LIPID AND APOLIPOPROTEIN ABNORMALITIES IN HIRSUTE WOMEN .1. THE ASSOCIATION WITH INSULIN RESISTANCE

OBJECTIVE: We attempted to evaluate apolipoprotein lipid levels in hirsute hyperandrogenic women and to clarify the influence of insulin resistance versus endogenous sex steroids on these profiles. STUDY DESIGN: Forty-seven women seen for evaluation of hirsutism in the Reproductive Endocrine Clinic were contrasted with 15 normal women. Thirty-one patients were treated with the gonadotropin-releasing hormone analog, leuprolide acetate, 7.5 mg intramuscularly monthly for 3 months. Insulin resistance was assessed before and after GnRH analog administration. Mean concentrations were compared with the Student t test and analysis of variance. RESULTS: Hirsute women were heavier and had higher systolic and diastolic blood pressures, more menstrual irregularities (all p < 0.01), and higher waist/hip ratios (p < 0.05). They had higher triglyceride, very-low-density lipoprotein cholesterol, and apolipoprotein C-III levels and lower high-density lipoprotein cholesterol concentrations (all p < 0.01). They had lower apolipoprotein A-I/A-II ratios (p < 0.01). After administration of GnRH analog, androgen and estrogens were suppressed and insulin resistance was unaltered. Insulin correlated with apolipoprotein lipid abnormalities. CONCLUSION: Lipid and apolipoprotein abnormalities in these hirsute women seem to be associated more with insulin resistance than with endogenous androgens or estrogens.