Upper body obesity and hyperinsulinemia are associated with anovulation

The objective of this study was to determine the effect of body fat distrib ution and hyperinsulinemia on the occurrence of ovulation. Fifty-six women (20-35 years old) either with overweight or obesity (body mass index greate r than or equal to 25) were studied. They were classified in two groups acc ording to waist/hip ratio (WHR); one with predominance of adiposity in the upper body segment (n = 29, WHR > 0.85) and the other with predominant adip osity in the lower body segment (n = 27, WHR less than or equal to 0.85). B asal body temperature and serum progesterone were determined in each cycle during 6 months. Serum insulin levels were measured at baseline and 30, 60, 90, 120 and 180 min after a 75-gram oral glucose load. The mean insulin va lues in response to oral glucose load in patients with upper body segment o besity were significantly higher than those corresponding to women with low er body segment obesity. Furthermore, the ratio between ovulated cycles and all the cycles studied in patients with upper body segment obesity was sig nificantly lower than that observed in patients with lower body segment obe sity. Upper body obesity seems to affect the ovulatory process and this may be related to the presence of hyperinsulinemia.