Body iron status and association with hyperinsulinaemia and hyperandrogenism in non-obese Indian women with polycystic ovarian syndrome

Background: Increased body iron stores, insulin and androgen levels have been reported in obese women with polycystic ovarian syndrome (PCOS). However, the status of iron and the influence of hormonal profile on iron status in non-obese women with PCOS has not been studied. The present study was thus designed to determine the iron status and hormones insulin and testosterone levels and their association with body iron status in non-obese women patients with PCOS. Methods: The present study included 33 non-obese women diagnosed as PCOS based on National Institutes of Health consensus 1990 criteria and 31 age-matched healthy women as controls. Height, weight, body mass index, fasting plasma glucose, iron status markers i.e., serum ferritin, iron, total iron binding capacity, insulin and testosterone levels were determined. Results: A significant increase in hormones insulin and testosterone levels (p<0.001) was found in patients with PCOS in comparison with controls. Similarly, a significant increase in serum ferritin levels was observed in PCOS patients compared to controls (p<0.05). A significant positive correlation was observed between serum insulin and testosterone levels (p<0.05). Similarly, a positive association was observed between serum testosterone and ferritin levels [p=0.007 odds ratio (OR) 7.0(1.715-28.568)]. Conclusions: The present study demonstrates that body iron stores, as reflected by serum ferritin concentrations, are increased even in non-obese PCOS patients. Androgen excess is associated with increased body iron stores in these patients with the possible additive effects of hyperinsulinaemia, through its perpetuating effect on increased androgens and iron-sparing effect of reduced menstrual losses.