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Fat Distribution and Adipose Products in Polycystic Ovary Syndrome

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Insulin Resistance and Polycystic Ovarian Syndrome

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Because adipose tissue is a complex endocrine organ that secretes many substances with profound effects on metabolism and the cardiovascular (CV) system, most obese subjects have an increased CV risk. However, 20% of obese subjects are metabolically healthy, and many studies suggest that fat distribution, in particular abdominal fat excess, is the most important factor that determines a secretion of adipose products that may increase CV risk.

Women with polycystic ovary syndrome (PCOS) present abdominal fat excess that is related to their androgen and/or insulin excess and that is present not only in the obese, but also in overweight and normal weight patients. Altered fat distribution plays an important role in the increased metabolic and CV risk observed in PCOS.

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References

  1. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935;29:181–186.

    Google Scholar 

  2. Carmina E, Legro R, Stamets K, Lowell J, Lobo RA. Differences in body weight between American and Italian women with the polycystic ovary syndrome: influence of the diet. Hum Reprod 2003; 11:2289–2293.

    Article  Google Scholar 

  3. Carmina E, Longo RA, Rini GB, Lobo RA. Phenotypic variation in hyperandrogenic women influences the finding of abnormal metabolic and cardiovascular risk parameters. J Clin Endocrinol Metab 2005;90:2545–2549.

    Article  CAS  PubMed  Google Scholar 

  4. Carmina E. Relative prevalence of different androgen excess disorders in 950 women referred because clinical hyperandrogenism. J Clin Endocrinol Metab 2006;91:2–6.

    Article  CAS  PubMed  Google Scholar 

  5. Siiteri PK. Adipose tissue as a source of hormones. Am J Clin Nutr 1987;45:227–282.

    Google Scholar 

  6. Pasquali R, Casimirri F. The impact of obesity on hyperandrogenism and polycystic ovary in premenopausal women. Clin Endocrinol (Oxf) 1993;39:1–16.

    Article  CAS  Google Scholar 

  7. Bringer J, Lefebrve P, Boulet F, et al. Body composition and regional fat patterning in polycystic ovarian syndrome: relationship to hormonal and metabolic profiles. Ann NY Acad Sci 1993; 687:115–123.

    Article  CAS  PubMed  Google Scholar 

  8. Peiris A, Sothmann M, Hoffman R, et al. Adiposity, fat distribution and cardiovascular risk. Ann Intern Med 1989;110:867–872.

    CAS  PubMed  Google Scholar 

  9. Williams MJ, Hunter GR, Kekes-Szabo T, Snyder S, Treuth MS. Regional fat distribution in women and risk for cardiovascular disease. Am J Clin Nutr 1997;65:855–860.

    CAS  PubMed  Google Scholar 

  10. Lord J, Wilkin T. Polycystic ovary syndrome and fat distribution: the central issue? Hum Fertil (Camb) 2002;5:67–71.

    Article  Google Scholar 

  11. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004; 89:2548–2556.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature 1994;372:425–432.

    Article  CAS  PubMed  Google Scholar 

  13. Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature 1998; 395:763–770.

    Article  CAS  PubMed  Google Scholar 

  14. Hileman SM, Pierroz DD, Flier JS. Leptin, nutrition and reproduction: timing is everything. J Clin Endocrinol Metab 2000;85:804–807.

    Article  CAS  PubMed  Google Scholar 

  15. Cock TA, Auwers J. Leptin: cutting the fat of the bone. Lancet 2003;362:1572–1574.

    Article  CAS  PubMed  Google Scholar 

  16. Matsumura K, Tsuchihashi T, Fujii K, Iida M. Keural regulation of blood pressure by leptin and the related peptides. Regul Pep 2003;114:79–86.

    Article  CAS  Google Scholar 

  17. Fantuzzi G, Faggioni R. Leptin in the regulation of immunity, inflammation and hematopoiesis. J Leuk Biol 2003;68:437–446.

    Google Scholar 

  18. Goldstein BJ, Scalia R. Adiponectin: a novel adipokine linking adipocytes and vascular function. J Clin Endocrinol Metab 2004;89:2563–2568.

    Article  CAS  PubMed  Google Scholar 

  19. Fernandez-Real JM, Lopez-Bermejo A, Casamitjana R, Ricart W. Novel interactions of adiponectin with the endocrine system and inflammatory parameters. J Clin Endocrinol Metab 2003;88:2714–2718.

