Association between Lipid Accumulation Product and Hirsutism in Patients with Polycystic Ovary Syndrome

Abstract

Objective Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disorder in women between menarche and menopause. Clinical hyperandrogenism is the most important diagnostic criterion of the syndrome, which manifests as hirsutism in 70% of cases. Hirsute carriers of PCOS have high cardiovascular risk. Lipid accumulation product (LAP) is an index for the evaluation of lipid accumulation in adults and the prediction of cardiovascular risk. The aim of this study was to evaluate the association between LAP and hirsutism in women with PCOS. Methods This was a cross-sectional observational study of a secondary database, which included 263 patients who had visited the Hyperandrogenism Outpatient Clinic from November 2009 to July 2014. The exclusion criteria were patients without Ferriman-Gallwey index (FGI) and/or LAP data. We used the Rotterdam criteria for the diagnosis of PCOS. All patients underwent medical assessment followed by measurement and recording of anthropometric data and the laboratory tests for measurement of the following: thyroid-stimulating hormone, follicle-stimulating hormone, prolactin, total testosterone, sex hormone binding globulin, 17-α-hydroxyprogesterone (follicular phase), glycohemoglobin A1c, and basal insulin. In addition, the subjects underwent lipid profiling and oral glucose tolerance tests. Other laboratory measurements were determined according to clinical criteria. LAP and the homeostatic model assessment index (HOMA-IR) were calculated using the data obtained. We divided patients into two groups: the PCOS group with normal LAP (< 34.5) and the PCOS group with altered LAP (> 34.5) to compare the occurrence of hirsutism. For statistical analysis, we used SPSS Statistics for Windows® and Microsoft Excel programs, with descriptive (frequencies, percentages, means, and standard deviations) and comparative analyses (Student's t-test and Chi-square test). We considered relations significant when the p-value was 0.05. Results LAP was high in most patients (n ¼ 177; 67.3%) and the FGI indicated that 58.5% of the patients (n ¼ 154) had hirsutism. The analysis by LAP quartiles showed a positive correlation (p ¼ 0.04) among patients with a high FGI and an upper quartile LAP (> 79.5) when compared with those with LAP < 29.0 (lower quartile). Conclusion This study demonstrated an association between high LAP and hirsutism. The FGI could represent a simple and low-cost tool to infer an increased cardiovascular risk in women with PCOS. ResumoObjetivo A síndrome dos ovários policísticos (SOP) é o distúrbio endócrino mais comum em mulheres entre a menarca e a menopausa. O hiperandrogenismo clínico é o critério diagnóstico mais importante da síndrome, que se manifesta como hirsutismo em 70% dos casos. Portadores de SOP hirsutas têm elevado risco cardiovascular. O Lipid accumulation product (LAP) é um índice para a avaliação da acumulação de lípidos nos adultos e é um preditor de risco cardiovascular. O objetivo deste estudo é avaliar a associação entre LAP e hirsutismo em por...