Hyperandrogenism Accompanies Increased Intra-Abdominal Fat Storage in Normal Weight Polycystic Ovary Syndrome Women
Hyperandrogenism Accompanies Increased Intra-Abdominal Fat Storage in Normal Weight Polycystic Ovary Syndrome Women
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DOI：
10.1210/jc.2016-2586
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发表时间：
2016-11-01
影响因子：
5.8
通讯作者：
Chazenbalk, Gregorio D.
中科院分区：
文献类型：
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作者：
Dumesic, Daniel A.;Akopians, Alin L.;Chazenbalk, Gregorio D.
内容：正常体重的多囊卵巢综合征（PCOS）妇女可能存在脂肪结构-功能改变，这可能是代谢功能障碍的基础。目的：本研究探讨正常体重的PCOS妇女是否存在脂肪结构-功能改变，并与高雄激素血症和/或高胰岛素血症相关。设计：这是一项前瞻性队列研究。设置：设置是一个学术医疗中心。患者：干预措施：所有妇女进行循环激素和代谢测量，频繁取样静脉葡萄糖耐量试验，全身双能X线吸收测定，腹部磁共振成像，和SC腹部脂肪活检。主要结果测量：循环激素和代谢产物，体脂及其分布，脂肪细胞的大小进行了比较PCOS和NL妇女，并相互关联在所有women.Results：循环LH和雄激素水平显着大于PCOS比NL妇女，空腹胰岛素水平，胰腺β细胞对葡萄糖的反应，和腹部脂肪总量。PCOS妇女的腹腔内脂肪量也显著增加，并且与所有妇女的循环雄激素、空腹胰岛素、甘油三酯和非高密度脂蛋白胆固醇水平呈正相关。SC腹部脂肪量并没有显着增加PCOS妇女，但包含了更大比例的小SC腹部脂肪细胞，血清雄激素水平呈正相关，在所有women.Conclusion：高雄激素血症在正常体重PCOS妇女与优先腹内脂肪沉积和增加人口的小SC腹部脂肪细胞，可以限制SC脂肪储存，促进代谢功能障碍。
Context: Normal weight polycystic ovary syndrome (PCOS) womenmay have altered adipose structure-function underlying metabolic dysfunction.Objective: This study examines whether adipose structure-functional changes exist in normal weight PCOS women and correlate with hyperandrogenism and/or hyperinsulinemia.Design: This is a prospective cohort study.Setting: The setting was an academic medical center.Patients: Six normal weight PCOS women and 14 age-and body mass index-matched normoandrogenic ovulatory (NL) women were included.Intervention(s): All women underwent circulating hormone and metabolic measurements; frequently sampled intravenous glucose tolerance testing; total body dual-energy x-ray absorptiometry; abdominal magnetic resonance imaging; and SC abdominal fat biopsy.Main Outcome Measure(s): Circulating hormones and metabolites, body fat and its distribution, and adipocyte size were compared between PCOS and NL women, and were correlated with each other in all women.Results: Circulating LH and androgen levels were significantly greater in PCOS than NL women, as were fasting insulin levels, pancreatic beta-cell responsiveness to glucose, and total abdominal fat mass. Intra-abdominal fat mass also was significantly increased in PCOS women and was positively correlated with circulating androgen, fasting insulin, triglyceride, and non-high-density lipoprotein cholesterol levels in all women. SC abdominal fat mass was not significantly increased in PCOS women, but contained a greater proportion of small SC abdominal adipocytes that positively correlated with serum androgen levels in all women.Conclusion: Hyperandrogenism in normal weight PCOS women is associated with preferential intra-abdominal fat deposition and an increased population of small SC abdominal adipocytes that could constrain SC adipose storage and promote metabolic dysfunction.