Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles, California.
Department of Medicine Statistics Core, David Geffen School of Medicine at University of California, Los Angeles, California.
J Clin Endocrinol Metab. 2019 Jun 1;104(6):2171-2183. doi: 10.1210/jc.2018-02086.
Normal-weight women with polycystic ovary syndrome (PCOS) may have adipose tissue insulin resistance (adipose-IR).
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.
Prospective cohort study.
Academic medical center.
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.
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.
Normal-weight women with PCOS have increased adipose-IR and altered ASC gene expression related to hyperandrogenism and IR.
患有多囊卵巢综合征（PCOS）的正常体重女性可能存在脂肪组织胰岛素抵抗（adipose-IR）。
研究正常体重的 PCOS 女性是否存在脂肪组织胰岛素抵抗和皮下（SC）腹部脂肪干细胞（ASC）基因表达改变，并与高雄激素血症和/或全身胰岛素抵抗相关。
前瞻性队列研究。
学术医疗中心。
10 名正常体重的 PCOS 女性和 18 名年龄和体重指数匹配的对照女性。
女性接受循环激素和代谢测量、IV 葡萄糖耐量试验、全身双能 X 射线吸收法和 SC 腹部脂肪活检。
比较两组之间的脂肪组织胰岛素抵抗（fasting insulin × total fatty acid levels）和 SC 腹部 ASC 基因表达，并与临床结果相关。
PCOS 女性的脂肪组织胰岛素抵抗高于对照组（P < 0.01），29 pmol/L × mmol/L 可区分两组，特异性为 94%，敏感性为 80%（P < 0.001）。脂肪组织胰岛素抵抗与血清雄激素和空腹甘油三酯（TG）水平的对数呈正相关（P < 0.01，所有相关性），与小脂肪细胞百分比呈正相关（P < 0.01），与急性葡萄糖胰岛素反应呈负相关（P < 0.05）；与胰岛素敏感性（Si；P < 0.025）和血清脂联素水平呈负相关（P < 0.05）。调整血清雄激素后，脂肪组织胰岛素抵抗与 Si 和空腹 TG 水平的相关性仍然显著。两组 ASC 基因表达不同。功能关键基因的表达与血清睾丸酮和/或空腹胰岛素水平相关。
患有 PCOS 的正常体重女性存在脂肪组织胰岛素抵抗和 ASC 基因表达改变，与高雄激素血症和胰岛素抵抗有关。
