{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:11:25Z","timestamp":1790377885595,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T00:00:00Z","timestamp":1338508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Instituto de Investigaci\u00f3n Carlos III","award":["FIS PI080944"],"award-info":[{"award-number":["FIS PI080944"]}]},{"name":"Instituto de Investigaci\u00f3n Carlos III","award":["PI110357"],"award-info":[{"award-number":["PI110357"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Abdominal adiposity and obesity influence the association of polycystic ovary syndrome (PCOS) with insulin resistance and diabetes. We aimed to characterize the intermediate metabolism phenotypes associated with PCOS and obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We applied a nontargeted GC-MS metabolomic approach to plasma samples from 36 patients with PCOS and 39 control women without androgen excess, matched for age, body mass index, and frequency of obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Patients with PCOS were hyperinsulinemic and insulin resistant compared with the controls. The increase in plasma long-chain fatty acids, such as linoleic and oleic acid, and glycerol in the obese patients with PCOS suggests increased lipolysis, possibly secondary to impaired insulin action at adipose tissue. Conversely, nonobese patients with PCOS showed a metabolic profile consisting of suppression of lipolysis and increased glucose utilization (increased lactic acid concentrations) in peripheral tissues, and PCOS patients as a whole showed decreased 2-ketoisocaproic and alanine concentrations, suggesting utilization of branched-chain amino acids for protein synthesis and not for gluconeogenesis. These metabolic processes required effective insulin signaling; therefore, insulin resistance was not universal in all tissues of these women, and different mechanisms possibly contributed to their hyperinsulinemia. PCOS was also associated with decreased \u03b1-tocopherol and cholesterol concentrations irrespective of obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Substantial metabolic heterogeneity, strongly influenced by obesity, underlies PCOS. The possibility that hyperinsulinemia may occur in the absence of universal insulin resistance in nonobese women with PCOS should be considered when designing diagnostic and therapeutic strategies for the management of this prevalent disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1373\/clinchem.2011.176396","type":"journal-article","created":{"date-parts":[[2012,3,17]],"date-time":"2012-03-17T00:17:00Z","timestamp":1331943420000},"page":"999-1009","source":"Crossref","is-referenced-by-count":100,"title":["Metabolic Heterogeneity in Polycystic Ovary Syndrome Is Determined by Obesity: Plasma Metabolomic Approach Using GC-MS"],"prefix":"10.1093","volume":"58","author":[{"given":"H\u00e9ctor F","family":"Escobar-Morreale","sequence":"first","affiliation":[{"name":"Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ram\u00f3n y Cajal & Universidad de Alcal\u00e1, Madrid, Spain"},{"name":"CIBER Diabetes y Enfermedades Metab\u00f3licas Asociadas, Spain"},{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Samino","sequence":"first","affiliation":[{"name":"CIBER Diabetes y Enfermedades Metab\u00f3licas Asociadas, Spain"},{"name":"Metabolomics Platform, Universitat Rovira i Virgili & Institut d'Investigaci\u00f3 Sanitaria Pere Virgili, Tarragona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Insenser","sequence":"first","affiliation":[{"name":"Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ram\u00f3n y Cajal & Universidad de Alcal\u00e1, Madrid, Spain"},{"name":"CIBER Diabetes y Enfermedades Metab\u00f3licas Asociadas, Spain"},{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Vinaixa","sequence":"first","affiliation":[{"name":"CIBER Diabetes y Enfermedades Metab\u00f3licas Asociadas, Spain"},{"name":"Metabolomics Platform, Universitat Rovira i Virgili & Institut d'Investigaci\u00f3 Sanitaria Pere Virgili, Tarragona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Luque-Ram\u00edrez","sequence":"first","affiliation":[{"name":"Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ram\u00f3n y Cajal & Universidad de Alcal\u00e1, Madrid, Spain"},{"name":"CIBER Diabetes y Enfermedades Metab\u00f3licas Asociadas, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A","family":"Lasunci\u00f3n","sequence":"first","affiliation":[{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria, Madrid, Spain"},{"name":"Department of Biochemistry-Research, Hospital Universitario Ram\u00f3n y Cajal & Universidad de Alcal\u00e1, Madrid, Spain, and CIBER Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Correig","sequence":"first","affiliation":[{"name":"CIBER Diabetes y Enfermedades Metab\u00f3licas Asociadas, Spain"},{"name":"Metabolomics Platform, Universitat Rovira i Virgili & Institut d'Investigaci\u00f3 Sanitaria Pere Virgili, Tarragona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2012,6,1]]},"reference":[{"key":"2020022705131132400_B1","first-page":"2434","article-title":"A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain","volume":"85","author":"Asuncion","year":"2000","journal-title":"J Clin Endocrinol 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