Relationship between body composition, insulin resistance, and hormonal profiles in women with polycystic ovary syndrome

Abstract

ObjectiveTo investigate how body fat influences glucose metabolism and hormone profiles in women with polycystic ovary syndrome (PCOS), compared to women without PCOS.MethodsWe conducted a cross-sectional study of 166 women with PCOS and 139 age-matched control women at Peking University Third Hospital (Beijing, China) from March 2016 to December 2021. All participants underwent bioimpedance rate assessment of clinical, anthropometric, hormonal, and metabolic features. In particular, body composition parameters were assessed, based on the methods used in a previous study. Homeostasis model assessment-insulin resistance (HOMA-IR) and other indices calculated from fasting glucose and insulin were used to measure insulin resistance. The hormonal profiles [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), prolactin (PRL), total testosterone (T), and androstenedione (A2)] were assessed by using biochemical methods. Two subgroup analyses were conducted according to waist-to-hip ratio (WHR; < 0.85, non-central obesity and ≥ 0.85, central obesity) and body fat percentage (BFP; < 35% for lean and ≥35% for obesity). The indices above were analyzed using a two-sided t-test or Wilcoxon rank sum test. Linear regression was used to investigate the effects of body composition on metabolism and sex hormones in the PCOS and control groups.ResultsCompared to women without PCOS, women with PCOS and central obesity (P=0.021), PCOS and noncentral obesity (P<0.001), PCOS and high BFP (P<0.001), and PCOS and low BFP (P<0.001) had more severe glucose metabolism evaluated with HOMA-IR. Women with PCOS experienced greater insulin sensitivity impairment than did the normal population for every equal increase in BFP. LH, LH/FSH, total testosterone, and androstenedione were significantly higher in patients with PCOS than in healthy controls, regardless of WHR and BFP stratification. However, negative correlations existed between body fat indices (i.e., BFP and body mass index) and hormone indices (i.e., LH and androstenedione) in the PCOS group, but were absent in the control group.ConclusionsObese and non-obese women with PCOS have more severe insulin resistance and sex-hormone disorders than women without PCOS. The effect of body fat on sex-hormone disorders is only exist in women with PCOS. These findings suggested that PCOS clinical guidelines should be more specific to body fat.Clinical trial registrationhttps://clinicaltrials.gov/, Registration No. NCT04264832.

Body Composition Parameters, Adiponectin, Leptin and Adiponectin/Leptin Ratio are Correlated with LH/FSH Ratio in Women with PCOS but not in Women without PCOS

“…These results were in accordance with other studies. 22,23,29 Based on our study, it is assumed that factors other than biometrics of body composition, such as adipokines, may contribute to insulin resistance in women with PCOS.…”

“…The present study used the bioimpedance method, which was indicated to be reliable in measuring body composition parameters. 22 Moreover, the heterogeneity of PCOS pathophysiology and influences of race and environment might contribute to this dissimilarity. Although body composition did not significantly differ between the two groups, fasting insulin level and HOMA-IR value were higher in women with PCOS, showing enhanced risk of glucose intolerance and insulin resistance in PCOS women.…”

“…21 Body composition can be easily measured using bioelectrical impedance analysis, which is noninvasive, inexpensive and reliable. 22 Studies have demonstrated that body composition parameters are different between women with PCOS and controls. Moreover, body composition parameters were correlated with increased leptin levels and lower adiponectin levels in PCOS women.…”

ApoC3 is expressed in oocytes and increased expression is associated with PCOS progression

“…Previous studies showed that elevated levels of several sex hormones, including LH, T and AMH, were associated with PCOS progression [ 40 , 41 ]. Our study revealed an upward trend of ApoC3 in plasma that is positively correlated with LH, T and AMH during the progression of PCOS, but had no significant relationship to those hormones in the control group.…”

Lean mass and associated factors in women with PCOS with different phenotypes

“…Insulin resistance and central obesity are often present in patients with PCOS, features that are strongly associated with adipose tissue dysfunction [7]. Obesity is clearly related to insulin resistance, but even lean women with PCOS are prone to develop insulin resistance [8,9], affecting about 45% of women as demonstrated in a previous study by our group [10]. Obesity is also a common finding, with a reported prevalence of 30% to 60%, that affects insulin levels regardless of its effects on insulin sensitivity [6,11,12].…”