Materials and Methods: As a prominent predisposing risk factor for PCOS, serum lipid profiles (Triglyceride, Total cholesterol, HDL, LDL, Apo lipoprotein A–I, Apo lipoprotein B and lipoprotein A), were analyzed in 154 subjects of PCOS. The diagnosis of PCOS has been based on the Rotterdam consensus criteria in this study. We also studied 16 identical twin pairs discordant for PCOS to evaluate the effects of environmental risk factors (including lipid indices profiles) for PCOS. Furthermore, we compared these 16 twin pairs with PCOS, in which just 15 (93.75%) of them was concordant for abnormal lipid profiles. Also the impact of lipid profile in patients with PCOS was confirmed by comparing total 22 identical and non-identical twin pairs, in which 21 out of them (95.45%) showed abnormal lipid profiles.

Result: PCOS and increased cholesterol level were higher in identical versus non-identical twins with concordance rates of 1.5 and 1.65 (based on the Rotterdam consensus criteria), respectively. Analysis of identical pairs showed weak association between impact of lipid profile and PCOS while in non-identical pairs, the PCOS was associated with an increased environmental risk (lipid profile).

Conclusion: Different lipid indices were affected by environmental and genetic risk factors in PCOS, but the contribution of environmental and genetic factors to the various PCOS-related changes in ovarian structures remains to be established.