Cover
Vol. 2 No. 1 (2012)

Published: June 30, 2012

Pages: 16-21

Research Article

Testosterone level and body mass index in women with polycystic ovary syndrome

Abstract

Background: Elevated serum concentrations of testosterone is common in women with polycystic ovary syndrome (PCOS)but it'srelationto body mass in dex(BMI), isstillunknown. Objective: The present study was conducted to investigate the relationship between testosterone level and body massindexin womenwith polycysticovary syndrome. Methods: A total of eighty PCOS women with average age 27.6±0.7 and BMI 31.9±0.5 were compared with twenty-two healthy women considered as a control group (age 28.2±1.1, BMI 28.8±1.0). Patients and controls were grouped according to (BMI: Lean, overweight and obese. Allwomen in both groups were subjected to the following investigations: evaluation of luteinizing hormone (LH), follicle stimulating hormone (FSH.), prolactin (PRL), testosterone levels and ultrasonography. Results: The serum levels of LH, LH/FSH and testosterone were significantly higher (P< 0.05) in PCOS compared to control women,while in FSH and PRL the difference was non significant. Obese women with PCOS also had a significantly higher (P<0.05) mean level of testosterone (1.33±0.28ng/ml) compared to lean and overweight patients (0.53±0.17, 0.61±0.08 ng/ml respectively). Uitrasound examination was performed in the ovulatory phase during (12-14) days of the cycle in both PCOS patients and controls, and all women with PCOS with evidence of polycystic ovaries on ultrasonography. Conclusion: Testosterone levelwas significantly elevated in obesecompared to overweightand lean women with PCOS.The role of weight reduction is more beneficial in the management of PCOS and improvementoftestosteronelevel.

