Skip to main content
Log in

The resting metabolic rate in women with polycystic ovary syndrome and its relation to the hormonal milieu, insulin metabolism, and body fat distribution: a cohort study

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Purpose

To evaluate possible alterations of a major determinant of energy expenditure, the resting metabolic rate (RMR), in women with polycystic ovary syndrome (PCOS) compared with age-BMI similar controls. To assess whether the hormonal milieu, the body fat distribution and the insulin metabolism may affect energy consumption in these patients.

Methods

This is a monocentric observational prospective cohort study, including 109 Caucasian PCOS subjects and 31 healthy control women. (Median age PCOS 26.0 ± 9.2 years, controls 25.5 ± 8.5 years; median BMI-body mass index PCOS 26.4 ± 9.4 kg/m2, controls 27.2 ± 12.8 kg/m2). RMR was evaluated by the SenseWear Armband (SWA), a reliable and validated metabolic holter, never previously used in the PCOS population to this purpose. Hormonal assessment, insulin metabolism evaluated by HOMA-IR and OGTT, anthropometric features (BMI and WHR) were also assessed.

Results

Median RMR resulted similar in PCOS and control women: 1520.0 ± 248.00 kcal/day vs 1464.0 ± 332.70 kcal/day (p = 0.472), even after adjusting for BMI, fat distribution, insulin metabolism parameters. RMR resulted significantly correlated with BMI, WHR, estradiol levels, SHBG, total cholesterol, triglycerides, basal glycaemia, basal insulinemia, AUC insulin 240’, and HOMA. In the subgroup of patients with WHR > 0.85, PCOS women showed a significantly lower RMR compared with controls.

Conclusions

The higher prevalence of obesity, which negatively influences the reproductive and general health of PCOS women, could be related to factors other than an intrinsic alteration of the RMR. Further studies are needed to clarify the possible role of the visceral fat in modulating the energy balance in PCOS.

Trial registration number

clinicaltrials.gov Identifier NCT03132545.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Pasquali R, Gambineri A (2018) New perspectives on the definition and management of polycystic ovary syndrome. J Endocrinol Invest 41(10):1123–1135

    Article  CAS  PubMed  Google Scholar 

  2. Rocca ML, Venturella R, Mocciaro R, Di Cello A, Sacchinelli A, Russo V, Trapasso S, Zullo F, Morelli M (2015) Polycystic ovary syndrome: chemical pharmacotherapy. Expert Opin Pharmacother 16:1369–1393

    Article  CAS  PubMed  Google Scholar 

  3. Legro RS (2012) Obesity and PCOS: implications for diagnosis and treatment. Semin Reprod Med 30:496–506

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Falbo A, Orio F, Venturella R, Rania E, Materazzo C, Tolino A, Zullo F, Palomba S (2009) Does metformin affect ovarian morphology in patients with polycystic ovary syndrome? A retrospective cross-sectional preliminary analysis. J Ovarian Res 31(2):5

    Article  CAS  Google Scholar 

  5. Genazzani AD, Shefer K, Della Casa D, Prati A, Napolitano A, Manzo A, Despini G, Simoncini T (2018) Modulatory effects of alpha-lipoic acid (ALA) administration on insulin sensitivity in obese PCOS patients. J Endocrinol Invest 41(5):583–590

    Article  CAS  PubMed  Google Scholar 

  6. Daniela R, Valentina I, Simona C, Valeria T, Antonio L (2018) Neuroendocrine regulation of food intake in polycystic ovary syndrome. Reprod Sci. 25(5):644–653 (Epub 2017 Sep 6)

    Article  CAS  Google Scholar 

  7. Wright CE, Zborowski JV, Talbott EO, McHugh-Pemu K, Youk A (2004) Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome. Int J Obes Relat Metab Disord 28:1026–1032

    Article  CAS  PubMed  Google Scholar 

  8. Ewens KG 1st, Jones MR, Ankener W, Stewart DR, Urbanek M, Dunaif A, Legro RS, Chua A, Azziz R, Spielman RS et al (2011) FTO and MC4R gene variants are associated with obesity in polycystic ovary syndrome. PLoS One 6:e16390

