Data from: Osteosarcopenia in reproductive-aged women with polycystic ovary syndrome: a multicenter case-control study

Context: Osteosarcopenia (loss of skeletal muscle and bone mass and/or
function usually associated with aging) shares pathophysiological
mechanisms with polycystic ovary syndrome (PCOS). However, the
relationship between osteosarcopenia and PCOS remains unclear. Objective:
We evaluated skeletal muscle index% (SMI%=[appendicular muscle mass/weight
{kg}]×100) and bone mineral density (BMD) in PCOS
(hyperandrogenism+oligoamenorrhea), and contrasted these musculoskeletal
markers against 3 reproductive phenotypes: (1) HA
(hyperandrogenism+eumenorrhea); (2) OA (normoandrogenic+oligoamenorrhea)
and, (3) controls (normoandrogenic+eumenorrhea). Endocrine predictors of
SMI% and BMD were evaluated across groups. Design, Setting, Participants:
Multicenter case-control study of 203 women (18–48y) in New York
State.  Results: PCOS group exhibited reduced SMI% (mean [95%CI];
26.2% [25.1,27.3] vs. 28.8% [27.7,29.8]), lower-extremity SMI% (57.6%
[56.7,60.0] vs. 62.5% [60.3,64.6]), and BMD (1.11 [1.08,1.14] vs. 1.17
[1.14,1.20] g/cm2) compared to controls. PCOS group also had decreased
upper (0.72 [0.70,0.74] vs. 0.73 [0.71,0.76] g/cm2) and lower (1.13
[1.10,1.16] vs. 1.15 [1.12,1.18] g/cm2) limb BMD compared to HA. Matsuda
index was lower in PCOS vs. controls and positively associated with SMI%
in all groups (All:P≤0.05). Only controls showed associations between
insulin-like-growth-factor-1 (IGF-1) and upper (r=0.84) and lower (r=0.72)
limb BMD (All:P<0.01). Unlike in PCOS, IGF binding-protein-2 was
associated with SMI% in controls (r=0.45) and HA (r=0.67), and with upper
limb BMD (r=0.98) in HA (All:P<0.05). Conclusions: Women with PCOS
exhibit early signs of osteosarcopenia compared to controls likely
attributed to disrupted insulin function. Understanding the degree of
musculoskeletal deterioration in PCOS is critical for implementing
targeted interventions that prevent and delay osteosarcopenia in this
clinical population.