title: Smoking is associated with increased free testosterone and fasting insulin levels in women with polycystic ovary syndrome, resulting in aggravated insulin resistance.
abstract: OBJECTIVE
  To evaluate the impact of smoking on endocrine, metabolic, and clinical parameters in women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Cohort analysis.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  346 women with PCOS, including 98 smokers and 248 nonsmokers.
  
  
  METHODS
  Screening panel, including physical examination, weight and height measurement, and ultrasound examination of the ovaries, and hormone and insulin measurements.
  
  
  METHODS
  Clinical, metabolic, and endocrine parameters, oral glucose tolerance test, calculation of insulin resistance indexes.
  
  
  RESULTS
  In women with PCOS, smoking was associated with statistically significantly increased levels of fasting insulin and calculated free testosterone (cFT) and with a raised free androgen index (FAI) score, which resulted in aggravated scores on the homeostatic model for assessment of insulin resistance (HOMA-IR). However, no differences were observed between the smoking and nonsmoking groups with regard to the clinical parameters for hirsutism, acne, ovulatory function (classified as eumenorrhea, oligomenorrhea, and amenorrhea), or polycystic ovaries using the ultrasound criteria recommended according to the Rotterdam definition.
  
  
  CONCLUSIONS
  In women with PCOS, smoking is associated with increased free testosterone and fasting insulin levels, resulting in aggravated insulin resistance. However, there were no differences between smokers and nonsmokers when clinical parameters were compared.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Cupisti
authors.forename: Lothar
authors.initials: L
authors.lastname: Häberle
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Oppelt
authors.forename: Christine
authors.initials: C
authors.lastname: Reissmann
authors.forename: Desiree
authors.initials: D
authors.lastname: Kronawitter
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006628:Hirsutism / Q000097:blood / Q000453:epidemiology; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood* / Q000453:epidemiology; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D010060:Ovulation / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000097:blood* / Q000453:epidemiology; D013739:Testosterone / Q000097:blood*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D007328:Insulin; D013739:Testosterone