Metabolic manifestations of polycystic ovary syndrome in nonobese adolescents: retinol-binding protein 4 and ectopic fat deposition

Adolescents with PCOS had higher intrahepatic lipid content and a statistical trend for higher retinol-binding protein 4 (RBP4) levels than controls. There may be an independent relationship between RBP4 and triglycerides.

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Aviva B. Sopher, M.D., M.S., Adrienne T. Gerken, A.B., William S. Blaner, Ph.D., Jeremy M. Root, B.A., Donald J. McMahon, M.S., Sharon E. Oberfield, M.D.

Volume 97, Issue 4, Pages 1009-1015



To determine whether nonobese adolescents with polycystic ovary syndrome (PCOS) have higher levels of retinol-binding protein 4 (RBP4) and ectopic fat than controls and whether RBP4 and ectopic fat correlate with comorbidities of metabolic disease.


Cross-sectional case-control study.


Pediatric clinical research center based in a quaternary care medical center.


Twenty-four nonobese adolescents between the ages of 13 and 21 years, 13 with PCOS and 11 controls.


Measurement of RBP4, insulin resistance, lipids, and body composition.

Main Outcome Measure(s):

Retinol-binding protein 4, reproductive and adrenal hormones, insulin resistance, intrahepatic and intramyocellular lipid levels, and visceral adipose tissue.


Adolescents with PCOS had higher intrahepatic lipid content and a statistical trend for higher RBP4 compared with controls. Retinol-binding protein 4 correlated with body fat, triglycerides, insulin resistance, and androgens but not intrahepatic lipid content; however, when adjusted for body fat, the correlation between RBP4 and triglycerides weakened to a statistical trend and was no longer statistically significant for the other measures.


This small preliminary study of nonobese adolescent girls suggests that RBP4 may be involved in the dyslipidemia associated with PCOS and that there may be an independent relationship between RBP4 and triglycerides but not between RBP4 and insulin resistance. Although intrahepatic lipid content was higher in PCOS, it did not correlate with RBP4, triglycerides, or insulin resistance.

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