Abstract
Insulin resistance and hyperandrogenemia observed in polycystic ovary syndrome (PCOS) are associated with metabolic disturbances and could be connected with body composition pattern. To date, several studies defining the parameters of body composition using dual energy X-ray absorptiometry (DXA) method in the group of PCOS patients have been published, however, without the analysis in different phenotypes. The aim of the present study was to investigate the relationships between serum androgens concentration, insulin resistance and distribution of fat mass using DXA method in various PCOS phenotypes according to the Rotterdam criteria. We examined 146 women: 34 (38%) had PCOS phenotype A, 20 (23%) phenotype B, 20 (23%) phenotype C and 15 (16%) phenotype D (with mean age of each phenotype 25 years), and 57 control subjects (mean age of 25.5 years). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum concentrations of testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S) were assessed and free androgen index (FAI) was calculated. In phenotypes A, B and C, we observed higher FAI in comparison to the control group (all p < 0.01). Serum concentrations of androstenedione and DHEA-S were higher in phenotypes A and C in comparison to the control group (all p < 0.01). However, only in phenotype A we found higher visceral adipose tissue (VAT) mass and android/gynoid ratio (A/G ratio) in comparison to the control group (all p < 0.01). In phenotype A, we observed connection of VAT with FAI (r = 0.58, p < 0.01). Accordingly, A/G ratio was related with FAI in all phenotypes (all p < 0.05). Additionally, in phenotype C, A/G ratio was related to serum concentrations of DHEA-S and androstenedione (r = 0.46, p = 0.03; r = 0.53, p = 0.01, respectively). We also found connections of HOMA-IR with VAT and A/G ratio in all phenotypes (all p < 0.05). Women with phenotype A had higher amount of VAT and A/G ratio in comparison to the control group. Serum concentration of androgens and insulin resistance are connected with VAT and A/G ratio in normoandrogenic and hyperandrogenic PCOS phenotypes.
Highlights
Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of reproductive age, with a prevalence of 6–20% according to the criteria used [1]
We did not observe differences in Homeostasis model assessment of insulin resistance (HOMA-IR) between the studied groups (p = 0.25), fasting glucose was higher in phenotype A vs. C (Table 1)
We found no correlation between HOMA-IR, serum concentrations of androstenedione, dehydroepiandrosterone sulfate (DHEA-S) and visceral adipose tissue (VAT) estimated with dual energy X-ray absorptiometry (DXA) (Table 2)
Summary
Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of reproductive age, with a prevalence of 6–20% according to the criteria used [1]. Most women with PCOS are characterized by metabolic abnormalities like abdominal obesity or insulin resistance, which form the risk factors for metabolic syndrome [2]. A number of studies have indicated that insulin resistance plays a crucial role in the pathogenesis of polycystic ovary syndrome [3]. Hyperandrogenemia includes elevated serum concentrations of total and free testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S). It has been reported that increased serum testosterone levels in PCOS women are associated with excess of visceral fat amount [5], as well as with insulin resistance and more frequent occurrence of impaired glucose tolerance [3]
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