Obesity and Insulin Resistance, Not Polycystic Ovary Syndrome, Are Independent Predictors of Bone Mineral Density in Adolescents and Young Women

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders that affects females of reproductive age. The characteristic features of PCOS individually have opposing effects on bone mineral density (BMD); however, their cumulative effect on BMD has not been clearly defined. Adolescence and young adulthood span a crucial period in achieving peak bone mass. Thus, a better understanding of the impact of PCOS on BMD in this age group is needed. Objectives: To determine whether BMD is different between young females with PCOS and controls and to identify factors that influence BMD in this population. Methods: Data from four cross-sectional studies with a total of 170 females aged 12-25 years with PCOS (n = 123) and controls (n = 47) with a wide range of BMIs (18.7-53.4 kg/m 2) were analyzed. Participants had fasting glucose, insulin, and free and total testosterone concentrations measured. HOMA-IR was calculated. Whole-body BMD was assessed by dual-energy X-ray absorptiometry. Multiple regression analysis for predicting BMD included PCOS status, menstrual age, obesity, HOMA-IR, and free testosterone. Results: HOMA-IR and total and free testosterone were significantly higher in PCOS compared to controls but there was no difference in BMD z-score between PCOS (0.8 ± 1.0) and controls (0.6 ± 1.0) (p = 0.36). Obesity (p = 0.03) and HOMA-IR (p = 0.02) were associated with BMD z-score. Conclusions: Obesity status and insulin resistance, but not PCOS status, were each independently associated with BMD in adolescents and young women who spanned a wide range of BMIs.

The influence of ESR1 polymorphisms on selected hormonal, metabolic and mineral balance markers in women with hyperandrogenism

“…In a study conducted in a group of 170 young women aged 12–25 years diagnosed with PCOS, Pereira-Eshraghi et al did not show a relationship between the level of free and total testosterone, or the presence of PCOS on bone mineral density. On the other hand, obesity and insulin resistance turned out to be an independent predictor of decreased BMD in the cervical and femoral neck 41 . Many previous studies have shown the effect of PCOS on BMD 42 , 43 .…”

Conceptualization of functional single nucleotide polymorphisms of polycystic ovarian syndrome genes: an in silico approach

“…It is manifested by several endocrine disturbances such as chronic anovulation, hyperandrogenism characterized by frontal alopecia, acne and hirsutism, presence of multiple cysts in ovaries, and metabolic consequences including a high risk of obesity, insulin resistance, type 2 diabetes mellitus (T2DM) and cardiovascular diseases [2,3] and psychological complications such as increased distress and depression [4]. Although not understood completely, this complex disorder is considered to be caused due to intricate interplay between various factors such as genetic and epigenetic predisposition, ethnicity, environmental influences, and lifestyle [5]. It was also conferred Supplementary Information The online version contains supplementary material available at https ://doi.org/10.1007/s4061 8-021-01498 -4.…”