Aim: The purpose of the study was to evaluate the prevalence of the metabolic syndrome (MS) in a cohort of young Mediterranean women with PCOS in reproductive age and to evaluate the association of the MS with clinical and biochemical parameters.
Setting: Among 200 PCOS (17-31 years) criteria of MS in accordance with the NCEP-ATPIII were used to construct 3 groups: no one criteria, 1 or 2 criteria and 3 or more criteria (affected by MS). All patients underwent clinical, hormonal and metabolic assessments.
Results: 36 women had no criteria, 101 women had 1 or 2 criteria, 63 women had 3 or more criteria. We found a prevalence of the MS of 31.5%. The women with MS had higher BMI, waist circumference and WHR than the other two groups. Among the 3 groups we found no differences in severity of hirsutism and menses abnormalities. However, the women with more criteria had more frequently acanthosis nigricans and less frequently acne. The group with MS respect the group without any criteria had higher levels of fasting insulin (P=0.014), glucose-stimulated insulin and glucose levels (P<0.001) and HOMA (P=0.039) and lower levels of HOMAOGTT (P<0.001) and QUICKI (P<0.001). Moreover, we found higher levels of cortisol and androstenedione responsiveness to 124 ACTH (P=0.004, P=0.040). There were no differences for the levels of androgens at baseline except for the Free Androgen Index (FAI) which was higher in the group with MS (P=0.023). Finally, the levels of SHBG were lower in patients with the MS respect to patients without any criteria (P<0.001).
Conclusion: Young women of the Mediterranean area present a higher prevalence of the MS respect to the general population. Moreover, the MS is associated with a more severe insulin resistance state and hyperandrogenemia and with a hyperactivity of the hypothalamic-pituitary-adrenal axis.