Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Sports Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Maturitas. 2024 Jul;185:107982. doi: 10.1016/j.maturitas.2024.107982. Epub 2024 Mar 31.
The potential effects of polycystic ovary syndrome (PCOS) on the musculoskeletal system are not well established. We examined the musculoskeletal system in women with PCOS in their late reproductive years.
STUDY-DESIGN: This cross-sectional study included 34 women with PCOS and 32 control women matched for age and body mass index (BMI).
Dual-energy x-ray absorptiometry (DXA) was used for body composition analysis and cross-sectional areas and fat fraction of muscles were assessed by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) of the abdomen and thigh. Muscle strength was measured using an isokinetic dynamometer.
The mean age of the PCOS group was 43 ± 3.7 years and of the control group 42.2 ± 3.5 years. Testosterone, free androgen index, and fasting insulin were higher in PCOS patients than controls (p < 0.001, p = 0.001 and p = 0.032, respectively). Patients and controls had similar values for total abdominal muscle area (TAMA), paraspinal muscle area, thigh muscle area, vertebral MRI-PDFF, thigh and paraspinal muscle MRI-PDFF. There was no difference in DXA-derived muscle and bone composition between the two groups. Body composition parameters measured by MRI and DXA were correlated with BMI and fasting insulin levels, but not with androgen levels in both groups. Subgroup analyses showed that PCOS women with obesity had higher TAMA than controls with obesity (p = 0.012). Apart than higher 60°/sec knee extensor average power in nonobese PCOS (p = 0.049), no difference in muscle mechanical function was detected between PCOS patients and controls.
Musculoskeletal composition and function are similar in PCOS patients and healthy women in late reproductive years. Body composition is linked with obesity and insulin resistance rather than hyperandrogenemia.
多囊卵巢综合征（PCOS）对骨骼肌肉系统的潜在影响尚未得到充分证实。我们研究了处于生育后期的 PCOS 女性的骨骼肌肉系统。
这项横断面研究纳入了 34 名 PCOS 女性和 32 名年龄和体重指数（BMI）匹配的对照组女性。
双能 X 线吸收法（DXA）用于身体成分分析，磁共振成像质子密度脂肪分数（MRI-PDFF）评估腹部和大腿肌肉的横截面积和脂肪分数。肌肉力量使用等速测力计测量。
PCOS 组的平均年龄为 43±3.7 岁，对照组为 42.2±3.5 岁。PCOS 患者的睾酮、游离雄激素指数和空腹胰岛素水平高于对照组（p<0.001、p=0.001 和 p=0.032）。患者和对照组的总腹部肌肉面积（TAMA）、脊柱旁肌肉面积、大腿肌肉面积、椎体 MRI-PDFF、大腿和脊柱旁肌肉 MRI-PDFF 相似。两组之间 DXA 测量的肌肉和骨骼成分无差异。两组 MRI 和 DXA 测量的身体成分参数与 BMI 和空腹胰岛素水平相关，但与雄激素水平无关。亚组分析显示，肥胖的 PCOS 女性的 TAMA 高于肥胖的对照组女性（p=0.012）。除了非肥胖 PCOS 患者 60°/秒膝关节伸肌平均功率较高（p=0.049）外，PCOS 患者和对照组之间的肌肉力学功能没有差异。
处于生育后期的 PCOS 患者和健康女性的骨骼肌肉组成和功能相似。身体成分与肥胖和胰岛素抵抗有关，而与高雄激素血症无关。
