Please cite this paper as: Dewailly D, Contestin M, Gallo C, Catteau-Jonard S. Metabolic syndrome in young women with the polycystic ovary syndrome: revisiting the threshold for an abnormally decreased high-density lipoprotein cholesterol serum level. BJOG 2010;117:175–180.
Objective To verify whether the adult threshold for an abnormally decreased high-density lipoprotein cholesterol (HDL-C) serum level (0.5 g/l) is appropriate in young women with polycystic ovary syndrome (PCOS).
Design Retrospective analysis of a database.
Setting Academic Hospital.
Population A total of 854 women aged 16–40 years having PCOS according to Rotterdam criteria.
Methods Criteria defining the metabolic syndrome (MetS) (increased waist circumference, systolic and/or diastolic blood pressure, triglycerides, fasting glycaemia and decreased HDL-C) were separately analysed and compared in three different subgroups (16–20 years, 20–30 years and 30–40 years). The prevalence of the MetS was calculated using two different thresholds (0.5 and 0.4 g/l) for HDL-C in the 16–20 years group.
Main outcomes measures Prevalence of MetS.
Results The prevalence of an abnormal HDL-C (<0.5 g/l) was higher in the youngest women (60%), whereas frequencies of abnormal waist circumference, systolic and/or diastolic blood pressure, triglycerides and fasting glycaemia were lower than in the two other groups. The prevalence of an abnormal HDL-C dropped to 27% when using a threshold of 0.4 g/l in the 16–20 years subgroup. The prevalence of the MetS in the 16–20 years subgroup was 11%, whatever the threshold, because HDL-C was <0.4 g/l in all women once they scored 3 or more.
Conclusions The adult threshold for HDL-C overestimates the prevalence of abnormal HDL-C in young women with PCOS. Until normative data about HDL-C in adult women under 20 years is available, we suggest using a threshold of 0.4 g/l or ignoring this criterion.