Women with polycystic ovary syndrome have higher Lp(a) than controls regardless of weight, a meta-analysis of 2,337 patients across 23 studies (High Blood Press Cardiovasc Prev 2023)

Original title: Plasma Lipoprotein(a) Levels in Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis

High Blood Press Cardiovasc Prev · 7 June 2023 · 6

Masson W, Barbagelata L, Lobo M, Lavalle-Cobo A, Corral P, Nogueira JP

This PRISMA-guided meta-analysis of 23 observational studies (2,337 patients) compared Lp(a) levels in women with polycystic ovary syndrome (PCOS) against controls. Women with PCOS had significantly higher Lp(a) overall (standardised mean difference 1.1, 95% CI 0.7-1.4, I2=93%), with similar effects in normal-weight (SMD 1.2, 95% CI 0.5-1.9) and overweight subgroups (SMD 1.2, 95% CI 0.5-1.8). Sensitivity analysis confirmed the results were robust. The findings suggest PCOS carries elevated cardiovascular risk via higher Lp(a), independent of body weight, supporting consideration of Lp(a) screening in this population.

Original abstract

Introduction: The polycystic ovary syndrome (PCOS) may represent an important model of lipid alterations. Lipoprotein(a) [Lp(a)] has emerged as a new marker of cardiovascular risk.

Aim: The main objective of this meta-analysis was to analyze the available evidence on Lp(a) levels in patients with PCOS compared to a control group.

Methods: This meta-analysis was performed according to PRISMA guidelines. A literature search was performed to detect studies that have quantified Lp(a) levels in women with PCOS compared to a control group. The primary outcome was Lp(a) levels expressed in mg/dL. Random effects models were used.

Results: Twenty-three observational studies including 2,337 patients were identified and considered eligible for this meta-analysis. In the overall analysis, the quantitative analysis showed that patients with PCOS have a higher Lp(a) levels (SMD: 1.1 [95% CI: 0.7 to 1.4]; I2=93%) compared to the control group. The results were similar in the analysis of the subgroups of patients according to body mass index (normal weight group: SMD: 1.2 [95% CI: 0.5 to 1.9], I2=95%; overweight group: SMD: 1.2 [95% CI: 0.5 to 1.8], I2=89%). Sensitivity analysis showed that the results were robust.

Conclusions: This meta-analysis shows that women with PCOS had higher levels of Lp(a) compared to healthy women used as a control group. These findings were observed in both overweight and non-overweight women.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.