Impaired Lipolysis, Diminished Fat Oxidation, and Metabolic Inflexibility in Obese Girls With Polycystic Ovary Syndrome
Impaired Lipolysis, Diminished Fat Oxidation, and Metabolic Inflexibility in Obese Girls With Polycystic Ovary Syndrome
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DOI：
10.1210/jc.2017-01958
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发表时间：
2018-02-01
影响因子：
5.8
通讯作者：
Arslanian, Silva
中科院分区：
文献类型：
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作者：
Kim, Joon Young;Tfayli, Hala;Arslanian, Silva
背景：代谢灵活性反映了胰岛素刺激期间从脂质氧化转变为碳水化合物氧化的能力，表现为呼吸商（RQ）增加。关于患有多囊卵巢综合征 (PCOS) 的青春期女孩的脂肪组织代谢和代谢灵活性知之甚少。 目的：我们研究了患有 PCOS 的肥胖女孩与不患有 PCOS 的肥胖女孩的全身脂肪分解、底物氧化和代谢灵活性。 患者/设计：将 21 名患有 PCOS 的肥胖女孩和 21 名不患有 PCOS 的肥胖女孩进行年龄和种族配对。测量了身体成分、腹部内脏脂肪组织（VAT）、性激素、血脂和脂联素。在禁食和高胰岛素正常血糖钳夹期间评估全身脂肪分解（[H-2(5)]甘油周转率）、RQ和底物氧化（间接量热法），并评估胰岛素敏感性（IS）。结果：尽管体重指数和体脂百分比相似，但患有 PCOS 的女孩与未患 PCOS 的女孩相比，其空腹脂肪分解和脂肪氧化较低， 高胰岛素血症期间 RQ 增加较少，脂肪分解和脂质氧化抑制受损，IS 较低。在多元回归中，代谢灵活性的最佳预测因子是[使用临床参数：脂联素、空腹甘油三酯和胰岛素（R-2 = 0.618，P < 0.0001）；使用研究参数：IS、VAT 和基线 RQ（R-2 = 0.756，P < 0.0001）]。结论：患有 PCOS 的肥胖女孩与未患 PCOS 的肥胖女孩相比，脂质动员减少，脂肪氧化减少，代谢不灵活。这种有利于脂肪堆积的脂肪组织功能障碍的代谢表型是否在患有 PCOS 的青春期女孩肥胖的诱导和维持中发挥作用仍有待确定。
Context: Metabolic flexibility reflects the ability to switch from lipid to carbohydrate oxidation during insulin stimulation manifested in increased respiratory quotient (RQ). Little is known about adipose tissue metabolism and metabolic flexibility in adolescent girls with polycystic ovary syndrome (PCOS).Objective: We investigated whole-body lipolysis, substrate oxidation, and metabolic flexibility in obese girls with PCOS vs obese girls without PCOS.Patients/Design: Twenty-one obese girls with PCOS and 21 obese girls without PCOS were pair-matched for age and race. Body composition, abdominal visceral adipose tissue (VAT), sex hormones, lipid profile, and adiponectin were measured. Whole-body lipolysis ([H-2(5)] glycerol turnover), RQ, and substrate oxidation (indirect calorimetry) were evaluated during fasting and a hyperinsulinemic-euglycemic clamp together with assessment of insulin sensitivity (IS).Results: Despite similar body mass index and percent body fat, girls with PCOS vs girls without PCOS had lower fasting lipolysis and fat oxidation, less increase in RQ during hyperinsulinemia with impaired suppression in lipolysis and lipid oxidation, and lower IS. In multiple regression, the best predictors of metabolic flexibility were [using clinical parameters: adiponectin, fasting triglycerides, and insulin (R-2 = 0.618, P < 0.0001); using research parameters: IS, VAT, and baseline RQ (R-2 = 0.756, P < 0.0001)].Conclusions: Obese girls with PCOS vs obese girls without PCOS have decreased lipid mobilization, diminished fat oxidation, and metabolic inflexibility. Whether this metabolic phenotype of adipose tissue dysfunction, which is conducive to fat accretion, plays a role in the induction and maintenance of obesity in adolescent girls with PCOS remains to be determined.