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Global Adiposity Rather Than Abnormal Regional Fat Distribution Characterizes Women with Polycystic Ovary Syndrome

Oxford Centre for Diabetes, Endocrinology, and Metabolism (T.M.B., J.A.H.W., F.K., M.I.M.), Churchill Hospital, Oxford OX3 7LJ, United Kingdom; Department of Radiology (C.A., S.J.G.), John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom; and Institute of Reproductive and Developmental Biology (S.F.), Imperial College (Hammersmith Campus), London W12 0NN, United Kingdom

Address all correspondence and requests for reprints to: Dr. Tom Barber, Diabetes Research Laboratories, Oxford Centre for Diabetes, Endocrinology, and Metabolism, Churchill Hospital, Old Road, Headington, Oxford OX3 7LJ, United Kingdom. E-mail: tom.barber{at}drl.ox.ac.uk.

Context: Obesity-related predisposition to polycystic ovary syndrome (PCOS) could reflect overall adiposity and/or regional accumulation of abdominal visceral fat.

Objective: The objective of the study was to compare distributions of visceral, abdominal sc, and gluteofemoral sc adipose tissue in PCOS cases vs. control women.

Design: This was a cross-sectional study.

Setting and Participants: Fat depot measurements from axial magnetic resonance imaging scans taken at anatomically predefined sites were compared between 22 body mass index (BMI)/fat mass-matched pairs of PCOS cases and controls; whole-group comparisons included 50 PCOS cases vs. 28 female controls. All subjects were of UK British/Irish origin.

Main Outcome Measure(s): We measured cross-sectional areas of adipose tissue within visceral (mid-L4), abdominal (mid-L4) sc, and gluteofemoral (greater trochanteric and midfemoral) sc fat depots. Other measurements included fat mass, BMI, testosterone, SHBG, and homeostasis model assessment of insulin resistance (a measure of insulin sensitivity). Whole-group analyses were adjusted for fat mass and age.

Results: There were no significant differences in fat-depot measurements between BMI/fat mass-matched pairs of PCOS cases and controls: mid-L4 visceral (P = 0.40), abdominal sc (P = 0.22), gluteal sc (P = 0.67), and midfemoral sc (P = 0.37) depots. Whole-group comparisons gave similar results after adjustments for fat mass and age. Fasting serum insulin concentrations (P = 0.03) and homeostasis model assessment of insulin resistance (P = 0.03) were significantly higher in the PCOS group than BMI/fat mass-matched controls.

Conclusions: PCOS cases and BMI/fat mass-matched control women are indistinguishable with respect to distribution of fat within visceral, abdominal sc, and gluteofemoral sc depots, despite significant differences in insulin resistance between these two groups.

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