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This version published online on April 3, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-2725
A more recent version of this article appeared on July 1, 2007
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Submitted on December 11, 2006
Accepted on March 28, 2007

ABDOMINAL FAT QUANTITY AND DISTRIBUTION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME AND EXTENT OF ITS RELATION TO INSULIN RESISTANCE

Enrico Carmina*, Salvo Bucchieri, Antonietta Esposito, Antonio Del Puente, Pasquale Mansueto, Francesco Orio, Gaetana Di Fede, and GiovamBattista Rini

Department of Clinical Medicine and Emerging Diseases, University of Palermo, 90139 Palermo, Italy; Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, 80131 Naples, Italy

* To whom correspondence should be addressed. E-mail: enricocarmina{at}libero.it.

Context: Increased abdominal fat has been linked to insulin resistance and increased cardiovascular risk. Because many patients with PCOS present abdominal obesity, it may be the cause of insulin resistance in this disorder.

Setting: Fat quantity and distribution was evaluated by dual x-ray absorptiometry (DXA) at the Department of Clinical Medicine of University of Palermo and at the Department of Endocrinology of University of Naples, Italy.

Patients: One hundred ten patients with PCOS and one hundred twelve weight matched controls were studied. Anthropometric data, blood glucose, serum insulin and testosterone were evaluated. Total, trunk and central abdominal fat quantity were measured by total body DXA.

Results: Compared to weight matched controls, patients with PCOS had similar quantity of total and trunk fat but higher quantity of central abdominal fat. This difference was not observed comparing obese PCOS and obese controls, but depended on differences between overweight and normoweight patients and controls. All obese subjects, independently on having PCOS or not, had increased central abdominal fat. The same parameter was increased in 71% of overweight PCOS and 50% of overweight controls and in 30% of normoweight PCOS. PCOS patients with increased central abdominal fat had significantly (p<0.01) higher insulin levels and significantly (p<0.01) reduced insulin sensitivity than controls with similar quantities of central abdominal fat. Overweight PCOS patients with normal abdominal fat had significantly (p<0.05) higher insulin levels and significantly (p<0.05) reduced insulin sensitivity than overweight controls with normal abdominal fat.

Conclusions: Most obese subjects, independently on being affected by PCOS or normal, have an abdominal form of obesity. However, abdominal fat excess may not be the only determinant of insulin resistance in PCOS.
Key words: PCOS • Hyperandrogenism • Abdominal fat • Insulin resistance




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