Subcutaneous and omental fat expression of adiponectin and leptin in women with polycystic ovary syndrome

To assess message expression of adiponectin and leptin in visceral and SC fat in women with polycystic ovary syndrome (PCOS) and in control women. Design: Prospective clinical trial. Setting: Academic medical centers in Mexico City, Mexico and New York, New York. Patient(s): Women with PCOS and control women. Intervention(s): Surgical biopsies of visceral (omental) and subcutaneous (SC) adipose tissue, fasting blood samples, and ultrasound measurements of visceral and SC fat. Main Outcome Measure(s): Messenger RNA assessment of adiponectin and leptin in adipose tissue samples; serum measurements of adiponectin, leptin, glucose, insulin, and hormone levels; measurements of fat quantity by ultrasound. Correlative analyses as well as comparisons between women with PCOS and control women were performed. Result(s): Confirming previous data, women with PCOS had more insulin resistance, similar serum leptin, but lower serum adiponectin compared with control women. When control women were divided into quartiles by body mass index (BMI), messenger RNA expression of leptin and adiponectin decreased with increasing BMI. Adiponectin and leptin expression was significantly lower in women with PCOS; in weight-matched patients and control women, leptin and adiponectin expression was statistically significantly lower in SC tissue, and adiponectin expression was statistically significantly lower in omental tissue in women with PCOS. In control women, there was greater expression in SC tissue compared with in visceral tissue. There were significant negative correlations between visceral and SC fat mass by both ultrasound as well as adiponectin and leptin expression in women with PCOS. Serum adiponectin correlated statistically significantly with visceral adiponectin expression (r = 0.64) in women with PCOS, and there was a statistically significant correlation between SC adiponectin expression and the Quantitative Insulin-Sensitivity Check Index as a marker of insulin resistance (r = 0.43). Conclusion(s): Adipocytokine expression in fat tissue appears to be down-regulated by an increased fat mass; this is particularly evident in the case of adiponectin expression in women with PCOS. It is probable that insulin resistance is a factor that may contribute, in part, to these findings