In women with polycystic ovary syndrome, insulin resistance may be more severe in those with metabolic syndrome than in those without it, according to data from a cross-sectional study of women with PCOS.
Even young women with PCOS should be screened for metabolic disturbances to more effectively prevent cardiovascular events later in life, wrote Dr. Hwi Ra Park of the Ewha Womans University College of Medicine, Seoul, South Korea, and colleagues.
The 113 women in the study had a mean age of 26 years and a 15% prevalence of metabolic syndrome (MS), which is lower than what has been reported in studies of PCOS patients in the United States (43%–46%) and Germany (31%). The prevalence of MS is about 4% in the general urban population of age-matched Korean women and about 6% in American women aged 20–29 years (Diabetes Res. Clin. Pract. 2007;77[suppl. 1]:S243–6).
Of the five components of the diagnosis of metabolic syndrome as per the National Cholesterol Education Program Adult Treatment Panel III, 45% of the women had a high-density lipoprotein cholesterol level of less than 50 mg/dL; 24% had a waist circumference greater than 80 cm; 20% had high systolic blood pressure (130 mm Hg or more) or high diastolic blood pressure (85 mm Hg or more); 13% had fasting triglyceride levels of at least 150 mg/dL; and 1% had fasting blood glucose levels of at least 110 mg/dL.
Compared with women who didn't have MS, those with MS had a higher body mass index, waist girth, systolic and diastolic blood pressures, fasting glucose, fasting and post-glucose load insulin levels, triglycerides, and free testosterone. Levels of HDL cholesterol, sex hormone-binding globulin, and luteinizing hormone were significantly lower in women with MS.
The results of a 75-g oral glucose tolerance test performed after an overnight fast showed plasma glucose and insulin levels were significantly higher in women with MS than in those without it.
“Insulin resistance is most likely the pathogenic link between PCOS and MS,” they said. Some data suggest women with PCOS and MS have higher rates of hyperandrogenemia, low serum sex hormone-binding globulin, and acanthosis nigricans, than do those without MS. That “may reflect more severe insulin resistance” in PCOS women with MS.