Interplay of Cortisol, Testosterone, and Abdominal Fat Mass in Normal-weight Women With Polycystic Ovary Syndrome

Journal of the Endocrine Society · 8 authors, 8 centres

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TL;DR

This cross-sectional study compared 20 normal-weight women with polycystic ovary syndrome (PCOS) to 20 matched controls. The central result found that while PCOS women had higher androgen levels and greater abdominal fat, their serum cortisol was lower and inversely correlated with abdominal fat mass, suggesting cortisol may influence fat distribution.

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This is a prospective, cross-sectional cohort study of 20 normal-weight women with NIH-defined PCOS and 20 age- and BMI-matched ovulatory controls. The study measured serum adrenal steroids (including 11-oxygenated androgens, cortisol, and cortisone) and body fat distribution via dual-energy x-ray absorptiometry. Results showed PCOS women had significantly higher total and free testosterone, androstenedione, and a greater android/gynoid fat mass ratio than controls. Serum 11-oxygenated androgen levels were comparable between groups and were inversely related to percentage total body fat, but this association was not significant after adjusting for cortisol. A key finding was that serum cortisol levels correlated inversely with android fat mass in all women, with a trend toward a lower cortisol-to-cortisone ratio in PCOS, suggesting reduced 11β-hydroxysteroid dehydrogenase activity. Limitations include the small sample size, use of morning serum rather than 24-hour urine collections, and lack of tissue-specific steroid metabolism measurements.

STUDY TYPE

cohort

SPECIALTY

endocrinology

SUMMARISED BY

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100% · A

ORIGINAL PAPER

PMC10315644

Interplay of Cortisol, Testosterone, and Abdominal Fat Mass in Normal-weight Women With Polycystic Ovary Syndrome

Journal of the Endocrine Society

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ABSTRACT

Abstract Context Ovarian and adrenal steroidogenesis underlie endocrine-metabolic dysfunction in polycystic ovary syndrome (PCOS). Adipocytes express aldo-keto reductase 1C3 and type 1 11β-hydroxysteroid dehydrogenase, which modulate peripheral androgen and cortisol production. Objectives To compare serum adrenal steroids, including 11-oxygenated androgens (11-oxyandrogens), cortisol, and cortisone between normal-weight women with PCOS and body mass index- and age-matched ovulatory women with normal-androgenic profiles (controls), and assess whether adrenal steroids associate with abdominal adipose deposition. Design Prospective, cross-sectional, cohort study. Setting Academic medical center. Patients Twenty normal-weight women with PCOS and 20 body mass index-/age-matched controls. Intervention(s) Blood sampling, IV glucose tolerance testing, and total-body dual-energy x-ray absorptiometry. Main Outcome Measure(s) Clinical characteristics, hormonal concentrations, and body fat distribution. Results Women with PCOS had higher serum total/free testosterone (T) and androstenedione (A4) levels and a greater android/gynoid fat mass than controls (androgens P < .001; android/gynoid fat mass ratio, P = .026). Serum total/free T and A4 levels correlated positively with android/gynoid fat mass ratio in all women combined ( P < .025, all values). Serum 11ß-hydroxyA4, 11-ketoA4, 11ß-hydroxyT, 11-ketoT, cortisol, and cortisone levels were comparable between female types and unrelated to body fat distribution. Serum 11-oxyandrogens correlated negatively with % total body fat, but lost significance adjusting for cortisol. Serum cortisol levels, however, correlated inversely with android fat mass ( P = .021), with a trend toward reduced serum cortisol to cortisone ratio in women with PCOS vs controls ( P = .075), suggesting diminished 11β-hydroxysteroid dehydrogenase activity. Conclusion Reduced cortisol may protect against preferential abdominal fat mass in normal-weight PCOS women with normal serum 11-oxyandrogens.

CITATION EXPORT

Daniel A Dumesic, Adina F Turcu, Haiping Liu et al.. Interplay of Cortisol, Testosterone, and Abdominal Fat Mass in Normal-weight Women With Polycystic Ovary Syndrome. Journal of the Endocrine Society. (2023). https://doi.org/10.1210/jendso/bvad079

AUTHORS

8 · 8 CENTRES

Daniel A Dumesic, Adina F Turcu, Haiping Liu, Tristan R Grogan, David H Abbott, Gwyneth Lu, Devyani Dharanipragada, Gregorio D Chazenbalk

Department of Obstetrics and Gynecology, University of California, Los Angeles, 1Los Angeles, CA 90095, USA
Division of Metabolism, Endocrinology, Nutrition and Diabetes, University of Michigan, Ann Arbor, MI 48103, USA
Division of Metabolism, Endocrinology, Nutrition and Diabetes, University of Michigan, Ann Arbor, MI 48103, USA
Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA 90024, USA
Department of Obstetrics and Gynecology, Wisconsin National Primate Research Center, University of WI-Madison, Madison, WI 53715, USA
Department of Obstetrics and Gynecology, University of California, Los Angeles, 1Los Angeles, CA 90095, USA
Department of Obstetrics and Gynecology, University of California, Los Angeles, 1Los Angeles, CA 90095, USA
Department of Obstetrics and Gynecology, University of California, Los Angeles, 1Los Angeles, CA 90095, USA