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Larsson I, Hulthén L, Landén M, Pålsson E, Janson P, Stener-Victorin E (2016) Dietary intake, resting energy expenditure, and eating behavior in women with and without polycystic ovary syndrome. Clin Nutr 35:213–218

    Article  PubMed  Google Scholar 

  10. Douglas CC, Norris LE, Oster RA, Darnell BE, Azziz R, Gower BA (2006) Difference in dietary intake between women with polycystic ovary syndrome and healthy controls. Fertil Steril 86:411–417

    Article  PubMed  Google Scholar 

  11. Behboudi-Gandevani S, Ramezani Tehrani F, Bidhendi Yarandi R, Noroozzadeh M, Hedayati M, Azizi F (2017) The association between polycystic ovary syndrome, obesity, and the serum concentration of adipokines. J Endocrinol Invest 40(8):859–866

    Article  CAS  PubMed  Google Scholar 

  12. Blaxter K (1989) Energy metabolism in animals and man. Cambridge University Press, Cambridge

    Google Scholar 

  13. Buscemi S, Verga S, Caimi G, Cerasola G (2007) A low resting metabolic rate is associated with metabolic syndrome. Clin Nutr 26:806–809 (Epub 2007 Oct 23)

    Article  CAS  PubMed  Google Scholar 

  14. Buscemi S, Donatelli M, Grosso G, Vasto S, Galvano F, Costa F, Rosafio G, Verga S (2014) Resting energy expenditure in type 2 diabetic patients and the effect of insulin bolus. Diabetes Res Clin Pract 106:605–610 (Epub 2014 Oct 2)

    Article  CAS  PubMed  Google Scholar 

  15. Kenny GP, Notley SR, Gagnon D (2017) Direct calorimetry: a brief historical review of its use in the study of human metabolism and thermoregulation. Eur J Appl Physiol 1:1. https://doi.org/10.1007/s00421-017-3670-5 (Epub ahead of print)

    Article  Google Scholar 

  16. Schoeller DA (1999) Recent advances in nutritional sciences recent advances from application of doubly labeled water to measurement of human energy. J Nutr 129:1765–1768

    Article  CAS  PubMed  Google Scholar 

  17. Cosar E, Köken G, Sahin FK, Akgün L, Uçok K, Genç A, Yilmazer M (2008) Resting metabolic rate and exercise capacity in women with polycystic ovary syndrome. Int J Gynaecol Obstet 101:31–34 (Epub 2008 Feb 20)

    Article  PubMed  Google Scholar 

  18. Georgopoulos NA, Saltamavros AD, Vervita V, Karkoulias K, Adonakis G, Decavalas G, Kourounis G, Markou KB, Kyriazopoulou V (2009) Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance. Fertil Steril 92:250–255 (Epub 2008 Aug 3)

    Article  CAS  PubMed  Google Scholar 

  19. Fruin ML, Rankin JW (2004) Validity of a multi-sensor armband in estimating rest and exercise energy expenditure. Med Sci Sports Exerc 36:1063–1069

    Article  PubMed  Google Scholar 

  20. Liden CB, Wolowicz M, Stivoric J, Teller A, Vishnubhatla S, Pelletier R, Farringdon J (2002) Accuracy and reliability of the sensewear armband as an energy expenditure assessment device. BodyMedia Inc., Pittsburgh

    Google Scholar 

  21. Farooqi N, Slinde F, Håglin L, Sandström T (2013) Validation of sensewear armband and actiheart monitors for assessments of daily energy expenditure in free-living women with chronic obstructive pulmonary disease. Physiol Rep 1:e00150

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25

    Google Scholar 

  23. Terry NL, Ryan ME (2012) Polycystic ovary syndrome (PCOS) 2012. National Institutes of Health Library, Bethesda. http://prevention.nih.gov/workshops/2012/pcos/docs/PCOS_Bibliography.pdf. Accessed 27 Mar 2013

  24. New MI, Lorenzen F, Lerner AJ, Kohn B, Oberfield SE, Pollack MS, Dupont B, Stoner E, Levy DJ, Pang S et al (1983) Genotyping steroid 21-hydroxylase deficiency: hormonal reference data. J Clin Endocrinol Metab 57:320–326

