Significance of obesity in the genesis of metabolic syndrome in women with polycystic ovary syndrome
J. Bjekic-Macut1, D. Macut2, I. Bozic2, D. Vojnovic-Milutinovic3, O. Stanojlovic4, B. Popovic2, T. Bogavac2, M. Petakov2, S. Ognjanovic2, T. Isailovic2, V. Elezovic2, M. Civcic2, S. Erceg2, G. Matic3 & S. Damjanovic2
Introduction: Metabolic disturbances that are common in polycystic ovary syndrome (PCOS), represent a risk factor for cardiovascular disease. The aim of this study was to define contribution of obesity for the development of dyslipidemia and insulin resistance in PCOS.
Methods: PCOS was diagnosed using ESHRE/ASRM criteria. We evaluated 158 women with PCOS who were divided into two subgroups according to body mass index (BMI) cut off value 25 kg/m2: non-obese PCOS (n=93; 20.65±2.0 kg/m2; 24.9±4.6 years) and overweight/obese PCOS (n=65; 31.0±4.6 kg/m2; 26.7±6.7 years). Controls group consisted of 30 healthy, non-obese (19.9±2.1 kg/m2, 27.5±5.3 years). In all subjects fasting blood samples were collected in follicular phase of menstrual cycle for determination of glucose, insulin, total cholesterol (TC), LDL, HDL, triglycerides, apolipoproteins (Apo) A1, A2, B and E, Lp(a), C-reactive protein (CRP), testosterone and SHBG. Blood pressure (BP), waist circumference (WC), free androgen index (FAI), homeostatic model (HOMA index), and ratios TC/HDL, LDL/HDL, triglycerides/HDL, ApoB/ApoA1 were also determined.
Results: In comparison to non-obese PCOS, obese PCOS had significantly higher levels of TC, LDL, triglycerides, ApoB, ApoE, CRP, HOMA, FAI, TC/HDL, LDL/HDL, triglycerides/HDL, ApoB/ApoA1, and significantly lower levels of HDL and ApoA1 (P<0.001). After adjustment for age, non-obese PCOS had borderline higher ApoB/ApoA1 than Controls (P=0.051). In PCOS group BMI significantly correlated with TC, HDL, triglycerides, HOMA, ApoB, and CRP (P<0.001). There were no significant correlations between FAI and metabolic indices. HOMA significantly correlated only with BMI (P<0.001).
Conclusion: Proaterogenic lipid profile and insulin resistance are metabolic consequences of PCOS. Obesity significantly worsens metabolic profile in women with PCOS.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.