Atherogenic Apolipoprotein Profile in Women with Polycystic Ovary Syndrome: Association with Paraoxonase-1 Activity

Abstract

Background Women with polycystic ovarian syndrome (PCOS) usually have dyslipidemia and an elevated cardiovascular risk. Paraoxonase-1 (PON1), an HDL-associated antioxidant enzyme, may contribute to changes in the apolipoprotein profile linked to atherogenesis. Aim of the Study: To investigate the connection between the atherogenic apolipoprotein profile and serum PON1 activity in PCOS-affected women. Methods: This case-control study included 50 women with newly diagnosed PCOS and 30 age-matched healthy controls. Apolipoprotein A-1 (ApoA-1), Apolipoprotein B (ApoB), serum PON1 activity, and the ApoB/ApoA-1 ratio were assessed. Independent samples t-test, Pearson's correlation analysis, and multiple linear regression analysis were performed. Results: While ApoB levels and the ApoB/ApoA-1 ratio were considerably greater than those of healthy controls, women with PCOS had significantly reduced PON1 activity and ApoA-1 concentrations (all P < 0.001). PON1 activity was significantly correlated negatively with BMI, ApoB, and the ApoB/ApoA-1 ratio, and positively with ApoA-1. After controlling for age and BMI, multiple linear regression analysis showed that PCOS was still independently linked to decreased PON1 activity. Study limitation: It is crucial to consider the several limitations of this study when assessing the findings. First, because of the single-center design and limited sample size, the results might not be as widely applicable. Second, a causal connection between decreased PON1 activity and the noted changes in the apolipoprotein profile cannot be established due to the case-control design. Third, no inflammatory biomarkers nor traditional lipid profile measures (total cholesterol, LDL-C, HDL-C, and triglycerides) were assessed. Finally, bigger prospective multicenter investigations are needed to corroborate these findings and further elucidate the significance of PON1 as a possible biomarker of cardiometabolic risk in women with PCOS. Conclusion: Reduced PON1 activity is linked to an unfavorable apolipoprotein profile in PCOS patients, suggesting that the development of atherogenic lipid abnormalities may be influenced by inadequate antioxidant defense.