INSULIN AND ANDROGEN RELATIONSHIPS WITH ABDOMINAL BODY-FAT DISTRIBUTION IN WOMEN WITH AND WITHOUT HYPERANDROGENISM

This retrospective study was carried out to investigate, in a large gr oup of hyperandrogenized women with polycystic ovary syndrome (PCOS) a nd nonhyperandrogenized control women, the interrelationships between sex steroids and indices of body fat distribution. Moreover, we invest igated the relationships between these parameters and insulin blood le vels, since obese women with abdominal pattern of fat distribution (A- BFD), as well as those with PCOS (either obese and nonobese) are chara cterized by moderate to severe hyperinsulinemia. A sample of 100 women with PCOS and that of 138 women without clinical signs of hyperandrog enism, who served as a control group, were investigated. The waist to hip circumference ratio (WHR) which was used to define different patte rns of fat topography was significantly (p < 0.05) higher in PCOS (0.8 4 +/- 0.10) than in control women (0.81 +/- 0.08). In both groups, wom en with WHR values lower than or equal to 0.85 were considered as havi ng a peripheral pattern of body fat distribution (P-BFD) whereas those having WHR values higher than 0.85 had A-BFD. Compared to controls, w omen with PCOS had higher LH, androgen and estrogen concentrations. In both PCOS and controls there were no differences in sex hormone level s between women with different patterns of fat distribution, except an drostenedione. which levels were significantly higher in women with A- BFD than with P-BFD. Women with PCOS showed significantly higher insul in levels than controls. Moreover, in both groups fasting and stimulat ed insulin were significantly higher in women with A-BFD than in those with P-BFD. Significant simple correlation coefficients were found be tween WHR and androstenedione in PCOS only, and between WHR and insuli n in both PCOS and controls. In multiple regression analysis, in which age and body mass index were included as independent variables, a wea k but significant correlation between WHR and androstenedione values w as found both in PCOS and controls separately, as well as in the whole sample of women considered together. On the contrary, correlation coe fficients between WHR and insulin were found in PCOS and controls cons idered separately and in the whole sample of women, even when the inde pendent effects of androgens had been taken into account in the analys is. These results are consistent with the hypothesis that the degree o f androgenization is only weakly correlated with A-BFD in premenopausa l women. Hyperinsulinemia, on the contrary, appears to be more consist ently correlated with A-BFD, regardless of the presence of PCOS. Wheth er these associations may have a causal relationship with different pa tterns of fat distribution remains to be further elucidated.