Background: Polycystic ovary syndrome (PCOS) is associated with reproductive and metabolic abnormalities. It is unknown whether overweight women with and without PCOS achieve similar benefits from weight loss for cardiovascular risk factors.

Method: Overweight BMI-matched women with (n=15) and without (n=17) PCOS (weight 95.3±17.6 kg, BMI 35.6±5.3 kg/m2, mean±SD) followed an 8-week weight loss regime.

Results: All subjects had similar reductions in weight (3.9±3.6 kg, 3.8% versus 4.5±4.1 kg, 4.7% respectively for PCOS and non-PCOS), waist circumference, fat mass, triglycerides, free testosterone and fasting and post-prandial insulin. At baseline, C-reactive protein (CRP) between groups was not significantly different (5.5±3.1 mg/L PCOS versus 4.9±3.0 mg/L non-PCOS). There was a significant interaction between PCOS status and CRP (P=0.016) such that CRP decreased with weight loss for non-PCOS women (-1.2±1.8 mg/L, P=0.025) but not for PCOS women. For all women, the change in CRP correlated with the change in weight (r=0.560 P=0.003), fat mass (r=0.477 P=0.016) and post-prandial insulin (r=0.402 P=0.046). Adiponectin, IL-6 and TNF- were not significantly different between groups before or after weight loss. Only subjects with baseline CRP levels below the median (4.52 mg/L) showed increases in adiponectin (0.98±1.3 µg/L) (P=0.015) and greater reductions in triglycerides (P=0.001) with weight loss.

Conclusion: A 4-5% weight loss improved lipid, glucose and insulin profiles in women with and without PCOS. This degree of weight loss was not effective in lowering CRP concentrations in PCOS women, suggesting that greater weight loss is required in this group to achieve equivalent cardiovascular benefit as non-PCOS women.