The Association Between Serum Ferritin Concentration and Visceral Adiposity Estimated by Whole-Body DXA Scan in Women With Polycystic Ovary Syndrome.

Agnieszka Adamska,Irina Kowalska,Agnieszka Łebkowska,Marcin Adamski,Anna Krentowska

doi:10.3389/fendo.2019.00873

Agnieszka Adamska, Irina Kowalska + Show 3 more

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https://doi.org/10.3389/fendo.2019.00873

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Abstract

Objective: Women with polycystic ovary syndrome (PCOS) are characterized by insulin resistance and higher prevalence of obesity. Serum ferritin is increased in obesity and is associated with insulin resistance. The aim of the present study was to evaluate the relationships between serum ferritin concentration with insulin resistance and body composition estimated by dual-energy X-ray absorptiometry (DXA) in PCOS women in comparison to the control group.Patients and Methods: One hundred four women were enrolled to the study−65 women with PCOS and 39 women matched for age and BMI as a control group. Serum ferritin concentration and oral glucose tolerance test (OGTT) were performed. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. DXA was performed to estimate fat, fat-free mass, and visceral adipose tissue (VAT).Results: Women with PCOS have higher serum concentration of ferritin (p = 0.002), insulin at baseline (p = 0.03), at 60 min of OGTT (p = 0.01), at 120 min of OGTT (p = 0.004), HOMA-IR (p = 0.03), and VAT (p = 0.0001) in comparison to the control group. We observed a relationship of serum ferritin with insulin concentration at baseline (r = 0.25, p = 0.04) and at 120 min of OGTT (r = 0.31, p = 0.01) and with HOMA-IR (r = 0.30, p = 0.01) in the PCOS group. We noticed an association between serum ferritin concentration and VAT (r = 0.42, p = 0.001), trunk fat mass (r = 0.25, p = 0.04), and android fat mass (r = 0.25, p = 0.04) in the PCOS group. Multiple regression analysis revealed that ferritin (p = 0.02, β = 0.17), insulin at baseline (p = 0.001, β = 0.30), glucose at the 120 min of OGTT (p = 0.007, β = 0.26), and triglycerides (p = 0.001, β = 0.33) were independent predictors of VAT amount in PCOS women.Conclusions: Elevated serum ferritin concentration is connected with insulin resistance as well as with DXA-estimated VAT, android, and trunk fat mass in PCOS women, and could be a marker of metabolic dysfunction.

Highlights

Polycystic ovary syndrome (PCOS) is a common disorder characterized by hyperandrogenism, ovulatory dysfunction, and characteristic changes in the ovaries [1]
The PCOS group and the control group were matched for age, BMI, and waist and hip circumference
The groups did not differ in terms of plasma glucose during Oral glucose tolerance test (OGTT), lipids, and serum thyroid-stimulating hormone (TSH) concentrations (Table 1)

Summary

Introduction

Polycystic ovary syndrome (PCOS) is a common disorder characterized by hyperandrogenism (biochemical and/or clinical), ovulatory dysfunction, and characteristic changes in the ovaries [1]. Approximately 50% of PCOS women are overweight or obese [2]. Insulin resistance (IR) and hyperinsulinemia are connected with weight gain and development of obesity in this population [3]. Women with PCOS have altered fat distribution and greater tendency to increased visceral adipose tissue (VAT) accumulation compared to BMI-matched general population [4], even in the normal range for BMI [5]. A number of studies have demonstrated that increased amount of VAT, which is metabolically more active than subcutaneous adipose tissue (SAT), is connected with dyslipidemia, hypertension, insulin resistance, and type 2 diabetes. It has been reported that elevated level of androgens is connected with abdominal fat deposition [6]

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