Pituitary desensitization to gonadotropin-releasing hormone increases abdominal adiposity in hyperandrogenic anovulatory women

Objective: To determine whether hyperandrogenism in anovulatory women affects body fat distribution. Design: Prospective nonrandomized study. Setting: An academic research environment. Patient(s): Ten hyperandrogenic anovulatory patients and 10 healthy women matched by body mass index. Intervention(s): Regional body fat analysis was performed before and after 3 months of GnRH analogue (GnRH-a) therapy. Main Outcome Measure(s): Body fat distribution was measured by waist-to-hip circumference ratio, single-slice computed tomography imaging (L2-3 interspace), and total body dual-energy x- ray absorptiometry. Result(s): Weight, body mass index, waist-to-hip circumference ratio, total body and leg fat mass, and subcutaneous adipose area were unaffected by the presence of hyperandrogenism or the use of GnRH- a therapy. Basal abdominal fat mass, abdomen-to-leg fat mass ratio, visceral adipose area, and total visceral adipose volume were comparable in both study groups. The abdominal fat mass increased in both groups during GnRH-a therapy, whereas the abdomen-to-leg fat mass ratio rose significantly only in the hyperandrogenic patients. During GnRH-a therapy, the hyperandrogenic patients demonstrated a significant increase in visceral adipose area compared with the healthy women so that total visceral adipose volume increased significantly in the former but not the latter. Conclusion(s): Three months of GnRH-a administration preferentially increased abdominal fat, as measured by single-slice computed tomography imaging and total body dual- energy x-ray absorptiometry, in hyperandrogenic anovulatory women.