title: Comparison of markers of insulin resistance and circulating androgens between women with polycystic ovary syndrome and women with metabolic syndrome.
abstract: OBJECTIVE
  Do women with the polycystic ovary syndrome (PCOS) differ from those with the metabolic syndrome (MetS) in markers of insulin resistance (IR) and circulating androgens?
  
  
  CONCLUSIONS
  Women with MetS have more pronounced IR than those with PCOS whereas only the latter have elevated circulating androgens.
  
  
  BACKGROUND
  PCOS and MetS share many similarities, including abdominal obesity and IR, and PCOS is regarded as the ovarian manifestation of MetS. However, there are limited data on the differences between markers of IR and circulating androgens between women with these two syndromes.
  
  
  METHODS
  A prospective study in 1223 Caucasian women with PCOS and 277 women without PCOS, matched for BMI, was performed between May 2004 and December 2011. The presence/absence of MetS in PCOS+ and PCOS- women was recorded and comparisons among the resulting four groups were performed.
  
  
  METHODS
  This study was performed in a university department of obstetrics and gynecology. The following markers of IR were determined: serum glucose and insulin levels, glucose/insulin ratio, area under the oral glucose tolerance test, homeostasis model assessment of IR index and quantitative insulin sensitivity check index.
  
  
  RESULTS
  PCOS+MetS+ women (n = 361) were more insulin-resistant than PCOS+MetS- women (n = 862) (P < 0.001 for the comparisons in all markers of IR). Similarly, PCOS-MetS+ women (n = 66) were more insulin-resistant than PCOS-MetS- women (n = 211) (P < 0.001 for the comparisons in all markers of IR). In contrast, PCOS+MetS+ showed only borderline significant differences in some markers of IR compared with PCOS-MetS+ women (P < 0.05). Similarly, PCOS+MetS- women showed only borderline significant differences in some markers of IR compared with PCOS-MetS- women (P = 0.037). Moreover, PCOS-MetS+ women were more insulin-resistant than PCOS + MetS- women (P < 0.001 for the comparisons in all markers of IR). Regarding circulating androgens, PCOS+MetS+ women had higher levels of circulating androgens than PCOS-MetS+ women (P < 0.001 for the comparisons in all circulating androgens). Similarly, PCOS+MetS- women had higher levels of circulating androgens than PCOS-MetS- women (P < 0.001 for the comparisons in all circulating androgens). In contrast, circulating androgens did not differ between PCOS+MetS+ women and PCOS+MetS- women. Similarly, circulating androgens did not differ between PCOS-MetS+ women and PCOS-MetS- women.
  
  
  CONCLUSIONS
  Only Caucasian women were included in the study. IR was not assessed with the euglycemic hyperinsulinemic clamp.
  
  
  CONCLUSIONS
  Even though MetS and PCOS have many similarities, they are distinct disorders. PCOS does not appear to simply represent the ovarian manifestation of MetS. Further studies are required to assess the contribution of hyperandrogenism to the pathogenesis of IR in PCOS.
  
  
  BACKGROUND
  No external funding was either sought or obtained for this study.
authors: First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece. ktziomalos@yahoo.com
authors: Konstantinos
authors: K
authors: Tziomalos
authors: Ilias
authors: I
authors: Katsikis
authors: Efstathios
authors: E
authors: Papadakis
authors: Eleni A
authors: EA
authors: Kandaraki
authors: Djuro
authors: D
authors: Macut
authors: Dimitrios
authors: D
authors: Panidis
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006115:Greece; D006785:Hospitals, University; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D009765:Obesity / Q000150:complications; D010044:Outpatient Clinics, Hospital; D050177:Overweight / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000728:Androgens; D015415:Biomarkers