Insulin resistance is not strictly associated with energy intake or dietary macronutrient composition in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Around 60% of PCOS patients are obese. Weight loss has consistently been shown to improve the clinical status of women with PCOS. We hypothesized that dietary factors are associated with the hormonal and metabolic abnormalities of PCOS. This case-control study included 43 women with PCOS and 37 ovulatory, nonhirsute controls matched to the study group by body mass index. Age ranged from 14 to 38 years. Both groups underwent anthropometric, laboratory, and nutritional assessment. End points included diet composition, body fat, and hormonal and metabolic variables related to insulin resistance. The groups had similar intake of energy, carbohydrate (53.51% ± 8.36% vs 51.83% ± 10.06%), protein (15% [12-18] vs 16% [13-19]), and total fat (30.51% ± 7.90% vs 30.80% ± 7.97%). Total body fat, sum of trunk skinfold measurements, and waist circumference were higher in the PCOS group (P < .05). Sex hormone-binding globulin was lower in PCOS patients than in controls, whereas total testosterone, free androgen index, postprandial glucose, fasting and postprandial insulin, homeostatic model assessment index, triglycerides, and total and low-density lipoprotein cholesterol (P < .050) were higher. Homeostatic model assessment index was correlated with central obesity in PCOS patients and controls alike. No association was detected between androgen status and macronutrient intake. In conclusion, central obesity and insulin resistance were not strictly associated with energy intake or dietary macronutrient composition in women with PCOS.