Dyslipidemia and oxidative stress in PCOS

Polycystic ovary syndrome (PCOS) is a common metabolic and reproductive disorder in women. An increased cardiovascular risk has to be anticipated in PCOS as it is a metabolically unstable condition. Among cardiovascular risk factors, dyslipidemia is certainly the most persistent and highly prevalent. Predominant observation is an elevation of LDL cholesterol in all PCOS patients. Decreased concentrations of HDL cholesterol are found in obese PCOS from the third decade of life onwards while triglycerides start to rise from the second decade of life. PCOS is associated with oxidative stress, namely increased production of free radicals followed by decreased serum antioxidant levels and antioxidant enzyme activity. Broad range of endocrine and metabolic disturbances like obesity, hyperinsulinemia as well as dyslipidemia might be responsible for PCOS-associated oxidative stress. Therapeutic interventions in PCOS women based on lifestyle modification as well as use of insulin sensitizers did not show significant effect on dyslipidemia. Statins are considered to be a group of promising agents that are safe and effective in improving total cholesterol, LDL cholesterol and triglycerides, and possess antioxidant activity. Supplementation with omega-3 fatty acids, α-lipoic acid and N-acetylcysteine is considered to have an anti-inflammatory and antioxidant effect and to improve dyslipidemia and insulin sensitivity in PCOS women.