The central issue? Visceral fat mass is a good marker of insulin resistance and metabolic disturbance in women with polycystic ovary syndrome
Abstract
Objective To establish whether visceral fat mass is the most significant variable correlating with insulin resistance and other metabolic parameters in women with polycystic ovary syndrome (PCOS). Design Prospective cross‐sectional trial. Setting Reproductive medicine clinic. Population Forty women with anovulatory PCOS. Methods Measurements were taken at recruitment, and analysis was performed to define correlations between the outcome measures and the explanatory variables. Main outcome measures Visceral and subcutaneous fat by computed tomography scan, insulin resistance, anthropometric measures, markers of the metabolic syndrome and androgens. Results Strong linear correlation of visceral fat to insulin resistance (r= 0.68, P < 0.001) was observed. There were also statistically significant correlations with fasting insulin (r= 0.73, P < 0.001), homeostasis model assessment β‐cell function (r= 0.50, P= 0.007), triglycerides (r= 0.45, P= 0.003), high‐density lipoprotein cholesterol (r=−0.42, P= 0.007), urate (r= 0.47, P= 0.002), Sex hormone binding globulin (r=−0.39, P= 0.01) and luteinising hormone (r=−0.32, P= 0.02). There were no significant correlations of testosterone with fat distribution or metabolic parameters. Insulin resistance showed closest correlation to visceral fat mass (r= 0.68, P < 0.001), then to waist circumference (r= 0.62, P < 0.001), with the weakest correlation being waist:hip ratio (r= 0.36, P= 0.01). The best regression model for predicting insulin resistance is with visceral fat mass and triglycerides as the explanatory variables (r= 0.72, P < 0.001). Conclusions Visceral fat is the most significant variable correlating with metabolic dysfunction in women with PCOS. Our data support the hypothesis that visceral fat either causes insulin resistance or is a very early effect of it. It also implies that reducing visceral fat should reduce insulin resistance which may account for the observations that exercise and weight loss appear to be more effective interventions than pharmacological treatments. The best anthropometric measure of insulin resistance is waist circumference.
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Central adiposity likely plays a key role in cardiometabolic risk in PCOS.
“The level of central adiposity likely plays a key role in cardiometabolic risk, as insulin resistance has been associated with higher levels of central adiposity in the PCOS population [32,34,35,36].”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [34]
Metabolic and endocrine derangements of PCOS contribute to making women with PCOS more prone to develop metabolic syndrome, type 2 diabetes mellitus, and infertility.
“Metabolic and endocrine derangements of PCOS both contribute to making women with PCOS more prone to develop metabolic syndrome, type 2 diabetes mellitus, and infertility [9,10,11].”
From Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS) (2019) · cites this paper as [9]
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- Authors
- Lord, J., Thomas, R., Fox, B., Acharya, U., & Wilkin, T.
- Affiliations
- Royal Cornwall Hospital Trust (GB)
- Royal Devon & Exeter NHS Foundation Trust (GB)
- Derriford Hospital (GB)
- Corresponding author
- Lord, J
- ORCID
- Lord, J
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2006-08-10
- Volume
- 113
- Issue
- 10
- Pages
- 1203-1209
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2083827626
- Cited by
- 158
- References
- 6
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 5 · 2021: 12 · 2020: 9 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 8 · 2015: 11 · 2014: 8 · 2013: 12 · 2012: 10
- FWCI
- 10.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- polycystic ovary syndrome, visceral fat mass, insulin resistance, metabolic syndrome, subcutaneous adipose tissue, triglycerides, beta-cell function, androgens, sex hormone-binding globulin, luteinizing hormone, uric acid, waist circumference, body fat distribution, weight loss, exercise intervention, women's health
- MeSH terms
- Adult, Blood Glucose, Cross-Sectional Studies, Female, Humans, Insulin Resistance, Polycystic Ovary Syndrome, Prospective Studies, Tomography, X-Ray Computed, Metabolic Syndrome, Intra-Abdominal Fat
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