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Effects of body fat percentage on hormonal profiles, metabolism and adipokine-related indicators in PCOS patients with a normal body mass index: A cross-sectional study

Year: 2025

Type: article

Abstract: BACKGROUND: To date, research on polycystic ovary syndrome (PCOS) has focused on patients who are overweight/obese, with less attention given to PCOS patients who have a normal body mass index (BMI). The latter may also exhibit an increased body fat percentage (BFP). Studies have shown that BFP can affect hormonal profiles, metabolism and adipokine-related indicators. Therefore, the aim of this study was to investigate the effects of BFP on the aforementioned indicators in PCOS patients with a normal BMI. METHODS: In total, 115 PCOS patients with and without a normal BMI were included in this cross-sectional cohort study. The women were divided into two groups: the high-BFP group (BFP≥30 %) and the normal-BFP group (BFP<30 %). Body composition indicators such as BFP were assessed with an Inbody770 body composition measuring instrument made by Biospace Co., Ltd. Serum hormonal profiles and glucose and lipid metabolism-related indicators were determined via biochemical assessments. Among the 115 PCOS patients with a normal BMI, 56 were tested for inflammation and adipokine-related indicators by ELISA. These indicators were analysed with a two-sided t test. RESULTS: The prevalence of high BFP in PCOS patients with a normal BMI was 60 %. With a waist‒to‒hip ratio ≥0.85 set as the threshold, the incidence of central obesity was 65.22 % in the high-BFP group and 19.57 % in the normal-BFP group. The LH/FSH ratio, free androgen index (FAI), and DHEAS and androstenedione levels were greater in the high-BFP group than in the normal-BFP group. On the basis of a HOMA-IR >2.69 as the diagnostic criterion for insulin resistance, no significant difference in the prevalence of insulin resistance was observed between the two groups. The blood glucose and insulin levels at 2 hours after sugar intake were greater in the high-BFP group than in the normal-BFP group. Among the lipid metabolism indicators, the triglyceride level was significantly greater and the HDL level was significantly lower in the high-BFP group than in the normal-BFP group. There were no significant differences in inflammation-related indicators between the two groups. With respect to adipokines, the leptin level was significantly higher in the high-BFP group than in the normal-BFP group. The levels of other indicators, such as adiponectin and resistin, did not differ significantly between the two groups. CONCLUSIONS: More attention should be given to PCOS patients with a normal BMI. Our study revealed that approximately 60 % of these patients have elevated BFP. A high BFP can lead to disruptions in sex hormone levels, metabolism and adipokine levels, which may further affect pregnancy outcomes. These findings suggest that a more intense focus on body composition analysis and BFP control is needed in the diagnosis and treatment of PCOS.

Source: Journal of Gynecology Obstetrics and Human Reproduction

DOI: 10.1016/j.jogoh.2025.103099