Body composition of individuals with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the principle forms of hyperandrogenism that affects women of reproductive age. Few studies have evaluated the body composition of patients with PCOS being based mainly on an evaluation of the quantity and distribution of the fat mass. Objectives: to evaluate the body composition of patients affected by PCOS and to establish the hormonal factors that determine possible differences in body composition compared with healthy women. Methods: 110 Caucasian women affected by clinical hyperandrogenism and/or irregular menstrual periods were included in the study; the control group was made up of 90 healthy Caucasian women, of reproductive age, without hyperandrogenism. The control group and the patients were similar in age (23 ± 3 vs. 24.1 ± 6.4 years old) but not in body weight or body mass index (BMI). A hematic sample was taken from both groups, on the fifth day of the menstrual cycle, to measure the quantities of glycaemia, insulin, testosterone (T), SHBG and dehydroepiandrosterone sulphate (DHEAS). In the hyperandrogenic patients the quantities of serum 17-hydroxyprogesterone (on the 5th day of the menstrual cycle) and of progesterone (on the 22nd day of the menstrual cycle) were also measured. Moreover, the hyperandrogenic patients underwent a pelvic or intra-vaginal ultrasound scan to evaluate the ovarian morphology. Results: the patients with classic PCOS showed serum levels higher in testosterone, FAI and insulin than the patients with ovulatory PCOS and idiopathic hyperandrogenism; the patients with ovulatory PCOS had higher levels of testosterone, FAI and insulin (p<0.01) than the control group. The patients with Idiopathic Hyperandro-genism had higher levels of testosterone (p<0.01) and FAI (p<0.01) but similar levels of BMI and insulin, and similar waist circumference and body composition. Conclusions: the hyperandrogenic patients have a different body composition to normal women. The increase in the fat free mass seems to be primarily a consequence of hyperinsulinemia, as the fat free mass correlated significantly with the circulating insulin and the insulin resistance. Consequently, these alterations have an influence on the body composition and therefore both on the quantity and distribution of body fat and on the increase in muscle mass.