Objective: Central obesity plays a major role in the pathophysiology of polycystic ovary syndrome (PCOS). However, little information exists concerning the impact of subcutaneous adipose tissue (SAT) on metabolic disturbances in PCOS. The aim of this study was to investigate whether SAT topography influences insulin resistance, impaired glucose tolerance, and metabolic parameters in PCOS women.
Design: Prospective case-control trial.
Subjects: Of 36 PCOS women aged 1641years and 87 healthy women aged 2034 years.
Measurements: Lipometry, metabolic and hormonal measurements, oral glucose tolerance test, and hirsutism score. The study protocol was approved by the local ethics committee.
Results: Trunk located SAT measure points correlated significantly positive with HOMA-index (homeostasis model assessment). A negative correlation was seen between calf-SAT and HOMA-index. A multiple regression analysis detected a positive association between HOMA-index and lower abdomen-SAT and upper back-SAT, whereas hip-SAT showed a negative association with HOMA-index. In overweight/obese PCOS patients lower abdomen and upper back-SAT showed significantly positive correlations with insulin resistance. There was no correlation of SAT topography with insulin resistance in lean PCOS women. Compared to PCOS women with normal glucose tolerance, patients with glucose intolerance had significantly increased trunk obesity and decreased leg fat. Increased trunk SAT layers were related to an unfavorable serum lipid profile whereas increased leg fat correlated positively with HDL cholesterol.
Conclusion: Increased trunk located SAT layers are associated with insulin resistance, impaired glucose tolerance, and an unfavorable lipid profile in women suffering from PCOS. High thickness of leg SAT emerges as being protective against metabolic disturbances in PCOS.