Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders.
ABSTRACT To analyze the correlations among insulin, androgens, body mass index (BMI), and other related metabolic anomalies in women with and without polycystic ovary syndrome (PCOS).
Retrospective study of normal and obese women with and without PCOS.
Gynecologic endocrinology units of Elche, San Juan, and Alicante Hospitals and Hormone Laboratory at Alicante University Hospital ("Miguel Hernández" University).
A total of 212 women were studied: 137 with PCOS and 75 without PCOS.
BMI, gonadotropins, insulin, androgens (T, androstenedione, DHEAS), 17alpha-hydroxyprogesterone, sex hormone-binding globulin, and triglycerides were studied. Glycemia and insulin response to the tolerance test (GTT) with a 100-g oral glucose load were also assessed in 103 women.
A good correlation between insulin and BMI was found in normal and obese women without hormonal dysfunction and in patients with or without PCOS. Good correlations, although lower, between insulin and T, and BMI, insulin, and T with triglycerides were also found in patients with PCOS. These patients fell into clearly distinct categories: with or without insulin resistance and with or without obesity, but slim women with PCOS had insulin and metabolic variables similar to those without PCOS, and most obese women with PCOS were insulin-resistant and more hyperandrogenic and hypertriglyceridemic.
Insulin, androgens, and BMI are related in women both with PCOS and without PCOS, especially in obese ones. Insulin and metabolic indices are similar in lean women with PCOS and those without PCOS, but obese women with PCOS are more insulin-resistant, hyperandrogenic, and hypertriglyceridemic. Three types of disorders can be distinguished: simple nonhyperandrogenic obesity, typical nonhyperinsulinemic PCOS, and insulin-resistant PCOS.
- [Show abstract] [Hide abstract]
ABSTRACT: According to some studies, polycystic ovarian syndrome (PCOS) patients have an increased risk for diabetes mellitus and often show an adverse cardiovascular risk profile. NT-proBNP was shown to have a high predictive value regarding cardiovascular events, especially in those without overt cardiovascular disease. The aim of this study was to investigate the levels of NT-proBNP in 70 women with PCOS and/or obesity in relation to other classical cardiovascular risk factors. There was no statistical difference between NT-proBNP levels between obese, lean PCOS and obese PCOS patients; between patients with or without metabolic syndrome; or between patients with different cardiovascular risk, according to The Androgen Excess and PCOS Society consensus. NT-proBNP does not show significant correlation to age, weight, BMI, WHR, WSR, systolic or diastolic blood pressure and results from oral glucose tolerance test (OGTT), except for immunoreactive insulin (IRI) at 120 min. NT-proBNP correlates weakly with HDL, but not with other indices of lipid metabolism.Journal of Obstetrics and Gynaecology 11/2013; 33(8):868-72. · 0.55 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The metabolic syndrome is a cluster of metabolic disorders characterized by insulin resistance and hyperinsulinaemia, and its presence can increase the risk of cardiovascular disease significantly. The metabolic syndrome is associated with increased circulating androgen levels in women, which may originate from the ovaries and adrenal glands. Adipocytes are also able to synthesise steroid hormones, and this output has been hypothesised to increase with elevated insulin plasma concentrations. However, the contribution of the adipocytes to the circulating androgen levels in women with metabolic syndrome is limited and the effects of insulin are not fully understood. The aim of this study was to investigate the presence of steroid precursors and synthetic enzymes in human adipocyte biopsies as markers of possible adipocyte androgen synthesis. We examined pre and mature adipocytes taken from tissue biopsies of abdominal subcutaneous adipose tissue of participating women from the Department of Obstetrics and Gynaecology, of the Royal Derby Hospital. The results showed the potential for localised adipocyte androgen synthesis through the presence of the androgen precursor progesterone, as well as the steroid-converting enzyme 17α-hydroxylase. Furthermore, we found the controlled secretion of androstenedione in vitro and that insulin treatment caused levels to increase. Continued examination of a localised source of androgen production is therefore of clinical relevance due to its influence on adipocyte metabolism, its negative impact on female steroidogenic homeostasis, and the possible aggravation this may have when associated to obesity and obesity related metabolic abnormalities such as hyperinsulinaemia.Molecular Genetics and Metabolism Reports. 01/2014; 1:254–263.
- [Show abstract] [Hide abstract]
ABSTRACT: Weight gain and fat accumulation are predisposing factors of PCOS. Life-style modification, including increasing physical activity, is the first line approach in managing PCOS. The objective of this study is to assess the effect of exercise intensity on weight changes, androstenedione and free testosterone level in female rats with estradiol valerate induced PCOS.Method and materials: 40 female Wistar rats were selected (180 +/- 20 g). They had every 2 to 3 consecutive estrous cycles during 12 to 14 days. The study was approved by ethical committee of Jahrom University of Medical Sciences. The first two groups were divided into control (n = 10) and polycystic (n = 30) that were induced PCOS by estradiol valerate injection after 60 days. The polycystic groups were divided into three groups of sham (n = 10), experiment group with low-intensity exercise (pco + l.exe) (n =10) and experiment group with moderate intensity exercise (pco + m.exe) (n =10). Exercises were performed during 6 sessions of 60 minutes per week for 8 weeks. (Moderate intensity: 28 m/min-70%-75%VO2Max. Low intensity (20 m/min-50%-55%VO2Max) running at 0 slope, 1 h/day, 6 days/week). ANOVA and LSD test were used for data analysis. In the present study, no significant differences were found in the decrease of total weights of rats. And also androstenedione level changes in experiment groups were higher compared to control group but no significant differences were found, also free testosterone level was significantly higher than the observer group. According to weight changes and sexual hormones (Free testosterone and androstenedione) exercise training especially with low intensity may improve symptoms of polycystic ovary syndrome.Journal of Ovarian Research 04/2014; 7(1):37. · 2.43 Impact Factor