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Hum. Reprod. Advance Access published online on March 27, 2009
Human Reproduction, doi:10.1093/humrep/dep072
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Lipid accumulation product index: a reliable marker of cardiovascular risk in polycystic ovary syndrome

D. Wiltgen1,2,3, I.G. Benedetto1,2, L.S. Mastella1,2 and P.M. Spritzer1,2,3,4

1 Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil 2 Laboratory of Molecular Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil 3 National Institute of Hormones and Women's Health- CNPq, Porto Alegre, Brazil

4 Correspondence address. Division of Endocrinology, Hospital de Clinicas de Porto Alegre Rua Ramiro Barcelos, 2350, CEP 90035-003 – Porto Alegre, RS – Brazil. Tel/Fax: +55-51-3308-3671; E-mail: spritzer{at}ufrgs.br

BACKGROUND: Metabolic disturbances are common features of polycystic ovary syndrome (PCOS), which possibly enhance the risk of cardiovascular disease. The aim of this study was to assess the accuracy of lipid accumulation product (LAP) index as a marker of cardiovascular risk in PCOS patients.

METHODS: Case–control study including 51 PCOS patients aged between 14 and 35 years and 44 body mass index (BMI) and age-matched controls. Measures included the LAP index, homeostasis model assessment (HOMA) index, glucose tolerance and plasma hormones, cholesterols and triglycerides.

RESULTS: LAP index was positively correlated with HOMA index in all subjects (r = 0.70; P < 0.001). Waist circumference (WC) (P = 0.002), HOMA index (P < 0.001) and LAP index (P = 0.035) were higher in PCOS patients than controls. On receiver operating characteristic curve analysis, an LAP index of 34.5 (sensitivity: 84%; specificity 79%) showed a better performance than non-high-density lipoprotein cholesterol, WC or BMI to identify insulin resistance (IR) in all subjects. In PCOS patients, the positive and negative predictive values for LAP ≥ 34.5 were 91 and 74%, respectively, compared with 73 and 61%, respectively, for WC ≥80 cm, and 43 and 20%, respectively, for WC ≥88 cm.

CONCLUSIONS: We have confirmed that IR is more common in PCOS than BMI-matched control women. Furthermore, the LAP index, an easily obtainable measure, is associated with HOMA index and an LAP ≥ 34.5 is an additional risk factor for cardiovascular disease in PCOS patients.

Key words: insulin resistance/homeostasis model assessment index/polycystic ovary syndrome/cardiovascular disease/lipid accumulation product index

Submitted on December 14, 2008; resubmitted on February 24, 2009; accepted on February 27, 2009.


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