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.
05 - 09 May 2012
European Society of Endocrinology