Contribution of hyperandrogenism to the development of metabolic syndrome in obese women with polycystic ovary syndrome

PURPOSE: To assess the contribution of hyperandrogenism to the development of metabolic syndrome (MetS) in obese women with polycystic ovary syndrome (PCOS). METHODS: Retrospective cross-sectional study conducted on 60 obese women with classic PCOS phenotype - Rotterdam Consensus - and 70 non-PCOS obese women. MetS was diagnosed by the NCEP-ATP III criteria and obesity was defined by body mass index. The Ferriman-Gallwey score (mFG) was used to evaluate hirsutism. The following measurements were performed: total testosterone, dehydroepiandrosterone sulfate (DHEA-S), glucose and insulin, total cholesterol, HDL, and triglycerides. Insulin resistance was measured using the HOMA-IR and insulin sensitivity index of Matsuda and De Fronzo (ISI). Statistical analysis was performed using the Student's t-test, chi(2) test and multivariate logistic regression analysis (p<0.05). RESULTS: Obese women with PCOS had significantly higher mFG (15.4 +/- 6.1), waist circunference (105.6 +/- 11.4 cm), DHEA-S (200.8 +/- 109.2 mu g/dL), testosterone (135.8 +/- 71.4 ng/dL), and HOMA-IR (8.4 +/- 8.5) values and lower ISI values (2.0 +/- 1.8) than non-obese PCOS women (3.2 +/- 2.1; 101.4 +/- 9.2 cm; 155.0 +/- 92.7 mu g/dL; 50.0 +/- 18.2 ng/dL; 5.1 +/- 4.7 and 3.3 +/- 2.7, respectively) (p<0.05). The frequency of MetS was higher in PCOS obese (75%) than non-PCOS obese (52.8%) women (p=0.015). Multivariate analysis did not reveal the contribution of the variables IFG, testosterone, and DHEAS to the development of MetS (p>0.05). CONCLUSION: Obese women with PCOS have a higher frequency of metabolic syndrome than non-PCOS obese women, and hyperandrogenism does not contribute to the development of metabolic syndrome in this group of women.