Obesity, body composition and metabolic disturbances in polycystic ovary syndrome.
BACKGROUND
We determined the impact of polycystic ovary syndrome (PCOS) and obesity on glucose and lipid metabolism and beta-cell function in women with PCOS.


METHODS
In 35 women with PCOS (17 lean, lean PCOS and 18 obese, obese PCOS) and 25 control women (9 lean, lean controls and 16 obese, obese controls), beta-cell function was evaluated by the first-phase insulin response after intravenous glucose, acute insulin response to glucose (AIRg); insulin sensitivity, determined as insulin sensitivity index (ISI), was evaluated by the euglycemic hyperinsulinemic clamp. Indirect calorimetry was used for the assessment of glucose and lipid oxidation. Body composition was estimated by dual X-ray absorptiometry scan.


RESULTS
When adjusted for obesity, PCOS was associated with higher 2-h glucose levels (P < 0.05), higher trunk/periphery fat ratio (P < 0.001), lower ISI (P < 0.001), lower insulin-stimulated glucose oxidation (GOX 2) (P < 0.05) and lower non-oxidative glucose metabolism (P < 0.05), but a normal AIRg compared with control women. Lean women with PCOS had lower ISI (P < 0.001), GOX-2 (P < 0.05) and higher trunk/periphery fat ratio (P < 0.05) than lean control women. In obese women with PCOS, ISI was reduced with 25% compared with obese control women, whereas trunk/peripheral fat ratio did not differ. AIRg was increased in obese groups compared with lean groups (P < 0.05), but was, in all groups, appropriate for the ambient action of insulin.


CONCLUSIONS
PCOS is associated with a low ISI, which in lean women with PCOS may partly be explained by higher trunk/peripheral fat ratio. AIRg was amplified by obesity, but was, in all groups, appropriate for prevailing insulin sensitivity, suggesting a normal beta-cell adaptation.
Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark. pernille.svendsen@hvh.regionh.dk
Pernille Fog
PF
Svendsen
Lisbeth
L
Nilas
Kirsten
K
Nørgaard
Jens-Erik Beck
JE
Jensen
Sten
S
Madsbad
D000328:Adult; D001786:Blood Glucose; D001823:Body Composition; D016022:Case-Control Studies; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism; D050417:Insulin-Secreting Cells / Q000502:physiology; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000150:complications* / Q000473:pathology; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D013739:Testosterone / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D013739:Testosterone; D005947:Glucose