Background/Objectives: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance, dyslipidemia and increased inflammation, which all benefit from dietary intake of monounsaturated and n-3 polyunsaturated fatty acids (MUFA and n-3 PUFA). Our goal was to compare the effects of MUFA-rich almonds vs n-3/n-6 PUFA-rich walnuts on metabolic and endocrine parameters in PCOS. Subjects/Methods: Thirty-one PCOS patients randomly received either walnuts or almonds containing 31 g of total fat per day for 6 weeks. At the beginning and at the end, anthropometric parameters, fasting lipids, phospholipid-fatty acids, inflammatory markers, androgens, oral glucose tolerance tests (OGTT) and frequently sampled intravenous-GTT were obtained. Results: Weight remained stable. Within group, walnuts increased the n-3/n-6 essential PUFA in the diet and plasma phospholipids. Walnuts decreased low-density lipoprotein-cholesterol by 6% from 3.76 ± 0.27 to 3.38 ± 0.22 mmol/l (P ¼ 0.05) and apoprotein B by 11% from 0.72 ± 0.04 to 0.64 ± 0.05 g/l (Po0.03). Although almonds also reduced low-density lipoprotein-cholesterol by 10% and apoprotein B by 9%, these were not significant. Walnuts increased insulin response during OGTT by 26% (Po0.02). Both walnuts and almonds increased adiponectin (walnuts from 9.5 ± 1.6 to 11.3 ± 1.8 mg per 100 ml, P ¼ 0.0241; almonds from 10.1 ± 1.5 to 12.2 ± 1.4 mg/dl, P ¼ 0.0262). Walnuts decreased HgBA1 from 5.7 ± 0.1 to 5.5 ± 0.1% (P ¼ 0.0006) with significant intergroup difference from almonds (P ¼ 0.0470). Walnuts increased sex hormone-binding globulin from 38.3±4.1 to 43.1±4.3 nmol/l (P ¼ 0.0038) and almonds reduced free androgen index from 2.6±0.4 to 1.8±0.3 (P ¼ 0.0470). Conclusion: Nut intake exerted beneficial effects on plasma lipids and androgens in PCOS.

Objective-To investigate adrenal steroid regulation in PCOS Design-5-hour oral glucose tolerance test (OGTT) and frequently sampled-intravenous GTT Setting-University research center Patients-Thirty patients Intervention-NoneMain outcome measures-Anthropometrics, leptin, cortisol, DHEAS, glucose, insulinResults-Morning cortisol correlated with sensitivity index (SI, r=0.540, p=0.0109), DHEAS correlated inversely with age (r=−0.6359), body mass index (BMI, r=−0.6199), fat mass (r= −0.630) and leptin (r=−0.5676) (p< 0.002 for all). Between the 2 nd and 4 th hour of OGTT, cortisol changes (Δ) exhibited 3 patterns: I. Responders (n=9, Δ:10.7±1.0μg/dL), II. Non-responders (n=10, Δ:−3.5±0.6μg/dL), III. Intermediates (n=11, Δ:4.3±1.0μg/dL). Compared to nonresponders, responders were more obese (BMI: 37.0±1.6 vs. 31.7±1.8kg/m 2 , p< 0.05); had higher leptin (28.9±1.7 vs. 24.1±1.1ng/mL, p<0.03) and lower DHEAS (133±12 vs. 236±32ng/mL, p<0.01), higher glucose at 1h of OGTT (195±13 vs. 131±12mg/dL, p< 0.05), higher AUC Glucose (332±20 vs. 265±17mg/dL, p=0.0208), higher AUC Insulin (244±50 vs. 125±30μU/mL, p=0.05) and lower nadir glucose (61±2 vs. 70±2mg/dL, p=0.0002).Conclusion-Obesity and insulin resistance are associated with lower morning cortisol and DHEAS but increased cortisol and DHEA responses after glucose ingestion. Morning steroid levels may not reflect the day-long exposure. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAnthropometric data-Subjects were seen after an overnight fast. Weight was determined in light clothing using the Tanita BWB800-P Digital Medical Scale. Height without shoes was measured using an Ayrton Model S100 stadiometer. Body composition was determined using bioelectrical impedance (Biostat, British Isles) (8). Because the fluctuations occurring in body-water during menstrual cycles can affect bioelectrical impedance, menstruating women were studied during the first ten days of their cycles. 5-h OGTT-Participantswere tested between 0600 and 0900, after an overnight fast. Water intake was permitted. An intravenous catheter was placed into the forearm and kept open with saline. At time point zero, participants drank 75 g of glucose (Glucola ™). Blood samples were obtained at baseline (time point -10 min) and then, after glucose ingestion, at 30-minute intervals for 5 hours. Subjects remained supine throughout the procedure to avoid the confounding effects of physical activity on blood glucose levels. Samples for glucose measurement were collected in N...