Bone mineral density in women with polycystic ovary syndrome.

K Katulski,A Czyzyk,K Paczkowska,N Ignaszak,B Meczekalski,N Podkowa,S Slawek,A Podfigurna-Stopa

doi:10.1007/s40618-014-0175-5

K Katulski, A Czyzyk + Show 6 more

Open Access

https://doi.org/10.1007/s40618-014-0175-5

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Abstract

PurposePCOS is a complex disorder and various features of this disorder may have great importance for bone metabolism. The aim of the study was to determine the relationship between existing hormonal disorders, and bone mineral density (BMD) in young women with PCOS.Methods69 reproductive-aged PCOS women and 30 age-matched healthy controls were enrolled to the study women. In each individual we assessed the body mass index (BMI). We evaluated the serum concentrations of: gonadotropins, prolactin (PRL), estradiol (E2), dehydroepiandrosterone sulfate (DHEAS), testosterone (T), thyroid stimulating hormone (TSH), free thyroxine (fT4). We used the Homeostatic Model Assessment–Insulin Resistance Index (HOMA–IR) to diagnose insulin resistance. Bone mineral density in the lumbar spine was measured by dual-energy X-ray absorptiometry (DXA).ResultsThe PCOS women had lower BMD values as compared to the controls (1.057 ± 0.1260 vs. 1.210 ± 0.1805 g/cm2, p < 0.0002). In the analysis of PCOS patients according to BMI, only in the subgroup of the normal weight PCOS we find significantly lower BMD in comparison to controls (p = 0.0049). In patients with PCOS, BMD was positively correlated with insulin concentration and HOMA–IR. In the controls Z-score values were positively correlated with insulin concentration and HOMA–IR.ConclusionsThe deleterious effect of estrogen deficiency on bones in PCOS is not balanced by androgen overproduction. Women with PCOS had significantly lower BMD of the lumbar spine compared to controls. Insulin seems to be one of the most important positive bone growth stimulators.

Highlights

Polycystic ovary syndrome (PCOS) is one of the most common disorders in reproductive-aged women and is characterized by oligo- or anovulation, clinical or biochemical hyperandrogenism and polycystic ovarian morphology on ultrasound [1,2,3]
In the analysis of PCOS patients according to body mass index (BMI), only in the subgroup of the normal weight PCOS we find significantly lower bone mineral density (BMD) in comparison to controls (p = 0.0049)
No significant differences in BMI were found between PCOS and controls

Summary

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common disorders in reproductive-aged women and is characterized by oligo- or anovulation, clinical or biochemical hyperandrogenism and polycystic ovarian morphology on ultrasound [1,2,3]. PCOS is a complex disorder and various features of this disorder may have an influence on bone metabolism. Peak bone mass is reached between 25 and 30 years of age, and 45–50 % of peak bone mass is formed during the adolescence period [3]. Peak bone mass is the maximal amount of bone tissue at the end of skeletal maturation, which is an important determinant of the (potential) development of osteoporosis. Many factors are supposed to influence bone deposition during growth [3]. Genetic factors are responsible for about 60–80 %, and hormonal and nutritional factors 40–60 % for the development of peak bone mass [5].

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