    Article  CAS  PubMed  Google Scholar 

  25. Treloar AE, Boynton RE, Behn BG, Brown BW (1967) Variation of the human menstrual cycle through reproductive life. Int J Fertil 12:77–126

    CAS  PubMed  Google Scholar 

  26. Peterkin BB (1990) Dietary guidelines for Americans. J Am Diet Assoc 90:1725–1727

    CAS  PubMed  Google Scholar 

  27. Orsini LF, Venturoli S, Lorusso R, Pluchinotta V, Paradisi R, Bovicelli L (1985) Ultrasonic findings in polycystic ovarian disease. Fertil Steril 43:709–714

    Article  CAS  PubMed  Google Scholar 

  28. Ciampelli M, Leoni F, Cucinelli F, Mancuso S, Panunzi S, De Gaetano A, Lanzone A (2005) Assessment of insulin sensitivity from measurements in the fasting state and during an oral glucose tolerance test in polycystic ovary syndrome and menopausal patients. J Clin Endocrinol Metab 90:1398–1406

    Article  CAS  PubMed  Google Scholar 

  29. Ziaee A, Esmailzadehha N, Oveisi S, Ghorbani A, Ghanei L (2015) The threshold value of homeostasis model assessment for insulin resistance in Qazvin Metabolic Diseases Study (QMDS): assessment of metabolic syndrome. J Res Health Sci 15:94–100

    PubMed  Google Scholar 

  30. Dahan MH, Abbasi F, Reaven G (2019) Relationship between surrogate estimates and direct measurement of insulin resistance in women with polycystic ovary syndrome. J Endocrinol Invest 1:1. https://doi.org/10.1007/s40618-019-01014-9 (Epub ahead of print)

    Article  CAS  Google Scholar 

  31. Santos-Lozano A, Hernández-Vicente A, Pérez-Isaac R (2017) Is the SenseWear Armband accurate enough to quantify and estimate energy expenditure in healthy adults? Ann Transl Med 5:97

    Article  PubMed  PubMed Central  Google Scholar 

  32. Faloia E, Canibus P, Gatti C, Frezza F, Santangelo M, Garrapa GG, Boscaro M (2004) Body composition, fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome. J Endocrinol Invest 27:424–429

    Article  CAS  PubMed  Google Scholar 

  33. Segal KR, Dunaif A (1990) Resting metabolic rate and postprandial thermogenesis in polycystic ovarian syndrome. Int J Obes 14:559–567

    CAS  PubMed  Google Scholar 

  34. Ravussin E, Lillioja S, Knowler WC, Christin L, Freymond D, Abbott WG, Boyce V, Howard BV, Bogardus C (1988) Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med 25(318):467–472

    Article  Google Scholar 

  35. DeLany JP, Kelley DE, Hames KC, Jakicic JM, Goodpaster BH (2013) High energy expenditure masks low physical activity in obesity. Int J Obes (Lond) 37:1006–1011

    Article  CAS  Google Scholar 

  36. Lührmann PM, Herbert BM, Neuhäuser-Berthold M (2001) Effects of fat mass and body fat distribution on resting metabolic rate in the elderly. Metabolism 50:972–975

    Article  PubMed  Google Scholar 

  37. Arner P (1995) Differences in lipolysis between human subcutaneous and omental adipose tissues. Ann Med 27:435–438

    Article  CAS  PubMed  Google Scholar 

  38. de Luis DA, Aller R, Izaola O, Gonzalez Sagrado M, Conde R (2005) Resting energy expenditure, cardiovascular risk factors and insulin resistance in obese patients. Ann Nutr Metab 49:381–385

    Article  CAS  PubMed  Google Scholar 

  39. Braun B, Zimmermann MB, Kretchmer N (1996) Relationships between glucose metabolism and thermogenesis with and without prior exercise in obese women with noninsulin-dependent diabetes mellitus. Metabolism 45:747–752

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. Romualdi.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare in relation to this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Romualdi, D., Versace, V., Tagliaferri, V. et al. The resting metabolic rate in women with polycystic ovary syndrome and its relation to the hormonal milieu, insulin metabolism, and body fat distribution: a cohort study. J Endocrinol Invest 42, 1089–1097 (2019). https://doi.org/10.1007/s40618-019-01029-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-019-01029-2

Keywords

Navigation