The impact of BMI on the plasma glucose and lipid status of women with polycystic ovary syndrome
Keywords:Body mass index, BMI, Fasting plasma glucose, Lipid profile, PCOS
Background: BMI status is theorized to impact on the plasma glucose and lipid parameters of women with polycystic ovary syndrome. Hence, this study was instituted to investigate this theory among women with polycystic ovary syndrome in Port Harcourt, Nigeria.
Methods: Medical records of 231 women with PCOS visiting a tertiary health center over a consecutive 10-year period were retrospectively acquired and analyzed. The obtained records were age, weight, height, calculated BMI, fasting plasma glucose and lipid profile (total cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein). The records were analyzed using Shapiro-Wilk, descriptive, chi-square, two-way analysis of variance, and Pearson’s tests. A two-tailed p-value of <0.05 was considered significant.
Results: Overweight and obesity was recorded among 33.3% and 45.5% of the study cohorts respectively. The obese cohorts had higher plasma levels and abnormal frequency of fasting glucose (<0.001), total cholesterol (<0.001), triglycerides (<0.001), high-density lipoprotein (<0.001) and low-density lipoprotein (<0.001) status than the normal weight and overweight cohorts. BMI correlated weakly with glucose (r=0.259; p = 0.003), inversely but weakly with high-density lipoprotein (r: -0.373 p<0.001) and weakly with triglycerides (r=0.316; p<0.001) among overweight cohorts. BMI correlated strongly with fasting glucose (r=0.578; p< 0.001), strongly with total cholesterol (r=0.840; p<0.001), moderately but inversely with high-density (r=-0.490; p=0.004), strongly with triglycerides (r=0.753; p<0.001) and strongly with low-density lipoprotein (r=0.759; p<0.001) among the obese cohorts.
Conclusions: Abnormal plasma glucose and lipid parameters seem to be prevalent among obese PCOS patients. Therefore, weight reduction should be a therapeutic target during their treatment.
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Meta. 2004;89:2745-9.
March WA, Moore VM, Willson KJ, Philips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010;25:544-51.
Boyle JA, Cunningham J, O’dea K, Dumbar T, Norman RJ. Prevalence of polycystic ovary syndrome in a sample of indigenous women in Darwin, Australia. Med J Aust. 2012;196:62-6.
Omokanye LO, Ibiwoye-Jaiyeola OA, Olatinwo A, Abdul IF, Durowade KA, Biliaminu SA. Polycystic ovary syndrome: Analysis of management outcomes among infertile women at a public health institution in Nigeria. Niger J Gen Pract. 2015;13:44-8.
Ugwu GO, Iyoke CA, Onah HE, Mba SG. Prevalence, presentation and management of polycystic ovary syndrome in Enugu, South East Nigeria. Niger J Med. 2013;22:313-6.
Stein IF, Leventhal ML. Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181-91
Teede H, Deeks A, Moran L. Polycystic ovary syndrome: A complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010;8:1-10.
Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: etiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 2011;7(4):219-31.
King J. Polycystic ovary syndrome. J Midwifery women health. 2006;51(6):415-22.
Sam S. Obesity and polycystic ovary syndrome. Obes Manag. 2007;3(2):69-72.
Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;91(1):162-8.
Rotterdam, ESHRE/ASRM-Sponsored, PCOS, Consensus, Workshop, Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1):19-25.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge. Clin Chem. 1972;18:499-502.
World Health Organization. Physical Status: The Use and Interpretation of Anthropometry. Geneva, Switzerland: World Health Organization, 1995. Technical Report Series;1995:854.
Standards of medical care in diabetes-2007. Diabetes Care. 2007;30(suppl 1):S4-41.
Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97.
Barcellos CRG, Rocha MP, Hayashida SAY, Mion D Jr, Lage SG, Marcondes JAM. Impact of body mass index on blood pressure levels in patients with polycystic ovary syndrome. Arq Bras Endocrinol Metabol. 2007;51:1104-9.
Lerchbaum E, Schwetz V, Giuliani A, Pietsch OB. Assessment of glucose metabolism in polycystic ovary syndrome. Hum Reprod. 2013;28:2537-44.
Naessen S, Carlstrom K, Garoff L, Glant R, Hirschberg AL. Polycystic ovary syndrome in bulimic women-an evaluation based on the new diagnostic criteria. Gynecol Endocrinol. 2006;22(7);388-94.
Hirschberg AL, Naessen S, Stridsberg M, Bystrom B, Holte J. Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome. Gynecol Endocrinol. 2004;19(2): 79-87.
Moran LJ, Noakes M, Clifton PM Wittert GA, Tomlinson L, Gallently C, et al. Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition. J Clin Endocrinol Metab. 2004;89(7):3337-44.
Baranowska B, Radzikowska M, Wasilewska-Dziubinska E, Kapli´nski A, Roguski K, Płonowski A.Neuropeptide Y, leptin, galanin and insulin in women with polycystic ovary syndrome. Gynecol Endocrinol. 1999;13(5):344-51.
Alvarez-Blasco F, Bottella-Carretero JI, Escober-Morreale HF. Prevalence of and characteristics of the polycystic syndrome in overweight and obese women. Arch Intern Med. 2006;166(19):2081-6.
Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(6):618-37.
Sadananjali S, Sreekantha S, Amruth H. Study of serum lipid profile and fasting blood sugar in polycystic ovarian syndrome. Int J Clin Biomed Res. 2016;2(4):1-6.
Kiranmayee D, Kavya K, Himabindu Y, Sariharibabu M, Madhuri GLJ, Venu S. Correlations between anthropometry and lipid profile in women with PCOS. J Hum Reprod Sci. 2017;10(3):167-72.
Maryam SA, Saeed P, Mehranghiz EM, Mohammed AJ, Soudabeh A, Bita S. Lipid profile in relation to anthropometric indices and insulin resistance in overweight women with polycystic ovary syndrome. Health Promot Perspect. 2013;3:206-16.
Wild RA. Dyslipidemia in PCOS. Steroids. 2012;77(4):295-9.
Mahabeer S, Naido C, Norman RJ, Jiali I, Reddi K, Joubert SM. Metabolic profiles and lipoprotein lipid concentrations in non-obese and obese patients with polycystic ovarian disease. Horm Metab Res. 1990;22(10):537-30.
Mahmoud MI, Habbeb F, Kasim K. Reproductive and biochemical changes in obese and nonobese polycystic ovary syndrome women. Alex J Med. 2015;51:5-9.