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J Clin Endocrinol Metab. 2019 Jun 1;104(6):2171-2183. doi: 10.1210/jc.2018-02086.

Adipose Insulin Resistance in Normal-Weight Women With Polycystic Ovary Syndrome.

Author information

1
Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles, California.
2
Department of Medicine Statistics Core, David Geffen School of Medicine at University of California, Los Angeles, California.
3
Technology Center for Genomics and Bioinformatics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California.
4
Department of Obstetrics and Gynecology and Wisconsin National Primate Research Center, University of Wisconsin, Madison, Wisconsin.

Abstract

CONTEXT:

Normal-weight women with polycystic ovary syndrome (PCOS) may have adipose tissue insulin resistance (adipose-IR).

OBJECTIVE:

To examine whether adipose-IR and subcutaneous (SC) abdominal adipose stem cell (ASC) gene expression are altered in normal-weight women with PCOS and correlated with hyperandrogenemia and/or whole-body IR.

DESIGN:

Prospective cohort study.

SETTING:

Academic medical center.

PATIENTS:

Ten normal-weight women with PCOS and 18 control subjects matched for age and body mass index.

INTERVENTION(S):

Women underwent circulating hormone and metabolic measurements, IV glucose tolerance testing, total-body dual-energy x-ray absorptiometry, and SC abdominal fat biopsy.

MAIN OUTCOME MEASURE(S):

Adipose-IR (fasting insulin × total fatty acid levels) and SC abdominal ASC gene expression were compared between groups and correlated with clinical outcomes.

RESULTS:

Adipose-IR was greater in women with PCOS than in control subjects (P < 0.01), with 29 pmol/L × mmol/L providing 94% specificity and 80% sensitivity in discriminating the two groups (P < 0.001). Adipose-IR positively correlated with serum androgen and log of fasting triglyceride (TG) levels, percentage of small adipocytes (P < 0.01, all correlations), and acute insulin response to glucose (P < 0.05); and negatively correlated with insulin sensitivity (Si; P < 0.025) and serum adiponectin levels (P < 0.05). Adjusting for serum androgens, adipose-IR correlations with Si and log TG levels remained significant. ASC genes were differentially expressed by the two groups. Expression of functionally critical genes was associated with serum testosterone and/or fasting insulin levels.

CONCLUSION:

Normal-weight women with PCOS have increased adipose-IR and altered ASC gene expression related to hyperandrogenism and IR.

PMID:
30649347
PMCID:
PMC6482023
[Available on 2020-01-11]
DOI:
10.1210/jc.2018-02086

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