    Article  CAS  PubMed  Google Scholar 

  20. Ryan AS, Berman DM, Nicklas BJ, et al. Plasma adiponectin and leptin levels, body composition and glucose utilization in adult women with wide ranges of age and obesity. Diabetes Care 2003;26:2283–2288.

    Article  Google Scholar 

  21. Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity to diabetes. Nature 2001; 409:307–312.

    Article  CAS  PubMed  Google Scholar 

  22. Kawanami D, Maemura K, Takeda N, et al. Direct reciprocal effects of resistin and adiponectin on vascular endothelial cells: a new insight into adipocytokine-endothelial interactions. Biochem Biophys Res Comm 2004;314:415–419.

    Article  CAS  PubMed  Google Scholar 

  23. Lee JH, Chan L, Yiannakouris N, et al. Circulating resistin levels are not associated with obesity or insulin resistance in humans and are not regulated by fasting leptin administration: cross-sectional and interventional study in normal, insulin-resistant and diabetic subjects. J Clin Endocrinol Metab 2003;88:4848–4856.

    Article  CAS  PubMed  Google Scholar 

  24. Silha JV, Krsek M, Skrha JV, Sucharda P, Nyomba BL, Murphy LJ. Plasma resistin, adiponectin and leptin levels in lean and obese subjects: correlations with insulin resistance. Eur J Endocrinol 2003; 149:331–335.

    Article  CAS  PubMed  Google Scholar 

  25. Ruan H, Lodish HT. Insulin resistance in adipose tissue: direct and indirect effects of tumor necrosis factor-α. Cytokine Growth Factor Rev 2003;14:447–455.

    Article  CAS  PubMed  Google Scholar 

  26. Hotamisligil GS. Inflammatory pathways and insulin action. Int J Obes Relat Metab Disord 2003;27(Suppl 3):S53–S55.

    Article  CAS  PubMed  Google Scholar 

  27. Mertens I, Van Gaal LF. Obesity, homeostasis and the fibrinolytic system. Obes Rev 2002;3:85–101.

    Article  CAS  PubMed  Google Scholar 

  28. Engeli S, Schling P, Gorzelniak K, et al. The adipose tissue renin-angiotensin-aldosterone system: role in the metabolic syndrome. Int J Biochem Cell Biol 2003;35:807–825.

    Article  CAS  PubMed  Google Scholar 

  29. Karelis AD, St-Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab 2004;89:2569–2575.

    Article  CAS  PubMed  Google Scholar 

  30. Brochu M, Tchernof A, Dionne IJ, et al. What are the physical characteristics associated with normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocrinol Metab 2001;86:1020–1025.

    Article  CAS  PubMed  Google Scholar 

  31. Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to metabolic syndrome. Endocr Rev 2000;21:697–738.

    Article  CAS  PubMed  Google Scholar 

  32. Grundy SM. Obesity, metabolic syndrome and cardiovascular disease. J Clin Endocrinol Metab 2004; 89:2595–2600.

    Article  CAS  PubMed  Google Scholar 

  33. Bosello O, Zamboni M. Visceral obesity and metabolic syndrome. Obes Rev 2000;1:47–56.

    Article  CAS  PubMed  Google Scholar 

  34. Van Pelt RE, Jankowski CM, Gozansky WS, Schwartz RS, Kohrt WM. Lower-body adiposity and metabolic protection in postmenopausal women. J Clin Endocrinol Metab 2005;90:4573–4578.

    Article  PubMed  CAS  Google Scholar 

  35. Fain JN, Madan AK, Hiler ML, Cheema P, Bahouth SW. Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans. Endocrinology 2004;145:2273–2282.

    Article  CAS  PubMed  Google Scholar 

  36. Tsigos C, Kyrou I, Chala E, et al. Circulating tumor necrosis factor alpha concentrations are higher in abdominal versus peripheral obesity. Metabolism 1999;48:1332–1335.

    Article  CAS  PubMed  Google Scholar 

  37. Futterweit W. Clinical features of polycystic ovarian disease. In: Futterweit W, ed, Polycystic Ovarian Disease. Berlin: Springer-Verlag, 1984, pp. 83–95.

