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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EDyslipidemia occurs in up to 70% of women with polycystic ovary syndrome (PCOS) in the United States. This article discusses the latest findings on the etiology, screening, and treatments for PCOS.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPolycystic Ovary Disorder\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELipid Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EDyslipidemia occurs in up to 70% of women with polycystic ovary syndrome (PCOS) in the United States. Tracy Lynn Setji, MD, Duke University Medical Center, Durham, North Carolina, USA, discussed the latest findings on the etiology, screening, and treatments for PCOS. Roughly 60% of women with PCOS are obese and insulin-resistant. At menopause, a woman with PCOS is likely to have had multiple cardiac risk factors for several decades [McGowan MP. \u003Cem\u003ECurr Treat Cardiovasc Med\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPCOS is the most common endocrinopathy among women of reproductive age, impacting 5% to 10% of premenopausal American women. Up to 40% of women with the syndrome will develop diabetes by the age of 50 years, and many are dyslipidemic [McGowan MP. \u003Cem\u003ECurr Treat Options Cardiovasc Med\u003C\/em\u003E 2011]. Beyond known alterations in triglycerides and high-density lipoprotein-cholesterol (HDL-C), women with PCOS have higher low-density lipoprotein-cholesterol (LDL-C) and non-HDL-C, regardless of their body mass index (BMI).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EA recent systematic review and meta-analysis found that triglyceride levels were 26 mg\/dL higher (95% CI, 17 to 35) and HDL-C concentrations 6 mg\/dL lower (95% CI, 4 to 9) in women with PCOS than in controls. LDL-C and non-HDL-C concentrations were also higher in PCOS subjects by 12 mg\/dL (95% CI, 10 to 16) and 19 mg\/dL (95% CI, 16 to 22), respectively [Wild RA et al. \u003Cem\u003EFertil Steril\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EDr. Setji reported that the atherogenic lipoprotein profile is likely related to insulin resistance. The elevation in LDL-C also appears to be due in part to hyperandrogenemia. Free androgen index (FAI), which is associated with increased LDL-C, is improved with administration of flutamide [Gambineri A et al. \u003Cem\u003EClin Endocrinol (Oxf)\u003C\/em\u003E 2004].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAndrogens are involved in the regulation of lipoprotein lipase and hepatic lipase activity (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). While estrogens increase the rate of LDL-C clearance by inducing upregulation of LDL-C receptors, androgens attenuate this process, decreasing catabolic removal of LDL-C [Diamanti-Kandarakis E et al. \u003Cem\u003ETrends Endocrinol Metab\u003C\/em\u003E 2007]. Testosterone administration has significant effects on lipid profiles but not on insulin resistance [Cupisti S et al. \u003Cem\u003EFertil Steril\u003C\/em\u003E 2010].\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12291\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12291\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12291\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EAndrogen Effects on LDL-C.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EGeographic, genetic, and lifestyle factors also affect the severity of dyslipidemia. Studies that compare women with PCOS from the Mediterranean region and the United States highlight these differences. Additionally, within the US, African-American women with PCOS have better lipid profiles than Caucasian women with the syndrome.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EAccording to Wild et al. [Wild RA et al. \u003Cem\u003EFertil Steril\u003C\/em\u003E 2011], women with PCOS should have a complete lipid profile, with reassessment every 2 years if normal and sooner if significant weight gain occurs (\u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12292\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12292\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12292\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n            \u003Cp id=\u0022p-10\u0022 class=\u0022first-child\u0022\u003EScreening Recommendations.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-11\u0022\u003EBesides modest increases in LDL-C, with a higher concentration of small, dense LDL-C, dyslipidemia in PCOS is also associated with a reduction in subclass HDL\u003Csub\u003E2\u003C\/sub\u003E. This category contains more cholesterol molecules per unit of alipoprotein than HDL\u003Csub\u003E3\u003C\/sub\u003E and may put women with the syndrome at higher risk for coronary artery disease [Demacker PN et al. \u003Cem\u003EAtherosclerosis\u003C\/em\u003E 1986]. Some studies also show decreases in apoA-1.\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003ELifestyle modification is first-line therapy, with low-fat diet and regular moderate-intensity exercise. Even without weight loss, moderate-intensity exercise (at least 30 minutes) a day can improve dyslipidemia in PCOS [Brown AJ et al. \u003Cem\u003EMed Sci Sports Exerc\u003C\/em\u003E 2009].\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/5\/29.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzn2h1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzn2h1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}