Adipose tissue has aberrant morphology and function in PCOS: enlarged adipocytes and low serum adiponectin, but not circulating sex steroids, are strongly associated with insulin resistance.
Artikel i vetenskaplig tidskrift, 2011

Context: Comprehensive characterization of the adipose tissue in women with polycystic ovary syndrome (PCOS), over a wide range of body mass indices (BMIs), is lacking. Mechanisms behind insulin resistance in PCOS are unclear. Objective: To characterize the adipose tissue of women with PCOS and controls matched pair-wise for age and BMI, and to identify factors, among adipose tissue characteristics and serum sex steroids, that are associated with insulin sensitivity in PCOS. Design/Outcome Measures: Seventy-four PCOS women and 31 controls were included. BMI was 18-47 (PCOS) and 19-41 kg/m2 (controls). Anthropometric variables, volumes of subcutaneous/visceral adipose tissue (magnetic resonance imaging; MRI), and insulin sensitivity (clamp) were investigated. Adipose tissue biopsies were obtained to determine adipocyte size, lipoprotein lipase (LPL) activity, and macrophage density. Circulating testosterone, free testosterone, free 17β-estradiol, SHBG, glycerol, adiponectin, and serum amyloid A were measured/calculated. Results: Comparison of 31 pairs revealed lower insulin sensitivity, hyperandrogenemia, and higher free 17β-estradiol in PCOS. Abdominal adipose tissue volumes/distribution did not differ in the groups, but PCOS women had higher waist-to-hip ratio, enlarged adipocytes, reduced adiponectin, and lower LPL activity. In regression analysis, adipocyte size, adiponectin, and waist circumference were the factors most strongly associated with insulin sensitivity in PCOS (R2=0.681, P < 0.001). Conclusions: In PCOS, adipose tissue has aberrant morphology/function. Increased waist-to-hip ratio indicates abdominal/visceral fat accumulation, but this is not supported by MRI. Enlarged adipocytes and reduced serum adiponectin, together with a large waistline, rather than androgen excess, may be central factors in the pathogenesis/maintenance of insulin resistance in PCOS.

blood

pathology

Body Height

physiology

Adult

Lipoprotein Lipase

Humans

Female

Body Weight

blood

metabolism

pathology

physiology

Sex Hormone-Binding Globulin

Body Mass Index

Insulin Resistance

Waist-Hip Ratio

physiology

metabolism

Glycerol

blood

Cell Size

Immunohistochemistry

Waist Circumference

Gonadal Steroid Hormones

pathology

Adipocytes

Adiponectin

Macrophages

Polycystic Ovary Syndrome

Adipose Tissue

Amyloid

blood

pathology

Författare

Louise Mannerås Holm

Göteborgs universitet

Henrik Leonhardt

Göteborgs universitet

Joel Kullberg

Akademiska Sjukhuset

Eva Jennische

Göteborgs universitet

Anders Odén

Chalmers, Matematiska vetenskaper, matematisk statistik

Göteborgs universitet

Göran Holm

Göteborgs universitet

Mikael Hellström

Göteborgs universitet

Lars Lönn

Göteborgs universitet

Gunilla Olivecrona

Umeå universitet

Elisabet Stener-Victorin

Göteborgs universitet

Malin Lönn

Göteborgs universitet

Journal of Clinical Endocrinology and Metabolism

0021-972X (ISSN)

Vol. 96 E304-11

Ämneskategorier

Endokrinologi och diabetes

DOI

10.1210/jc.2010-1290

PubMed

21084397