Serum visfatin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome

BACKGROUND Visfatin, a protein secreted by adipose tissue, is suggested to play a role in pathogenesis of insulin resistance. In polycystic ovary syndrome (PCOS), insulin resistance might be involved in the development of endocrine and metabolic abnormalities. The aim of the study was to asses the relation between serum visfatin concentration and insulin sensitivity and markers of hyperandrogenism in lean and obese PCOS patients. METHODS The study group consisted of 70 women with PCOS (23 lean and 47 obese) and 45 healthy women (25 lean and 20 obese). Euglycemic hyperinsulinemic clamp and the measurements of serum visfatin, sex hormones were performed. RESULTS The PCOS group had lower insulin sensitivity (P = 0.00049) and higher serum visfatin (P = 0.047) in comparison to the control group. The decrease in insulin sensitivity was present in both the lean (P = 0.019) and obese (P = 0.0077) PCOS subjects, whereas increase in serum visfatin was observed only in lean PCOS subjects (P = 0.012). In the whole group, serum visfatin was negatively correlated with insulin sensitivity (r = −0.27, P = 0.004). This relationship was also observed in the subgroup of lean (r = −0.30, P = 0.038), but not obese women. Additionally, in lean women, visfatin was associated with serum testosterone (r = 0.47, P = 0.002) and free androgen index (r = 0.48, P = 0.002), independently of other potential confounding factors. CONCLUSIONS Visfatin is associated with insulin resistance and markers of hyperandrogenism in lean PCOS patients.