Human Reproduction, Vol 13, 535-541, Copyright © 1998 by Oxford University Press
G Gennarelli, J Holte, L Wide, C Berne and H Lithell
Immunoreactive serum leptin was analysed in 49 women with polycystic ovary
syndrome (PCOS) distributed on a wide range of body mass index (BMI; kg/m2)
and in 32 normally menstruating women with comparable age, BMI, physical
activity and dietary habits. All women with PCOS had increased androgen
concentrations and obese women with PCOS (BMI > or = 25, n=24) also
showed decreased insulin sensitivity and a preferential accumulation of
truncal-abdominal body fat. Anthropometric and hormonal variables, insulin
sensitivity, and pancreatic beta-cell activity were investigated in all
women. Percentage body fat was calculated using gender-specific regression
equations based on skinfold measurements. Serum leptin concentrations were
higher in obese than in non-obese women (P < 0.001), but did not differ
between the women with PCOS and controls, nor did they differ between
glucose intolerant and glucose tolerant, or hirsute and non-hirsute women
with PCOS. Both groups showed strong correlations between serum leptin
concentrations and percentage body fat, BMI, body fat distribution, fasting
plasma insulin and C-peptide, early insulin secretion, the free androgen
index (FAI), and the degree of insulin resistance. After correcting for
percentage body fat, only the FAI in the women with PCOS remained
significant (P < 0.05). However, in a multiple regression analysis with
both percentage body fat and the FAI as independent variables, the FAI
increased only minimally (2%) the explained variation in leptin
concentrations. Thus, serum leptin concentrations are almost exclusively
determined by the total amount of body fat, independent of its location,
and do not confirm the hypothesis that leptin is involved in the
development of the hormonal and metabolic abnormalities in the PCOS.
ARTICLES
Is there a role for leptin in the endocrine and metabolic aberrations of polycystic ovary syndrome?
Department of Obstetrics and Gynecology, Uppsala University, Sweden.
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