Endocrine Abstracts (2012) 29 P1237

Extreme obesity partly blunts the discriminative metabolic effects of polycystic ovary syndrome (PCOS)

P. Marzullo1,2, A. Brunani1, E. Uccelli1, S. Maestrini1, S. Mai1, M. Berselli1, M. Rinaldi1, G. Guzzaloni1, A. Tagliaferri1, G. Aimaretti2 & A. Liuzzi1

1IRCCS Istituto Auxologico Italiano, Piancavallo, Verbania, Italy; 2Università del Piemonte Orientale ‘A. Avogadro’, Novara, Italy.

The epidemic of obesity and diabetes is increased worldwide, and both are more prevalent in PCOS than non-PCOS ovulatory women. In the general population, the risk of cardiovascular mortality is at least doubled in women with extreme obesity (BMI>40 kg/m2). To explore if PCOS adds further metabolic detriment to extreme obesity, this prospective study compared the metabolic profiles, OGTT-derived insulin sensitivity and body composition between 30 adult PCOS and 30 non-PCOS women with extreme obesity (age, 27.8±5 vs 27.7±7 years; BMI, 44.8±4.4 vs 43.7±3 kg/m2; WHR, 0.87±0.1 vs 0.89±0.1) seen consecutively at the IRCSS Istituto Auxologico Italiano for workup of obesity. None had a history of cardiometabolic disorders and PCOS was diagnosed by Rotterdam and AE-PCOS criteria. PCOS and non-PCOS women had similar levels of glucose and insulin, total or fractionated cholesterol and C-reactive protein. HbA1c (5.5±0.4 vs 5.6±0.4%), HOMA-IR (3.2±1.2 vs 3.1±2.1) and microalbuminuria (52.4±60.5 vs 73.7±52 mg/l) were comparable between groups. OGTT-derived measures of insulin sensitivity in PCOS and non PCOS women revealed equivalent values of early phase insulin secretion (insulinogenic index, 1.8±1.2 vs 1.8±1.5) and β-cell function (oral disposal index, 4.8±3.1 vs 6.1±5.3). Alternatively, the Matsuda index of insulin sensitivity was lower in PCOS than non-PCOS women (2.8±0.8 vs 3.7±2, P<0.05). DXA-derived measures of fat body mass were similar between groups (52.5±4.1 vs 50.5±4.8%), while trunk-fat was increased in PCOS (30.9±5.8 vs 25±5.5%, P<0.01) and coexisted with an increase in leptin levels (58.8±24.6 vs 44.7±16.4 mcg/l, P<0.05). Adiponectin levels were not different between the study groups (14.7±11.2 vs 10.4±5.8 mcg/ml). Current data suggest that many indices of metabolic homeostasis are superimposed between PCOS obese and non-affected obese counterpart. However, dissimilarities in insulin sensitivity and fat accumulation emphasize the importance of adequate long-term management of PCOS women suffering from extreme obesity.

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 work was supported, however funding details unavailable.