Testosterone is associated with insulin resistance index independently of adiposity in women with polycystic ovary syndrome

<p><b>Objective:</b> To study the associations between androgens, glucose homeostasis, inflammation and statin treatment in women with polycystic ovary syndrome (PCOS).</p> <p><b>Design and methods:</b> Oral glucose tolerance tests, androgens, hs-CRP and interleukin-1 receptor antagonist (IL-1Ra) were analyzed at baseline and after 6 months of atorvastatin (20 mg/d) or placebo treatment in 27 women with PCOS.</p> <p><b>Results:</b> Testosterone associated with insulin resistance measured with ISI<sub>Matsuda</sub> independently of BMI, age and SHBG concentrations and the full model, including IL-1Ra, hs-CRP and HDL-C, also showed independency of BMI and waist circumference (<i>p</i> ≤ .042). Free androgen index (FAI) associated with ISI<sub>Matsuda</sub> independently of adiposity (<i>p</i> ≤ .025) but in the full model with waist circumference the association was insignificant. ISI<sub>Matsuda</sub> decreased with testosterone >1.2 nmol/l compared with lower levels at baseline (<i>p</i> = .043) and at six months (<i>p</i> = .003). Accordingly, 30-minute insulin levels were increased with moderately elevated testosterone independently of adiposity (<i>p</i> ≤ .046). Increased fasting glucose and AUC insulin associated with statin treatment independently of adiposity and the associations attenuated after adjusting for testosterone.</p> <p><b>Conclusions:</b> Moderately elevated testosterone concentrations together with obesity-related inflammatory factors modify glucose homeostasis by increasing insulin resistance and early insulin secretion.</p>