References

  1. Azziz R, Marin C, Hoq L, BadamgaravE, and Song PHealth care-related economic burden of the polycystic ovary syndrome during the reproductive life span. J. Clin. Endocrinol. Metab. 2005;90:4650-4658.
  2. Stein IF and Leventhal NL. Amenorrhea associated with bilateral polycystic ovaries. Am.Obstet. Gynecol. 1935; 29: 181-191.
  3. The Rotterdam ESHRE/ASRM-sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycysticovary syndrome. Hum.Reprod.2004;19:41-47.
  4. Balen AH. The pathogenesis of polycysticovary syndrome: the enigma unravels. Lancet. 1999; 354:966-967.
  5. Lobo RA, Goebelsmann U and Horton R Evidence for the importance of peripheral tissue events in the development of hirsutism in polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 1983:57:393-397.
  6. KirschnerMA, Samojlik E, Drejka M, Szmal E, Schneider G and Ertel N. Androgen-ostrogen metabolism in women with upper body versus lower body obesity. J. Clin. Endocrinol. Metab. 1990;70:473-479.
  7. Legro R S. Pregnancy considerations in women with polycystic ovary syndrome. Clinical Obstetrics and Gynecology. 2007;50(1):295-304.
  8. Pasquali R, Casimirri F, Venturoli S, Antonio M, Morselli L, Reho S et al. Body fat distribution has weight-independent effects on clinical, hormonal, and metabolic features of women with polycystic ovary syndrome. Metab. Clin. Exp. 1994;43:706-713.
  9. Pasquali R, Casimirri F and Vicennati V. Weight control and its beneficial effect on fertility in women with obesity and polycysticovary syndrome. Hum. Reprod. 1997; 12:82-87.
  10. Rebuffe-Scrive M, Marin P and Bjorntorp P Effect of testosterone on abdominal adipose tissue in men. Int. J. Obes. 1991; 15:791-795.
  11. Peiris AN, Mueller RA, Struve M. F, Smith GA and Kissebah AH. Relationship of androgenic activity to splanchnic insulin metabolism and peripheral glucose utilization in premenopausal women. J. Clin. Endocrinol. Metab. 1987;64:162-169.
  12. Roden M, Price TB, Perseghin G, Petersen KF, Rothman DL, Cline GW et al. Mechanism of free fatty acid - induced insulin resistance in humans. J. Clin. Invest. 1996; 97: 2859-2865.
  13. Hillier SG and Tetsuka M. Role of androgens in follicle maturation and atresia. Bailleres Clin. Obstet. Gynaecol. 1997;11:249-260.
  14. Jakimiuk AJ, Weitsman SR, Brzechffa PR and Magoffin DAAromatase mRNA expression in individual follicles from polycysticovaries. Mol. Hum. Reprod. 1998; 4: 1-8.
  15. GoudasVTand Dumesic DA. Polycysticovarysyndrome. Endocrinol. Metab. Clin. North Am. 1997;26(4):893-912.
  16. Tolino A, Gambardella V, Caccavale C, D'Ettore A, Giannotti F, D'Anto V et al. Evaluation of ovarian functionality after a dietary treatment in obese women with PCOS. Eur. J. Obstet. Gynecol. Reprod. Biol. 2005; 119:87-93.
  17. Jonard S, Robert Y, Cortet-Rudelli C, Pigny P, Decanter C and Dewailly D. Ultrasound examination of polycystic ovaries: is it worth counting the follicles?.Hum.Reprod. 2003; 18(3):598-603.
  18. Anttila L, Koskinen P, Kaihola H, Erkkola R, Irjala K and Runtiainen K. Serum androgen and gonadotropin levels decline after progestogen-induced withdrawal bleeding in oligomenorrheic women with or without polycystic ovaries. Fertil. Steril. 1992; 58(4):697-702.
  19. WHO expert consultation. Appropriate body mass index for asian population and its implications for policy and intervention strategies. The Lancet. 2004; 157-163.
  20. Bardin CW and Paulsen CA. The testes. In: Textbook of Endocrinology. sixth edition. Philadelphia: Williams, H.R. and Saunders,W.B. 1981 p.293.
  21. Valkenburg O, Steegers-Theunissen RPM, Smedts HPМ, Dallinga-Thie GM, Fauser BCJ, Westerveld EH and Laven JSE. A more atherogenic serum lipoprotein profile is present in women with PCOS: a case-control study. J.Clin. Endocrinol.Metab.2008; 93(2):470-476.
  22. Apridonidze JE. T, Essah PA, luorno MJ and Nestler Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2005;90:1929-1935.
  23. Vrbikova J, Cifkova R, Jirkovska A, Lanska V, Platilova H, Zamrazil V et al Cardiovascular risk factor in young Czech female with PCOS. Hum. Reprod.2003; 18(5):980-984.
  24. Yesilada E, Sahin I, Ozcan H, Yildirim IH, Yologlu S and Taskapan C Increased micronucleus frequencies in peripheral blood lymphocytes in women with polycystic ovary syndrome. Europ. J. of Endocrinol.2006; 154(4): 563-568.
  25. Ducluzeau P-H, Cousin P, Malvoisin E, Bornet H, Vidal H, Laville M et al Glucose-to-insulin ratio rather than sex Hormone-binding globulin and adiponectin levels is the best predictor of insulin resistance in nonobese women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2003:88:3626-3631.
  26. Guyatt G, Weaver B, Cronin L, Dooley JA andAzziz R. Health-related quality of life in women with polycystic ovary syndrome, a self-administered questionnaire, was validated. J. Clin. Epidemiol. 2004;57:1279-1287.
  27. Dewailly D, Catteau-Jonard S, Reyss AC, MaunouryLefebvre C, Poncelet E et al The excess in 2-5 mm follicles seen at ovarian ultrasonography is tightly associated to the follicular arrest of the polycystic ovary syndrome.Hum. Reprod. 2007;22(6): 1562-1566.
  28. Haddad L, Evans JC, Gharani N, Robertson C, Rush K, Wiltshire S et al. Variation within the type 2 diabetes susceptibility gene calpain-10 and polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2002;87:2606-2610.
  29. Glueck CJ, Papanna R, Wang P, Goldenberg N and SieveSmith L. Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome. Metabolism.2003;52:908-915.
  30. Balen AH, Conway GS, Kaltsas G, Techatrasak K, Manning PJ West C et al. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum. Reprod. 1995; 10:2107-2111.
  31. Azziz R, Ehrmann D, Legro RS,Whitcomb RW, Hanley R, Fereshetian AG et al Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial. J. Clin. Endocrinol. Metab. 2001:86:1626-1632.
  32. Cascella T, Palomba S, De Sio I, Manguso F, Giallauria F, De Simone B et al Visceral fat is associated with cardiovascular risk in women with polycystic ovary syndrome. Hum. Reprod. 2008; 23(1): 153-159.
  33. Topcu S, Caliskan M, Ozcimen EE, Tok D, Uckuyu A, Erdogan D et al. Do young women with polycystic ovary syndrome show early evidence of preclinical coronary artery disease?. Hum.Reprod. 2006;21(4):930-935.
  34. Welt CK, TaylorAE, Martin KAand Hall JE. Serum inhibin B in PCOS: regulation by insulin and luteinizing hormone. J. Clin. Endocrinol. Metab.2002;87(12):5559-5565.
  35. Kalro BN, Loucks TL and Berga SL. Neuromodulation in polycystic ovary syndrome. Obstet. Gynecol. Clin. North Am. 2001;28:35-62.
  36. Chang WY, Knochenhauer ES, BartolucciAAand Azziz R. Phenotypic spectrum of polycysticovary syndrome: clinical and biochemical characterization of the three major clinical subgroups. Fertil. Steril. 2005; 83:1717-1723.
  37. Pasquali R. Obesity and androgens: facts and perspectives. Fertil Steril. 2006; 85:1319-1340.
  38. Jonard S and Dewailly D. The follicular excess in polycystic ovaries, due to intra-ovarian hyperandrogenism, may bethe main culprit forthe folliculararrest. Hum.Reprod. update. 2004; 10:107-117.