The Connections Between Androgens and Adipose Tissue Function in Polycystic Ovary Syndrome Patients

Few studies reported that androgens levels could be among the regulators of adipose tissue hormones. Polycystic ovary syndrome (PCOS) is characterized by both increased adiposity and hyperandrogenism, but the relationship between androgens levels and adipokines in PCOS has not been well characterized. Our aim was to study the relationship between leptin, adiponectin, total testosterone, sex hormone binding globulin (SHBG) and free androgen index (FAI) in PCOS patients. We conducted a cross-sectional study on 131 PCOS patients (mean age 24 [6] yrs, mean body mass index (BMI) 25.8 [10.44] kg/m2) diagnosed based on Rotterdam Consensus criteria. All the patients were evaluated by clinical, paraclinical and hormonal exam. HOMA-IR was calculated for all the patients. Leptin was positively associated with age (p<0.05), BMI (p<0,0001), waist-hip ratio (WHR) (p<0.0001), waist circumference (WC) (p<0,0001), HOMA-IR (p<0,0001), insulinemia (p<0.0001) and FAI (p<0,0001) and negatively with SHBG (p<0.0001). Adiponectin was negatively associated with age (p<0.05), BMI (p<0,0001), WC (p<0,0001), WHR (p<0,0001), HOMA-IR (p<0,0001), insulinemia (p<0.0001) and FAI (p<0,005) and positively associated with SHBG (p<0,0001). Both adipokines were not correlated with total testosterone. The association between serum leptin and FAI/SHBG was lost after adjustment for age and body mass index. In turn the relationship between leptin and FAI, but not SHBG was independent of HOMA-IR. Circulating adiponectin was associated with SHBG independently of adiposity and HOMA-IR, but the association with FAI was lost after adjustment for HOMA-IR. In conlusion, circulating adipokines are correlated with FAI and SHBG serum levels. This association seems to be mediated by adiposity for leptin. Although the link between adiponectin and FAI is probably due to insulin resistance, SHBG seems to directly modulate adiponectin production.