Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls.
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.
Glintborg
Dorte
D
Department of Endocrinology, Odense University Hospital, Kløvervaenget 6, 3rd floor, 5000 Odense C, Denmark. dorte.glintborg@dadlnet.dk
Andersen
Marianne
M
Hagen
Claus
C
Frystyk
Jan
J
Hulstrøm
Veronica
V
Flyvbjerg
Allan
A
Hermann
Anne Pernille
AP
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
C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D036361:Peptide Hormones; D013739:Testosterone