Endocrine Abstracts

Background: Obesity exacerbates many aspects of the PCOS phenotype, especially cardiovascular risk factors, infertility. The objective of the study was to determine the effects of overweight and obesity on the metabolic features of PCOS.

Material and methods: 116 PCOS women (according to Rotterdam criteria, mean age 27.16±3.87 years) were investigated in Vilnius city (Lithuania) in 2009–2011. Height, body mass and waist circumference were measured. Participants were tested for FSH, LH, total testosterone, sex hormone-binding globulin (SHBG), DHEAS, estradiol, fasting glucose, fasting insulin, and lipid profile. Free androgen index (FAI) and insulin resistance HOMA-IR index were calculated. PCOS women were divided into three groups according to BMI: 50 normal weight women, 27 overweight women and 39 obese women.

Results: Obese women with PCOS had lower LH compared to normal weight women. Obese and overweight women had more prominent androgen excess compared to normal weight PCOS women (obese FAI=8.37±4.77, overweight FAI=6.74±3.13, normal weight FAI=4.06±2.84, P<0.0001 obese vs normal weight, P=0.003 overweight vs normal weight). 71.8% of obese, 37% of overweight and 16% of normal weight women with PCOS were insulin-resistant. Obese women demonstrated higher by 3.62 HOMA-IR compared to normal weight (P<0.0001) and higher by 3.00 compared to overweight PCOS women (P<0.0001). Obese women with PCOS had lower HDL cholesterol, higher LDL cholesterol and higher triglyceride compared to normal weight PCOS women, and lower HDL cholesterol compared to overweight PCOS women. Overweight PCOS women had lower HDL cholesterol and higher triglyceride compared to normal weight PCOS women. 85.7% of obese, 14.3% of overweight and none of normal weight PCOS women had metabolic syndrome.

Conclusions: Obesity in women with PCOS is significantly associated with worse metabolic features: greater androgen excess, hirsutism, insulin-resistance and dyslipidaemia.