PITUITARY DESENSITIZATION TO GONADOTROPIN-RELEASING-HORMONE INCREASESABDOMINAL ADIPOSITY IN HYPERANDROGENIC ANOVULATORY WOMEN

Objective: To determine whether hyperandrogenism in anovulatory women affects body fat distribution. Design: Prospective nonrandomized study . Setting: An academic research environment. Patient(s): Ten hyperandr ogenic anovulatory patients and 10 healthy women matched by body mass index. Intervention(s): Regional body Fat analysis was performed befor e and after 3 months of GnRH analogue (GnRH-a) therapy. Main Outcome M easure(s): Body fat distribution was measured by waist-to-hip circumfe rence ratio, single-slice computed tomography imaging (L2-3 interspace ), and total body dual-energy x-ray absorptiometry. Result(s): Weight, body mass index, waist-to-hip circumference ratio, total body and leg fat mass, and subcutaneous adipose area were unaffected by the presen ce of hyperandrogenism or the use of GnRH-a therapy. Basal abdominal f at mass, abdomen-to-leg fat mass ratio, visceral adipose area, and tot al visceral adipose volume were comparable in both study groups. The a bdominal Eat mass increased in both groups during GnRH-a therapy, wher eas the abdomen-to-leg fat mass ratio rose significantly only in the h yperandrogenic patients. During GnRH-a therapy, the hyperandrogenic pa tients demonstrated a significant increase in visceral adipose area co mpared with the healthy women so that total visceral adipose volume in creased significantly in the former but not the latter. Conclusion(s): Three months of GnRH-a administration preferentially increased abdomi nal fat, as measured by single-slice computed tomography imaging and t otal body dual-energy x-ray absorptiometry, in hyperandrogenic anovula tory women. (Fertil Steril(R) 1998;70:94-101. (C) 1998 by American Soc iety for Reproductive Medicine.).