Ovarian SAHA syndrome is associated with a more insulin-resistant profile and represents an independent risk factor for glucose abnormalities in women with polycystic ovary syndrome: a prospective controlled study

J Am Acad Dermatol. 2013 Dec;69(6):922-30. doi: 10.1016/j.jaad.2013.09.014. Epub 2013 Oct 11.

Abstract

Background: SAHA syndrome is characterized by the tetrad: seborrhea, acne, hirsutism, and androgenetic alopecia. No previous study has examined the prevalence of glucose abnormalities in ovarian SAHA and explored whether it may be an independent risk factor for glucose abnormalities.

Objective: In a prospective controlled study, we investigated the spectrum of glucose abnormalities in ovarian SAHA and explored whether it is associated with a more insulin-resistant profile.

Methods: In all, 316 patients with a diagnosis of polycystic ovary syndrome (PCOS) (56 with SAHA) and 102 age-matched healthy women were examined and underwent a 2-hour oral glucose tolerance test. Serum glucose homeostasis parameters, hormones, and adipokines were determined.

Results: SAHA prevalence was 17.7% in patients with PCOS and predominance of the severe PCOS phenotype. Ovarian SAHA was independently associated with a more insulin-resistant profile (higher homeostatic model assessment of insulin resistance score, lower quantitative insulin sensitivity check index [QUICKI] and MATSUDA indices, and relative hypoadiponectinemia), and represented an independent risk factor for glucose abnormalities regardless of anthropometric features, age, and PCOS phenotype.

Limitation: There was no performance of skin biopsies.

Conclusion: The prompt recognition of SAHA syndrome in women with PCOS permits an earlier diagnosis and surveillance of metabolic abnormalities, especially in Mediterranean PCOS population exhibiting a lower prevalence of glucose abnormalities.

Keywords: BMI; HA; HOMA-IR; IGF; IR; OA; OGTT; PCO; PCOS; QUICKI; SAHA; SAHA syndrome; SHBG; acne; adiponectin; androgenetic alopecia; body mass index; hirsutism; homeostatic model assessment of insulin resistance; hyperandrogenemia; insulin resistance; insulin-like growth factor; oligoanovulation; oral glucose tolerance test; polycystic ovarian morphology; polycystic ovary syndrome; quantitative insulin sensitivity check index; seborrhea; seborrhea, acne, hirsutism, and androgenetic alopecia; sex hormone-binding globulin.

MeSH terms

  • Acne Vulgaris / complications*
  • Acne Vulgaris / metabolism*
  • Adolescent
  • Adult
  • Alopecia / complications*
  • Alopecia / metabolism*
  • Dermatitis, Seborrheic / complications*
  • Dermatitis, Seborrheic / metabolism*
  • Female
  • Glucose / metabolism*
  • Hirsutism / complications*
  • Hirsutism / metabolism*
  • Humans
  • Insulin Resistance*
  • Ovarian Diseases / complications*
  • Ovarian Diseases / metabolism*
  • Polycystic Ovary Syndrome / complications*
  • Polycystic Ovary Syndrome / metabolism*
  • Prospective Studies
  • Risk Factors
  • Syndrome
  • Young Adult

Substances

  • Glucose