Association between Bone Mineral Density and Insulin Resistance in Polycystic Ovarian Syndrome – A Case–control Observational Study

BACKGROUND: Polycystic ovarian syndrome (PCOS) has bidirectional effects on the skeleton due to hormonal dysfunction and insulin resistance (IR). AIMS: We examined bone mineral density (BMD) and its relationship with IR using the homeostasis model of assessment (HOMA) in patients with PCOS and matched controls. MATERIALS AND METHODS: In this case-control observational study, we included 74 patients newly diagnosed with PCOS and a similar number of age-and weight-matched healthy women as controls. Haematological, biochemical and hormonal parameters were measured in a fasting blood sample during the follicular phase, and the BMD Z score was calculated using dual energy X-ray absorptiometry. The results were analysed using relevant statistical methods, and P < 0.05 was considered significant. RESULTS: The study participants ( n = 148) had a mean age of 23.6 ± 3.7 years and a body mass index (BMI) of 25.2 ± 3.2 kg/m 2 . Among the PCOS patients, 25 (34%) had a normal BMI and 49 (66%) were obese. The BMD at the femoral neck ( P = 0.4313) and lumbar spine ( P = 0.1410) was comparable between the PCOS and control groups. Correlation analysis showed a positive correlation of BMD with testosterone and 17-hydroxy progesterone (17OHP) ( P < 0.001). None of the BMD parameters correlated with HOMA in either group. CONCLUSION: BMD at the lumbar spine and femoral neck was similar between patients with PCOS and controls. Further studies with a larger sample size, longer follow-up periods and fracture data are needed to confirm our findings.