The central issue? Visceral fat mass is a good marker of insulin resistance and metabolic disturbance in women with polycystic ovary syndrome
- 10 August 2006
- journal article
- Published by Wiley in BJOG: An International Journal of Obstetrics and Gynaecology
- Vol. 113 (10), 1203-1209
- https://doi.org/10.1111/j.1471-0528.2006.00973.x
Abstract
To establish whether visceral fat mass is the most significant variable correlating with insulin resistance and other metabolic parameters in women with polycystic ovary syndrome (PCOS).Prospective cross-sectional trial.Reproductive medicine clinic.Forty women with anovulatory PCOS.Measurements were taken at recruitment, and analysis was performed to define correlations between the outcome measures and the explanatory variables.Visceral and subcutaneous fat by computed tomography scan, insulin resistance, anthropometric measures, markers of the metabolic syndrome and androgens.Strong linear correlation of visceral fat to insulin resistance (r = 0.68, P < 0.001) was observed. There were also statistically significant correlations with fasting insulin (r = 0.73, P < 0.001), homeostasis model assessment beta-cell function (r = 0.50, P = 0.007), triglycerides (r = 0.45, P = 0.003), high-density lipoprotein cholesterol (r = -0.42, P = 0.007), urate (r = 0.47, P = 0.002), Sex hormone binding globulin (r = -0.39, P = 0.01) and luteinising hormone (r = -0.32, P = 0.02). There were no significant correlations of testosterone with fat distribution or metabolic parameters. Insulin resistance showed closest correlation to visceral fat mass (r = 0.68, P < 0.001), then to waist circumference (r = 0.62, P < 0.001), with the weakest correlation being waist:hip ratio (r = 0.36, P = 0.01). The best regression model for predicting insulin resistance is with visceral fat mass and triglycerides as the explanatory variables (r = 0.72, P < 0.001).Visceral fat is the most significant variable correlating with metabolic dysfunction in women with PCOS. Our data support the hypothesis that visceral fat either causes insulin resistance or is a very early effect of it. It also implies that reducing visceral fat should reduce insulin resistance which may account for the observations that exercise and weight loss appear to be more effective interventions than pharmacological treatments. The best anthropometric measure of insulin resistance is waist circumference.Keywords
This publication has 37 references indexed in Scilit:
- Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndromeFertility and Sterility, 2004
- Body fat distribution, insulin sensitivity, ovarian dysfunction and serum lipoproteins in patients with polycystic ovary syndromeGynecological Endocrinology, 2002
- Polycystic ovary syndrome and fat distribution: The central issue?Human Fertility, 2002
- Body fat distribution, insulin sensitivity, ovarian dysfunction and serum lipoproteins in patients with polycystic ovary syndromeGynecological Endocrinology, 2002
- Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disordersFertility and Sterility, 1999
- Relationship between volumes and areas from single transverse scans of intra-abdominal fat measured by magnetic resonance imagingInternational Journal of Obesity, 1997
- Pathophysiology and Pathogenesis of Visceral Fat ObesityObesity Research, 1995
- Sex hormone-binding globulin and female reproductive functionThe Journal of Steroid Biochemistry and Molecular Biology, 1995
- The independent effects of polycystic ovary syndrome and obesity on serum concentrations of gonadotrophins and sex steroids in premenopausal womenClinical Endocrinology, 1994
- Enhanced early insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose toleranceJournal of Clinical Endocrinology & Metabolism, 1994