PCOS patients present with hypoadiponectinaemia, in relation with abdominal adiposity and hyperandrogenism. Our present results suggest that hyperandrogenism and abdominal obesity, by reducing the serum levels of the insulin sensitizer adipokine adiponectin, might contribute to the insulin resistance of PCOS.

The prevalence of NCAH among hyperandrogenic patients from Spain is 2.2%. Basal serum 17-hydroxyprogesterone measurements have an excellent diagnostic performance, yet the cutoff value should be established in each laboratory to avoid false-negative results.

OBJECTIVE -Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo-or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer.RESEARCH DESIGN AND METHODS -Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 g ethinyl-estradiol plus 2 mg cyproterone acetate (Diane 35 Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment. RESULTS -Despite the fact that treatment with Diane35 Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane 35 Diario.CONCLUSIONS -Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo-or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. Diabetes Care 30:2309-2313, 2007P olycystic ovary syndrome (PCOS) is a predominantly hyperandrogenic disorder (1) that affects 6 -7% of premenopausal women (2-5). Aside from the hyperandrogenic features and ovarian dysfunction characteristic of the syndrome, obesity and insulin resistance are frequently associated with PCOS (6,7).We have reported previously (8) that overweight and obese women with PCOS have increased serum ferritin levels that do not relate to chronic inflammation, indicating that body iron stores are increased in these women in agreement with what has been published for other insulin-resistant conditions (9). The increase in body iron stores might contribute to the insulin resistance and ␤-cell dysfunction frequently found in PCOS patients (10), as has been previously proposed for insulin resistance (11), the metabolic syndrome (12), and type 2 diabetes (13,14).We hypothesized that genetic factors, the absence of a regular menstrual blood loss, or even hyperinsulinemia resulting from insulin resistance, considering that insulin might stimulate intestinal iron absorption by upregulating the activity of hypoxia-inducible factor-1 ␣ and downregulating hepcidin expression (15,16), may have contributed to the increased body iron stores and serum ferritin levels observed in PCOS patients.Our recent results suggest that mutations in the hereditary hemochromatosis gene do not p...