Joon Young Kim1, Hala Tfayli2, Sara F Michaliszyn3, Sojung Lee1, Silva Arslanian4. 1. Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 2. Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon. 3. Human Performance and Exercise Science, Youngstown State University, Pittsburgh, Pennsylvania. 4. Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: silva.arslanian@chp.edu.
Abstract
OBJECTIVE: To investigate the key physical, metabolic, hormonal and cardiovascular characteristics of metabolically healthy obese (MHO) versus unhealthy obese (MUHO) girls with polycystic ovary syndrome (PCOS). DESIGN: Cross-sectional study. SETTING: Research center. PATIENT(S): Seventy obese girls with PCOS were divided into 19 MHO and 51 MUHO based on cutoff points for in vivo insulin sensitivity (within and < 2 SDs of the mean of the insulin sensitivity of the normal-weight girls, respectively). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Body composition, abdominal fat, in vivo insulin sensitivity and secretion (hyperinsulinemic-euglycemic and hyperglycemic clamps respectively), hormonal profile, and cardiovascular disease risk markers. RESULT(S): MUHO-PCOS girls had higher waist circumference, visceral adipose tissue, leptin, and free testosterone, lower SHBG and E2, higher non-high-density lipoprotein (HDL) cholesterol and atherogenic lipoprotein particle concentrations, smaller HDL particle size, and higher high-sensitivity C-reactive protein compared with MHO-PCOS girls. Hepatic and peripheral insulin sensitivity were lower with higher first- and second-phase insulin secretion, but β-cell function relative to insulin sensitivity was lower in MUHO versus MHO. Pair matching of MHO and MUHO regarding age and body mass index revealed similar findings. MUHO-PCOS girls had larger visceral adiposity, lower insulin sensitivity and β-cell function, worse hormonal profile, and severely atherogenic lipoprotein concentrations compared with MHO-PCOS girls. CONCLUSION(S): MHO-PCOS girls have favorable physical, metabolic, hormonal, and cardiovascular disease (CVD) characteristics and lower risk biomarkers for type 2 diabetes compared with their MUHO-PCOS peers. A greater understanding of the contrast in this risk phenotype in obese girls with PCOS may have important implications for therapeutic interventions, their outcomes, and their durability.
OBJECTIVE: To investigate the key physical, metabolic, hormonal and cardiovascular characteristics of metabolically healthy obese (MHO) versus unhealthy obese (MUHO) girls with polycystic ovary syndrome (PCOS). DESIGN: Cross-sectional study. SETTING: Research center. PATIENT(S): Seventy obesegirls with PCOS were divided into 19 MHO and 51 MUHO based on cutoff points for in vivo insulin sensitivity (within and < 2 SDs of the mean of the insulin sensitivity of the normal-weight girls, respectively). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Body composition, abdominal fat, in vivo insulin sensitivity and secretion (hyperinsulinemic-euglycemic and hyperglycemic clamps respectively), hormonal profile, and cardiovascular disease risk markers. RESULT(S): MUHO-PCOS girls had higher waist circumference, visceral adipose tissue, leptin, and free testosterone, lower SHBG and E2, higher non-high-density lipoprotein (HDL) cholesterol and atherogenic lipoprotein particle concentrations, smaller HDL particle size, and higher high-sensitivity C-reactive protein compared with MHO-PCOSgirls. Hepatic and peripheral insulin sensitivity were lower with higher first- and second-phase insulin secretion, but β-cell function relative to insulin sensitivity was lower in MUHO versus MHO. Pair matching of MHO and MUHO regarding age and body mass index revealed similar findings. MUHO-PCOS girls had larger visceral adiposity, lower insulin sensitivity and β-cell function, worse hormonal profile, and severely atherogenic lipoprotein concentrations compared with MHO-PCOSgirls. CONCLUSION(S): MHO-PCOSgirls have favorable physical, metabolic, hormonal, and cardiovascular disease (CVD) characteristics and lower risk biomarkers for type 2 diabetes compared with their MUHO-PCOS peers. A greater understanding of the contrast in this risk phenotype in obesegirls with PCOS may have important implications for therapeutic interventions, their outcomes, and their durability.
Authors: Mark R Palmert; Catherine M Gordon; Alex I Kartashov; Richard S Legro; S Jean Emans; Andrea Dunaif Journal: J Clin Endocrinol Metab Date: 2002-03 Impact factor: 5.958
Authors: Kristina M Utzschneider; Ronald L Prigeon; Mirjam V Faulenbach; Jenny Tong; Darcy B Carr; Edward J Boyko; Donna L Leonetti; Marguerite J McNeely; Wilfred Y Fujimoto; Steven E Kahn Journal: Diabetes Care Date: 2008-10-28 Impact factor: 19.112
Authors: Donna F Vine; Lawrence J Beilin; Sally Burrows; Rae-Chi Huang; Martha Hickey; Roger Hart; Spencer D Proctor; Trevor A Mori Journal: J Endocr Soc Date: 2020-05-26