de Melo Cavalcante Rebeca Bandeira, Leão Lenora Maria Camarate Silveira Martins, Tavares Ana Beatriz Winter, Lopes Karynne Grutter, Kraemer-Aguiar Luiz Guilherme
Postgraduate Program in Clinical and Experimental Pathophysiology, Rio de Janeiro State University Faculty of Medical Sciences, Rio de Janeiro, Brazil.
Endocrinology Department of Internal Medicine, Rio de Janeiro State University Faculty of Medical Sciences, Rio de Janeiro, Brazil.
Horm Metab Res. 2025 Jan;57(1):25-32. doi: 10.1055/a-2386-9281. Epub 2024 Sep 3.
The high cardiometabolic risk associated with polycystic ovary syndrome (PCOS) may be linked to central fat accumulation. This study compared fat distribution between women with PCOS and controls matched by body mass index. It also sought to determine if insulin resistance (IR), androgens, or inflammatory markers correlate with body composition parameters in PCOS patients. In total, thirty-five women with PCOS and 37 controls, aged 18-40 years, were included. Hormonal/metabolic profiles, inflammatory biomarkers [tumor necrosis factor-alpha (TNF-α and interleukin-6 (IL-6)], anthropometry (waist circumference, waist-to-hip ratio, lipid accumulation product [LAP], visceral adiposity index [VAI]), and body composition assessed through dual-energy X-ray absorptiometry were assessed. The PCOS group exhibited significantly higher androgen levels and markers of IR. However, levels of TNF-α and IL-6 were comparable between the groups. Despite having similar total body fat mass (FM), the PCOS group had excessive central fat, including increased truncal FM and visceral adipose tissue (VAT). In PCOS, androgens were not associated with body fat or its distribution. IL-6 was positively correlated with total and truncal FM, while insulinemia and the homeostatic model assessment for IR were positively associated with VAT, as well as with total and truncal FM. Although anthropometric measurements and indices were positively associated with DXA-derived central FM parameters, our data suggest that LAP is the most effective tool for assessing central fat deposition and metabolic dysfunction in the PCOS patients studied herein. Furthermore, in this population, IR, rather than androgens or proinflammatory cytokines, is more closely associated with abdominal obesity.
多囊卵巢综合征（PCOS）相关的高心脏代谢风险可能与中心性脂肪堆积有关。本研究比较了PCOS女性与按体重指数匹配的对照组之间的脂肪分布情况。研究还试图确定胰岛素抵抗（IR）、雄激素或炎症标志物是否与PCOS患者的身体成分参数相关。总共纳入了35名年龄在18至40岁之间的PCOS女性和37名对照组女性。评估了激素/代谢谱、炎症生物标志物[肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）]、人体测量指标（腰围、腰臀比、脂质堆积产物[LAP]、内脏肥胖指数[VAI]）以及通过双能X线吸收法评估的身体成分。PCOS组的雄激素水平和IR标志物显著更高。然而，两组之间的TNF-α和IL-6水平相当。尽管两组的总体脂肪量（FM）相似，但PCOS组存在过多的中心性脂肪，包括躯干FM和内脏脂肪组织（VAT）增加。在PCOS中，雄激素与体脂及其分布无关。IL-6与总体和躯干FM呈正相关，而胰岛素血症和IR的稳态模型评估与VAT以及总体和躯干FM呈正相关。尽管人体测量指标和指数与双能X线吸收法得出的中心FM参数呈正相关，但我们的数据表明，LAP是评估本文所研究的PCOS患者中心性脂肪沉积和代谢功能障碍的最有效工具。此外，在该人群中，与腹部肥胖关系更密切的是IR，而非雄激素或促炎细胞因子。