    Google Scholar 

  38. Panidis D, Kourtis A, Farmakiotis D, Mouslech T, Rousso D, Koliakos G. Serum adiponectin levels in women with polycystic ovary syndrome. Hum Reprod 2003;18:1790–1796.

    Article  CAS  PubMed  Google Scholar 

  39. Kelly CJ, Lyall H, Petrie JR, et al. A specific elevation in tissue plasminogen antigen in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:3287–3290.

    Article  CAS  PubMed  Google Scholar 

  40. Jaatinen TA, Matinlauri I, Anttila L, Koskinen P, Erkkola R, Irjala K. Serum total renin is elevated in women with polycystic ovarian syndrome. Fertil Steril 1995;63:1000–1004.

    CAS  PubMed  Google Scholar 

  41. Morris RS, Wong IL, Hatch IE, Gentzschein E, Paulson RJ, Lobo RA. Prorenin is elevated in polycystic ovary syndrome and may reflect hyperandrogenism. Fertil Steril 1995;64:1099–1103.

    CAS  PubMed  Google Scholar 

  42. Gonzalez F, Thusu K, Abdel-Rahman E, Prabhala A, Tomani M, Dandona P. Elevated serum levels of tumor necrosis alpha in normal-weight women with polycystic ovary syndrome. Metabolism 1999; 48:437–441.

    Article  CAS  PubMed  Google Scholar 

  43. Carmina E, Orio F, Palomba S, et al. Evidence for altered adipocyte function in polycystic ovary syndrome. Eur J Endocrinol 2005;152:389–394.

    Article  CAS  PubMed  Google Scholar 

  44. Escobar-Morreale HF, Villuendas G, Botella-Carretero JI, Sancho J, San Millan JL. Obesity, and not insulin resistance, is the major determinant of serum inflammatory cardiovascular risk markers in premenopausal women. Diabetologia 2003;46:625–633.

    CAS  PubMed  Google Scholar 

  45. Orio F, Palomba S, Cascella T, et al. Is plasminogen activator inhibitor-1 a cardiovascular risk in young women with polycystic ovary syndrome. Reprod Biomed Online 2004;9:505–510.

    CAS  PubMed  Google Scholar 

  46. Atiomo WU, Fox R, Condon JE, et al. Raised plasminogen activator inhibitor 1 (PAI-1) is not an independent risk factor in the polycystic ovary syndrome. Clin Endocrinol (Oxf) 2000; 52:487–492.

    Article  CAS  Google Scholar 

  47. Lamarche B. Abdominal obesity and its metabolic complications: implications for the risk of ischemic heart disease. Coronary Artery Dis 1988;9:473–481.

    Article  Google Scholar 

  48. Sampson M, Kong C, Patel A, Unwin R, Jacobs HS. Ambulatory blood pressure profiles and plasminogen activator inhibitor (PAI-1) activity in lean women with and without the polycystic ovary syndrome. Clin Endocrinol (Oxf) 1996;45:623–629.

    Article  CAS  Google Scholar 

  49. Sills ES, Dreaws CD, Perloe M, Tucker MJ, Kaplan CR, Palermo GD. Absence of profound hyperinsulinism in polycystic ovary syndrome is not associated with subtle elevations in the plasminogen activator inhibitor system. Gynecol Endocrinol 2003;17:231–237.

    CAS  PubMed  Google Scholar 

  50. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanisms and implications for pathogenesis. Endocr Rev 1997;18:774–800.

    Article  CAS  PubMed  Google Scholar 

  51. Kirchengast S, Huber J. Body composition characteristics and body fat distribution in lean women with polycystic ovary syndrome. Hum Reprod 2001;16:1255–1260.

    Article  CAS  PubMed  Google Scholar 

  52. Horejsi R, Moller R, Rackl S, et al. Android subcutaneous adipose topography in lean and obese suffering from PCOS: comparison with type II diabetic women. Am J Phys Anthropol 2004;124:275–281.

    Article  CAS  PubMed  Google Scholar 

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Carmina, E. (2007). Fat Distribution and Adipose Products in Polycystic Ovary Syndrome. In: Diamanti-Kandarakis, E., Nestler, J.E., Panidis, D., Pasquali, R. (eds) Insulin Resistance and Polycystic Ovarian Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-310-3_2

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  • DOI: https://doi.org/10.1007/978-1-59745-310-3_2

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-763-1

  • Online ISBN: 978-1-59745-310-3

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