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Body fat linked to insulin resistance in women with PCOS
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Body fat appears to be directly associated with insulin resistance in women with polycystic ovary syndrome, according to recent findings.
However, the relationship between body fat and hyperandrogenism in this population appears to be more ambiguous, and may be to some extent affected by insulin resistance and hyperinsulinemia, the researchers wrote.
In the study, researchers evaluated 116 white women with PCOS enrolled in the Verona PCOS Pathophysiology and Phenotype (Verona 3P) Study to determine the effect of body fat on insulin resistance and androgen excess.
All study participants underwent a complete medical assessment, including menstrual history, measurement of body weight, height, waist circumference, blood pressure and hirsutism evaluation based on the modified Ferriman-Gallwey score.
The researchers found that participants who were insulin resistant had significantly higher total fat mass (89%) and higher truncal fat mass (127%) vs. insulin-sensitive participants (both P<.001). Both of these measures were higher in hyperandrogenemic participants than in normoandrogenemic participants (total fat mass, 22%; P=.087; truncal fat mass, 28%; P=.09).
An inverse association was noted between all adiposity measures and insulin sensitivity (P<.001), and a direct association was seen between adiposity parameters and serum free testosterone (P≤.001). There was a statistically significant inverse association between insulin sensitivity and serum free testosterone levels (P<.001).
Multiple regression analysis revealed that total fat mass or truncal fat, in addition to free testosterone levels and age, were independently predictive of insulin sensitivity. Conversely, insulin sensitivity, but not total fat mass or truncal fat, was independently predictive of free testosterone concentrations.
“In conclusion, our findings suggest that body fat plays a major role in determining insulin resistance in PCOS women,” the researchers wrote. “Conversely, the association between body fat and hyperandrogenism seems to be indirect, and at least in part mediated by insulin resistance and the associated hyperinsulinemia. These data underline the major role of body fat excess in several key clinical aspects of PCOS, further indicating the need for strategies aimed at counteracting obesity in these women.”
Disclosure: The study was funded in part by the University of Verona.
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