Evidence for competing effects of body mass, hyperinsulinemia, insulin resistance, and androgens on leptin levels among lean, overweight, and obese women with polycystic ovary syndrome.
OBJECTIVE
To evaluate the relationships between leptin, body composition, insulin resistance, androgens, and reproductive indices among women with polycystic ovary syndrome (PCOS).


METHODS
Matched case-control study.


METHODS
Academic reproductive endocrine practice; school of public health.


METHODS
Forty-six Caucasian women with PCOS and 46 population-based controls matched by age and body mass index (BMI).


METHODS
None.


METHODS
Leptin, insulin, androgenic hormones, body composition parameters; reproductive parameters.


RESULTS
Overall, leptin levels among women with PCOS did not differ significantly from those of control women (20.4 +/- 14.9 vs. 21.9 +/- 14.3 ng/mL). However, within the lowest BMI tertile, women with PCOS had significantly lower leptin levels (9.6 vs. 18.3 ng/mL), comparable insulin, and higher testosterone concentrations than controls of similar body mass. Within the overweight and obese subgroups, both insulin and testosterone levels were increased among women with PCOS; leptin levels, although higher among obese cases, were not statistically different than those in controls.


CONCLUSIONS
Below a certain BMI, hyperandrogenic women with PCOS have lower leptin levels than controls. Conversely, overweight and obese PCOS subjects appear to produce insufficient leptin for a given fat mass, relative to the degree of hyperinsulinemia, potentially because of the competing effects of adipocyte insulin resistance and androgens on leptin.
Remsberg
Karen E
KE
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261, USA.
Talbott
Evelyn O
EO
Zborowski
Jeanne V
JV
Evans
Rhobert W
RW
McHugh-Pemu
Kathleen
K
D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006946:Hyperinsulinism; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000150:complications; D010414:Pennsylvania; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D012016:Reference Values; D012098:Reproduction / Q000502:physiology; D013851:Thinness / Q000097:blood* / Q000150:complications; D044465:White People
D020738:Leptin