Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, US.
Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, US.
J Clin Endocrinol Metab. 2020 Sep 1;105(9):e3400-14. doi: 10.1210/clinem/dgaa426.
Osteosarcopenia (loss of skeletal muscle and bone mass and/or function usually associated with aging) shares pathophysiological mechanisms with polycystic ovary syndrome (PCOS). However, the relationship between osteosarcopenia and PCOS remains unclear.
We evaluated skeletal muscle index% (SMI% = [appendicular muscle mass/weight (kg)] × 100) and bone mineral density (BMD) in PCOS (hyperandrogenism + oligoamenorrhea), and contrasted these musculoskeletal markers against 3 reproductive phenotypes (i): HA (hyperandrogenism + eumenorrhea) (ii); OA (normoandrogenic + oligoamenorrhea) and (iii), controls (normoandrogenic + eumenorrhea). Endocrine predictors of SMI% and BMD were evaluated across the groups.
DESIGN, SETTING, AND PARTICIPANTS: Multicenter case-control study of 203 women (18-48 years old) in New York State.
PCOS group exhibited reduced SMI% (mean [95% confidence interval (CI)]; 26.2% [25.1,27.3] vs 28.8% [27.7,29.8]), lower-extremity SMI% (57.6% [56.7,60.0] vs 62.5% [60.3,64.6]), and BMD (1.11 [1.08,1.14] vs 1.17 [1.14,1.20] g/cm2) compared to controls. PCOS group also had decreased upper (0.72 [0.70,0.74] vs 0.77 [0.75,0.79] g/cm2) and lower (1.13 [1.10,1.16] vs 1.19 [1.16,1.22] g/cm2) limb BMD compared to HA. Matsuda index was lower in PCOS vs controls and positively associated with SMI% in all groups (all Ps ≤ 0.05). Only controls showed associations between insulin-like growth factor (IGF) 1 and upper (r = 0.84) and lower (r = 0.72) limb BMD (all Ps < 0.01). Unlike in PCOS, IGF-binding protein 2 was associated with SMI% in controls (r = 0.45) and HA (r = 0.67), and with upper limb BMD (r = 0.98) in HA (all Ps < 0.05).
Women with PCOS exhibit early signs of osteosarcopenia when compared to controls likely attributed to disrupted insulin function. Understanding the degree of musculoskeletal deterioration in PCOS is critical for implementing targeted interventions that prevent and delay osteosarcopenia in this clinical population.
骨质疏松-肌少症（通常与衰老相关的骨骼肌和骨量和/或功能丧失）与多囊卵巢综合征（PCOS）具有共同的病理生理机制。然而，骨质疏松-肌少症与 PCOS 之间的关系仍不清楚。
我们评估了 PCOS（高雄激素血症+少经）患者的骨骼肌指数%（SMI%=[四肢骨骼肌质量/体重（kg）]×100）和骨密度（BMD），并将这些肌肉骨骼标志物与 3 种生殖表型（i）：HA（高雄激素血症+正常月经）（ii）；OA（正常雄激素+少经）和（iii）对照（正常雄激素+正常月经）进行对比。评估了各组中 SMI%和 BMD 的内分泌预测因子。
设计、地点和参与者：纽约州多中心病例对照研究，纳入 203 名 18-48 岁的女性。
与对照组相比，PCOS 组的 SMI%（平均值[95%置信区间（CI）]；26.2%[25.1,27.3] vs 28.8%[27.7,29.8]）、下肢 SMI%（57.6%[56.7,60.0] vs 62.5%[60.3,64.6]）和 BMD（1.11[1.08,1.14] vs 1.17[1.14,1.20]g/cm2）较低。与 HA 相比，PCOS 组的上肢（0.72[0.70,0.74] vs 0.77[0.75,0.79]g/cm2）和下肢（1.13[1.10,1.16] vs 1.19[1.16,1.22]g/cm2）的 BMD 也较低。与对照组相比，PCOS 组的 Matsuda 指数较低，并且与所有组的 SMI%呈正相关（均 P<0.05）。仅在对照组中，胰岛素样生长因子（IGF）1与上肢（r=0.84）和下肢（r=0.72）BMD 之间存在相关性（均 P<0.01）。与 PCOS 不同的是，IGF-结合蛋白 2 与对照组（r=0.45）和 HA（r=0.67）的 SMI%相关，与 HA 的上肢 BMD（r=0.98）相关（均 P<0.05）。
与对照组相比，PCOS 患者表现出骨质疏松-肌少症的早期迹象，这可能归因于胰岛素功能紊乱。了解 PCOS 患者肌肉骨骼恶化的程度对于实施预防和延迟该临床人群骨质疏松-肌少症的针对性干预措施至关重要。
