Endocrine Abstracts

Introduction: Weight loss is a key initial treatment strategy in obese women with polycistic ovary syndrome (PCOS) and improves insulin sensitivity and metabolic risk factors. In some women with PCOS it may reduce hyperandrogenism and restore menstrual function, ovulation and fertility. The aim of this study was to reveal clinical predictors of menstrual response to weight loss in overweight women with PCOS.

Design: overweight unovulatory women with PCOS (age 25.7±5.9 yr, body mass index (BMI) 32.3+5.3 kg/m²) followed a 6-month weight loss program. We estimated ovulation induction (by ultrasound scanning), change in menstrual cycle, anthropometric measurements, endocrine parameters and insulin sensitivity.

Results: Mean reductions in weight by 9.0±5.9 kg (P<0.001) and BMI by 3.3±2.1 kg/m² (P<0,001) occurred for the subjects over the study duration. That was followed by reduction in fasting insulin (from 20.8±17.4 to 11.1±7.8 mU/liter, P=0.002), glucose (from 5.7±0.6 to 5.3±0.5 mmol/L, P=0.01) and the homeostasis model assessment of insulin sensitivity (HOMA) (from 5.2±4.2 to 2.7±1.9, P=0.06). Of 30 subjects, 15 (50%) responded to the intervention with improvements in menstrual cyclicity (responders). Compared to nonresponders, responders had lower baseline anti-mullerian hormone (AMH) levels (6.3±3.3 vs 9.8±4.2 ng/ml; P=0.015) and higher BMI (34.8±5.6 vs 30.4±4.2 kg/m², P=0.026). Using ROC-curves we calculated that the value of AMH less than 6.5 ng/ml can predict improvement of menses (sensitivity 73%, specificity 67%) by weight loss in overweight women with PCOS.

Conclusions: AMH measurement can be useful in the pretreatment identification of women with PCOS who will benefit from lifestyle intervention by menstrual improvements.

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.