Flavia Tosi1, Daniela Di Sarra, Jean-Marc Kaufman, Cecilia Bonin, Rosa Moretta, Enzo Bonora, Elisabetta Zanolin, Paolo Moghetti. 1. Departments of Endocrinology, Diabetes, and Metabolism (F.T., D.D., R.M., E.B., P.M.), and Obstetrics and Gynaecology (C.B.), University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; Laboratory for Hormonology and Department of Endocrinology (J.-M.K.), Ghent University Hospital, 9000 Ghent, Belgium; and Department of Public Health and Community Medicine (E.Z.), University of Verona, 37129 Verona, Italy.
Abstract
CONTEXT/ OBJECTIVE: Obesity is a common feature of women with polycystic ovary syndrome (PCOS). The aim of this study was to assess the role of body fat on insulin resistance and androgen excess in these subjects. PATIENTS/ DESIGN: One hundred sixteen consecutive Caucasian women with PCOS, diagnosed by the Rotterdam criteria, underwent accurate assessment of clinical, anthropometric, hormonal, and metabolic features. In particular, total fat mass and fat distribution were assessed by dual-energy x-ray absorptiometry, serum-free T by liquid chromatography mass spectrometry and equilibrium dialysis and insulin sensitivity by the glucose clamp technique. RESULTS: Total fat mass and truncal fat were significantly higher in insulin-resistant than in insulin-sensitive PCOS subjects (+89% and +127%, respectively, both P < .001), and both tended to be higher in hyperandrogenemic than in normoandrogenemic women (+22% and +28%, respectively, P = .087 and P = .090). All parameters of adiposity correlated inversely with insulin sensitivity (P < .001) and directly with serum-free T (P ≤ .001). A statistically significant inverse relationship was observed between insulin sensitivity and serum-free T concentrations (r = -0.527, P < .001). In a multiple regression analysis, either total fat mass or truncal fat, in addition to serum-free T and age, were independent predictors of insulin sensitivity. However, insulin sensitivity, but not total fat mass or truncal fat, was an independent predictor of free T concentrations. CONCLUSIONS: These data suggest that body fat contributes to determining insulin resistance in PCOS women. However, the association between body fat and hyperandrogenism seems to be to a large extent explained by insulin resistance.
CONTEXT/ OBJECTIVE: Obesity is a common feature of women with polycystic ovary syndrome (PCOS). The aim of this study was to assess the role of body fat on insulin resistance and androgen excess in these subjects. PATIENTS/ DESIGN: One hundred sixteen consecutive Caucasian women with PCOS, diagnosed by the Rotterdam criteria, underwent accurate assessment of clinical, anthropometric, hormonal, and metabolic features. In particular, total fat mass and fat distribution were assessed by dual-energy x-ray absorptiometry, serum-free T by liquid chromatography mass spectrometry and equilibrium dialysis and insulin sensitivity by the glucose clamp technique. RESULTS: Total fat mass and truncal fat were significantly higher in insulin-resistant than in insulin-sensitive PCOS subjects (+89% and +127%, respectively, both P < .001), and both tended to be higher in hyperandrogenemic than in normoandrogenemic women (+22% and +28%, respectively, P = .087 and P = .090). All parameters of adiposity correlated inversely with insulin sensitivity (P < .001) and directly with serum-free T (P ≤ .001). A statistically significant inverse relationship was observed between insulin sensitivity and serum-free T concentrations (r = -0.527, P < .001). In a multiple regression analysis, either total fat mass or truncal fat, in addition to serum-free T and age, were independent predictors of insulin sensitivity. However, insulin sensitivity, but not total fat mass or truncal fat, was an independent predictor of free T concentrations. CONCLUSIONS: These data suggest that body fat contributes to determining insulin resistance in PCOSwomen. However, the association between body fat and hyperandrogenism seems to be to a large extent explained by insulin resistance.
Authors: Samantha C Fisch; Ariella Farzan Nikou; Elizabeth A Wright; Julia D Phan; Karen L Leung; Tristan R Grogan; David H Abbott; Gregorio D Chazenbalk; Daniel A Dumesic Journal: Fertil Steril Date: 2018-12 Impact factor: 7.329
Authors: Daniel A Dumesic; Julia D Phan; Karen L Leung; Tristan R Grogan; Xiangmiang Ding; Xinmin Li; Luis R Hoyos; David H Abbott; Gregorio D Chazenbalk Journal: J Clin Endocrinol Metab Date: 2019-06-01 Impact factor: 5.958
Authors: Daniel A Dumesic; Alin L Akopians; Vanessa K Madrigal; Emmanuel Ramirez; Daniel J Margolis; Manoj K Sarma; Albert M Thomas; Tristan R Grogan; Rasha Haykal; Tery A Schooler; Bette L Okeya; David H Abbott; Gregorio D Chazenbalk Journal: J Clin Endocrinol Metab Date: 2016-08-29 Impact factor: 5.958