Impaired ApoB-Lipoprotein and Triglyceride Metabolism in Obese Adolescents With Polycystic Ovary Syndrome.

Context: Adolescents with polycystic ovary syndrome (PCOS) have atherogenic dyslipidemia and increased cardiovascular disease (CVD) risk, and this is exacerbated in obesity. Objective: To determine and compare fasting and nonfasting lipid and apolipoprotein (Apo) Blipoprotein metabolism in 3 groups of adolescent girls: healthy-weight controls, obese without PCOS (obese-control), and obese with PCOS (obese-PCOS). Design, setting, and participants: Participants aged 12 to 17 years were recruited for this crosssectional study from a pediatric weight management clinic and the local community in Alberta, Canada. Main Outcome Measures: Plasma lipids and ApoB lipoproteins, including triglycerides (TGs) and ApoB100-and ApoB48-lipoproteins, were measured in the fasted and postprandial state following a high-fat meal. Results: Obese-control (n = 12) and obese-PCOS (n = 18) groups had twofold higher concentrations of fasting plasma TG and ApoB100-and ApoB48-lipoprotein remnants compared to healthy-weight controls (n = 10) (ApoB48-lipoproteins: 19.32 +/- 2.10, 24.02 +/- 4.28, and 8.95 +/- 1.05 mu g/mL, respectively; P < 0.001). The obese-PCOS group had 50% higher fasting plasma TG level compared to the obese-control group. The postprandial response was higher in both obese-controls and obese-PCOS subjects compared with healthy-weight controls in plasma TG area under the curve (AUC) (1028.0 +/- 83.67, 1587.01 +/- 259.6, and 615.42 +/- 76.42 mg/mL center dot h, respectively; P < 0.01) and ApoB48((AUC)) (191.30 +/- 19.06, 238.8 +/- 37.73, and 96.58 +/- 9.17 mg/ mL center dot h, respectively; P < 0.0001). Nonfasting plasma TG((AUC)) and ApoB48((AUC)) were positively correlated with free testosterone (r = 0.38; P < 0.001 and r = 0.33; P < 0.05, respectively), and these relationships were highly associated with insulin and body mass index. Conclusions: Adolescent girls with obesity and PCOS have elevated fasting and postprandial plasma TG and ApoB-lipoprotein remnants, providing evidence of early subclinical CVD risk, and these indices are highly associated with impaired insulin metabolism and hyperandrogenemia.