title: Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls.
abstract: OBJECTIVE
  Polycystic ovary syndrome (PCOS) patients are abdominally obese and are at increased risk of developing the metabolic syndrome. Low adiponectin and ghrelin levels in PCOS patients could be caused by insulin resistance as well as high testosterone levels.
  
  
  METHODS
  Adiponectin and ghrelin levels were evaluated in 51 hirsute PCOS patients referred to the outpatient clinic of an academic, tertiary care medical centre and in 63 weight-matched female controls. Relationships between adiponectin, ghrelin, leptin, body composition, testosterone and insulin were examined.
  
  
  METHODS
  Measurements of body composition including waist-hip-ratio (WHR), body mass index (BMI) and whole body dual-energy X-ray absorptiometry scan measures of body fat mass. Measurements of fasting levels of adiponectin, ghrelin, leptin, androgen status, oestradiol, lipid variables and insulin during follicular phase.
  
  
  RESULTS
  Adiponectin levels were significantly decreased in obese PCOS patients compared with weight-matched controls (geometric mean (-2 to 2 s.d.) 5.3 (2.5-11.1) vs 7.3 (3.0-17.4) mg/l, P<0.05). Mean ghrelin was significantly lower in hirsute PCOS patients than in controls (0.6 (0.3 to 1.4) vs 0.8 (0.4 to 1.7) microg/l, P<0.001) and this remained significant after subdividing subjects according to waist circumference and BMI. During multiple regression analysis, testosterone correlated positively with adiponectin and negatively with ghrelin independent of BMI, WHR and total fat mass.
  
  
  CONCLUSIONS
  Obese hirsute PCOS patients demonstrated significantly lower adiponectin levels than weight-matched controls suggesting a very high risk for the metabolic syndrome. Furthermore, ghrelin levels were decreased in hirsute PCOS patients and showed a significant, negative correlation with testosterone independent of body composition.
authors.affiliation: Department of Endocrinology, Odense University Hospital, Kløvervaenget 6, 3rd floor, 5000 Odense C, Denmark. dorte.glintborg@dadlnet.dk
authors.forename: Dorte
authors.initials: D
authors.lastname: Glintborg
authors.forename: Marianne
authors.initials: M
authors.lastname: Andersen
authors.forename: Claus
authors.initials: C
authors.lastname: Hagen
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.forename: Veronica
authors.initials: V
authors.lastname: Hulstrøm
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Anne Pernille
authors.initials: AP
authors.lastname: Hermann
mesh_terms: D015502:Absorptiometry, Photon; D052242:Adiponectin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001824:Body Constitution; D015992:Body Mass Index; D005260:Female; D054439:Ghrelin; D006628:Hirsutism / Q000453:epidemiology / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood*; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism*; D036361:Peptide Hormones / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology / Q000378:metabolism*; D012044:Regression Analysis; D012307:Risk Factors; D013739:Testosterone / Q000097:blood; D049629:Waist-Hip Ratio
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D036361:Peptide Hormones; D013739:Testosterone