Anti-oxidative function and composition of high-density-lipoprotein (HDL) in the polycystic ovary syndrome

The polycystic ovary syndrome (PCOS) is characterised by oligo-amenorhea,
clinical or biochemical hyperandrogenism and polycystic ovaries on ultrasound.
It affects approximately 5 % of premenopausal women. PCOS is associated with
insulin resistance, dyslipidemia and abnormal surrogate endpoints for
atherosclerosis. Several patterns of dyslipidemia have been described in PCOS;
low high density lipoprotein (HDL)-cholesterol is a frequent finding.
HDL particles play an important role in the protection against atherosclerosis,
in part by their anti-oxidative capacity. The composition of an HDL particle is
a determinant of its function.
Both insulin resistance and low levels of plasma HDL-cholesterol have been
associated with impaired anti-oxidative function of HDL particles in
predominantly male study populations. No studies of anti-oxidative function of
HDL in women have been performed yet.
We hypothesize that PCOS women, who are often obese and insulin resistant, and
frequently have low plasma HDL-cholesterol, have impaired (composition and)
anti-oxidative function of HDL particles, contributing to their cardiovascular
risk.

Endothelial progenitor cells (EPC*s) are involved in endothelial repair. The
circulating number of EPC*s is reduced in patients with cardiovascular risk
factors, such as insulin resistance. We hypothesize that PCOS women, who are
often insulin resistant, have lower circulating numbers of EPC*s than controls.

Primary research question

Do obese PCOS women with reduced insulin sensitivity have HDL particles that
have impaired anti-oxidative function in comparison with lean controls with
normal insulin sensitivity?


Secondary research question

Do obese PCOS women with reduced insulin sensitivity have a different
composition of HDL particles in comparison with lean controls with normal
insulin sensitivity?


Explorative research question

Do obese PCOS women with reduced insulin sensitivity have lower numbers of
circulating endothelial progenitor cells (EPC*s) in comparison with lean
controls with normal insulin sensitivity?

Case-control

Questionaire on cardiovascular risk factors.
Physical examination: height, weight, waist- en hip circumference
Vena punction: max 50 ml blood

Abnormal values for cholesterol, triglycerides or glucose could be found,
requiring further investigation and treatment.

Burden and risk are estimated to be low.