Lipid profile in nonobese pregnant women with polycystic ovary syndrome: a prospective controlled clinical study.

Alterations in lipid pattern and increased risk for obstetric/neonatal complications have been observed in 34 patients with polycystic ovary syndrome (PCOS). Pregnancy leads to physiologic changes in lipoprotein 35 metabolism, and alterations in lipid profile have been related with adverse pregnancy outcomes. Based 36 on these considerations, the aim of the present prospective controlled clinical study was to test the 37 hypothesis that the changes in the lipid profile in patients with PCOS during pregnancy are characteristic 38 and potentially related to the increased risk of obstetric/neonatal complications. One hundred and fifty 39 nonobese PCOS women and 150 age- and body mass index (BMI)-matched healthy controls were 40 enrolled. Serum lipids, glucose, insulin, and androgens levels were serially assayed in all subjects before 41 and throughout pregnancy. Serum low-density lipoprotein (LDL) and triglyceride (TG) concentrations 42 were significantly (P < 0.05) higher in PCOS group than in healthy controls at each assessment. Through- 43 out pregnancy, serum LDL and TG levels increased significantly (P < 0.05) in both groups, although the 44 change from pre-pregnancy values was significantly (P < 0.05) greater in PCOS patients than in healthy 45 controls. A significant (P < 0.05) relationship was observed between serum LDL and TG changes and 46 changes in both insulin sensitivity indexes and androgen levels in PCOS patients alone. After adjusting 47 for maternal age, pre-pregnancy BMI and lipid levels, body weight gain, and insulin-resistance markers, 48 serum TG concentrations during pregnancy were directly and independently associated with obstetric 49 complications in both groups, whereas serum LDL levels only in PCOS patients. We can conclude that 50 nonobese PCOS patients had specific changes in lipid profile during pregnancy, and that the lipid pattern 51 typical of PCOS may account for the more frequent adverse pregnancy outcomes. PCOS-related hormonal 52 and metabolic features, such as insulin resistance and high androgen levels, may mediate this 53 phenomenon.