THE FREE TESTOSTERONE TO DEHYDROEPIANDROSTERONE-SULFATE MOLAR RATIO AS A MARKER OF VISCERAL FAT ACCUMULATION IN PREMENOPAUSAL OBESE WOMEN

The aim of this paper was to investigate the relationship between sex hormones and fat distribution in premenopausal obese women. Serum conc entrations of sex hormones, glucose tolerance and fat distribution wer e determined in a population of non-diabetic obese women, in the outpa tient clinic of University Hospital, Sari, Italy. The subjects were 40 consecutive premenopausal obese women (BMI > 25). The amounts of visc eral, abdominal subcutaneous, and femoral subcutaneous fat, and the vi sceral to abdominal subcutaneous fat ratio were measured by ultrasound techniques. Serum concentrations of total testosterone (T), free test osterone (FT), dehydroepiandrosterone sulphate (DHEAS), Delta(4)-andro stenedione (A), 17-beta-estradiol (E(2)), sex hormone binding globulin (SHBG), and the FT to DHEAS molar ratio were measured during the foll icular phase. Plasma glucose and insulin concentrations were evaluated during an oral glucose tolerance test. Of all sex hormones, the FT/DH EAS molar ratio was the parameter that most closely related to the amo unt of visceral fat (r: 0.544, P < 0.001), and this positive associati on was maintained (P < 0.01) after adjustment for age, BMI and insulin levels (fitted model: R(2) adjusted: 0.504; F ratio: 14.73; P-value: < 0.0001). DHEAS was inversely correlated with the amount of visceral fat (r: -0.324, P < 0.05). T was inversely correlated with the amounts of both abdominal subcutaneous (r: -0.409, P < 0.01) and visceral fat (r: -0.324, P < 0.05). The FT to DHEAS molar ratio is the androgenic parameter that most closely relates to the accumulation of visceral fa t in premenopausal obese women.