A total of 441 patients with PCOS were included in this study, whose height, weight, waist circumference were measured. Fasting venous blood specimens were collected on their first to fifth day of menstrual cycle to measure their concentration of sex hormones and metabolic parameters. All patients were devided into two groups according to the international diabetes federation(IDF) diagnostic criteria: MS group and non-MS group. Differences between the two groups were compared, including age, blood pressure, BMI, waist circumference, waist-to hip circumference ratio, fasting glucose, fasting insulin, LDL-C, HDL-C, Lp(a), triglyceride, total cholesterol etc. Correlations between the 4 ratios and parameters in MS diagnostic criteria mentioned above were analyzed respectively. The whole patients were divided into 6 groups by the number of abnormal component, from 0 component to 5 components. The mean values of 4 ratios were compared between 6 groups. The diagnostic value of 4 ratios were determined and compared by ROC curves. Results Mean values of the 4 serum lipoprotein ratio were increased as increase in the number of abnormal components, and all of the ratios were significantly correlated with parameters in MS criteria. TG/HDL-C obtained the highest area under the curve(AUC) of 0.941 determined by ROC curves, suggesting that TG/HDL-C has the greatest diagnostic value of MS. The cutoff value of TG/HDL-C was set at 1.089, with the sensitivity of 0.864 and the specificity of 0.891. Conclusion TG/HDL-C has the best diagnostic value for MS among 4 ratios. Patients with PCOS whose TG/HDL-C ratio is over 1.089 should be informed about the risk of MS, and take medical intervention to prevent MS.

Key words: serum lipoprotein ratio, metabolic syndrome, polycystic ovary syndrome, cardiovascular disease, diagnostic value

CLC Number:

R711.75

Li Yanglu, Ruan Xiangyan, Cui Yamei, Zhao Yue, Wu Hongqin, Du Juan, Alfred O. Mueck. Diagnostic value of four serum lipoprotein ratios in patients with polycystic ovary syndrome for metabolic syndrome[J]. Journal of Capital Medical University, 2015, 36(4): 559-566.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2015.04.009

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2015/V36/I4/559

References

[1] Dokras A. Cardiovascular disease risk factors in polycystic ovary syndrome[J]. Semin Reprod Med, 2008,26(1):39-44.
[2] Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid lowering therapy-a review of the evidence[J]. J Intern Med, 2006,259(5):493-519.
[3] Millán J, Pintó X, Muoz A, et al. Lipoprotein ratios: physiological significance and clinical usefulness in cardiovascular prevention[J]. Vasc Health Risk Manag, 2009,5:757-765.
[4] Kannel W B, Vasan R S, Keyes M J, et al. Usefulness of the triglyceride-high-density lipoprotein versus the cholesterol-high-density lipoprotein ratio for predicting insulin resistance and cardiometabolic risk(from the Framingham Offspring Cohort)[J]. Am J Cardiol, 2008,101(4):497-501.
[5] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS)[J]. Hum Reprod, 2004,19(1):41-47.
[6] Alberti K G, Zimmet P, Shaw J. et al. The metabolic syndrome-a new worldwide definition[J]. Lancet, 2005,366(9491):1059-1062.
[7] Ehrmann D A, Liljenquist D R, Kasza K, et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome[J]. J Clin Endocrinol Metab, 2006,91(1):48-53.
[8] 胡卫红,乔杰,王黎娜,等.多囊卵巢综合征患者代谢综合征的发生及临床特征的相关性[J].北京大学学报,2010,42(2):159-163.
[9] 刘静,赵冬,王薇,等.北京自然人群代谢综合征发病率及影响因素的研究[J].心肺血管病杂志,2007,26(2):65-68.
[10] 顾东风,Reynolds K,杨文杰,等.中国成年人代谢综合征的患病率[J].中华糖尿病杂志,2005,13(3):181-186.
[11] Zhang J, Fan P, Liu H, et al. Apolipoprotein A-I and B levels, dyslipidemia and metabolic syndrome in south-west Chinese women with PCOS[J]. Hum Reprod, 2012,27(8):2484-2493.
[12] Walldius G, Jungner I. Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy[J]. J Intern Med, 2004,255(2):188-205.
[13] Natarajan S, Glick H, Criqui M, et al. Cholesterol measures to identify and treat individuals at risk for coronary heart disease[J]. Am J Prev Med, 2003,25(1):50-57.
[14] Xiang S K, Hua F, Tang Y, et al. Relationship between serum lipoprotein ratios and Insulin resistance in polycystic ovary syndrome[J]. Int J Endocrinol, 2012,2012:173281.
[15] Genest J, Frohlich J, Fodor G, et al. Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease: summary of the 2003 update[J]. CMAJ, 2003,169(9):921-924.
[16] Sierra-Johnson J, Romero-Corral A, Somers V K, et al. ApoB/apoA-I ratio: an independent predictor of insulin resistance in US non-diabetic subjects[J]. Eur Heart J, 2007,28(21):2637-2643.
[17] Carnevale Schianca G P, Pedrazzoli R, Onolfo S, et al. ApoB/apoA-I ratio is better than LDL-C in detecting cardiovascular risk[J]. Nutr Metab Cardiovasc Dis, 2011,21(6):406-411.
[18] Ingelsson E, Schaefer E J, Contois J H, et al. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women[J]. JAMA, 2007,298(7):776-785.
[19] Boizel R, Benhamou P Y, Lardy B, et al. Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels[J]. Diabetes Care, 2000,23(11):1679-1685.
[20] 崔常清.胰岛素抵抗的机制与临床研究进展[J].中国煤炭工业医学杂志,2012,15(7):1119-1121.