Obesity contributes more to increasing ApoB/ApoA1 ratio than hyperandrogenism in PCOS women aged 20–38 years in China

We investigated the association between the apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) ratio and insulin resistance (IR), metabolic syndrome (MS) and its components in Chinese polycystic ovary syndrome (PCOS) adults. We also examined whether hyperandrogenism is involved in obesity-related metabolic abnormalities in a cohort of patients. A clinical cross-sectional study consisting of 532 Chinese PCOS adults aged 20-38 years was designed. Each subject underwent a physical examination and laboratory evaluation. We found that the ApoB/ApoA1 ratio was significantly higher in patients with MS compared to those without MS. This test provided 83.6% sensitivity and 67.6% specificity with a threshold value of 0.60 in MS. The ApoB/ApoA1 ratio increased significantly as the number of MS components increased. After adjusting for age, the patients with MS or IR were more likely to be in the high ApoB/ApoA1 group, and the ApoB/ApoA1 ratio was associated significantly with each of the MS components, high free testosterone (FT), and high free androgen index (FAI). After adjusting for age and body mass index (BMI), the association persisted for all factors excluding high blood pressure (BP), high fasting plasma glucose (FPG), high FT, and high FAI. Therefore, the ApoB/ApoA1 ratio was strongly associated with IR, MS and its components, high FT, and high FAI. A high ApoB/ApoA1 ratio appears to be a good predictive marker of MS in Chinese PCOS adults. Obesity, especially central obesity, contributes more to increasing ApoB/ApoA1 ratio than increased BP, FPG, FT and FAI in this cohort of PCOS patients.