Determinants of Circulating Adiponectin in Women with Polycystic Ovary Syndrome

Abstract

Background and Aim: Adiponectin is regarded as a possible link between adiposity and insulin resistance. Ghrelin and leptin are considered as signals of energy status. We evaluated the relationships between these peptides, androgens and insulin sensitivity in women affected by polycystic ovary syndrome. Methods: Thirty-six women with PCOS were examined with euglycemic hyperinsulinemic clamp (to determine M/I, index of insulin sensitivity). Leptin, ghrelin, adiponectin, androgens, and SHBG were determined. Statistics was done using correlation analysis and backward stepwise multiple regression. Results: The positive correlation of adiponectin with testosterone remains significant even after adjustment for BMI (p = 0.01), M/I (p = 0.009) and for both M/I and BMI (p = 0.02). In multiple regression with testosterone, M/I, leptin and ghrelin as independent variables, the model including testosterone (p = 0.03) and ghrelin (p = 0.002) explained 49% of the variability (p < 0.0012) of adiponectin. Conclusions: Both adiponectin and ghrelin can be involved in the pathophysiology of PCOS but their relation must be delineated further.

Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

“…These results suggest a very high risk for the metabolic syndrome in obese PCOS patients and support that metabolic screening is of high relevance especially in this subgroup of patients. Our findings of significantly lower adiponectin levels in PCOS than in weightmatched controls as well as the close, inverse relation between adiponectin and BMI have previously been reported (8,10,11,23,(30)(31)(32).…”

“…These results may seem conflicting as previous studies have described significantly higher adiponectin levels in women than in men (34,35) and furthermore, that testosterone supplementation was followed by decreased adiponectin levels (34,36). However, our data are supported by two previous studies finding significant positive associations between adiponectin and testosterone levels in PCOS (11,32). Vribkova et al suggested that this association was caused by a more complex interrelation between testosterone, oestradiol and adiponectin in PCOS (32).…”

“…However, our data are supported by two previous studies finding significant positive associations between adiponectin and testosterone levels in PCOS (11,32). Vribkova et al suggested that this association was caused by a more complex interrelation between testosterone, oestradiol and adiponectin in PCOS (32). In the present study, we found significantly decreased oestradiol levels in our patient population, which may have affected results (25).…”

“…To our knowledge, we are the first to demonstrate a fat-independent relationship between testosterone and ghrelin levels in PCOS, but few previous studies have demonstrated significant bivariate correlations between ghrelin and testosterone in PCOS patients (21,39). In most studies, no significant correlations were found between ghrelin and testosterone in PCOS (18,20,32,38). The inclusion of heterogeneous patient groups including hyperandrogen as well as non-hyperandrogen PCOS patients and the use of commercially available RIA kits for the evaluation of testosterone levels may have affected results in some of these studies.…”

Rosiglitazone treatment increases plasma levels of adiponectin and decreases levels of resistin in overweight women with PCOS: a randomized placebo-controlled study

“…The production of adiponectin is decreased in obesity (8,9), and its plasma levels have been shown to correlate negatively with waist-to-hip ratio (WHR, 11) and body mass index (BMI,8). Decreased plasma levels of adiponectin have been observed in subjects with type 2 diabetes mellitus and coronary artery disease (12), and in women with PCOS (13)(14)(15)(16).…”