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Insulin resistance and secretion in polycystic ovarian disease

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Abstract

In order to verify the relationship between insulin resistance and hyperandrogenism in Polycystic ovary disease (PCOD), circulating levels of insulin in response to oral glucose tolerance test (OGTT) were assessed in 23 PCOD patients and 10 matched control subjects without obesity, acanthosis nigricans and impaired glucose tolerance. In PCOD patients serum total testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), LH and LH/FSH ratio were significantly higher than in control subjects; whereas urinary 17-ketosteroids (17-KS) and glycemie response to OGTT were not different. PCOD patients were clearly hyperinsulinemic before and during OGTT compared to the control group: mean ± SD basal insulin (Io) (23.4 ± 10.3 vs 11.3 ± 4.6 μU/ml, p < 0.001) and the sums of insulin levels (Σ I) during OGTT (341.4 ± 148.9 vs 162.2 ± 56 μU/ml, p < 0.001). In the two groups serum T, but not DHEA-S, LH, urinary 17-KS and the degree of obesity, was strongly associated with l0 (r = 0.458, p < 0.01) and 11 (r = 0.419, p < 0.02), as well as with insulin resistance as assessed by basal (r = 0.425, p < 0.02) and postglucose challenge (r = 0.384, p < 0.05) insulin to glucose ratio. These results confirm that the hyperinsulinism and insulin resistance in PCOD is not related to obesity and suggest that the hyperandrogenism may be partially responsable of the observed imbalance in glucose-insulin homeostasis.

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References

  1. Yen S.S.C. Polycystic ovan syndrome. In: Yen S.S.C., Jaffe R.B. (Eds.), Reproductive Endocrinology. Saunders, Philadelphia, 1978, p. 306.

    Google Scholar 

  2. Burghen G.A., Givens J.R., Kitabchi A.E. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J. Clin. Endocrinol. Metab. 50: 113, 1980.

    Article  PubMed  CAS  Google Scholar 

  3. Chang R.J., Nakamura R.M., Judd H.L, Kaplan S.A. Insulin resistance in nonobese patients with polycystic ovarian disease. J. Clin. Endocrinol. Metab. 57: 356, 1982.

    Article  Google Scholar 

  4. Wortsman J., Soler N.G. Abnormalities of fuel metabolism in the polycystic ovary syndrome. Obstet. Gynecol. 60: 342, 1982.

    PubMed  CAS  Google Scholar 

  5. Cotrozzi G., Matteini M., Relli P., Lazzari T. Hyperinsulinism and insulin resistance in polycystic ovarian syndrome: a verification using oral glucose, I.V. glucose and tolbutamide. Acta Diabetol. Lat. 20 (2): 135, 1983.

    Article  PubMed  CAS  Google Scholar 

  6. Goldzieher J.W. Polycystic ovarian disease. Fertil. Steril. 35:371,1981.

    PubMed  CAS  Google Scholar 

  7. Bray G.A., Jordan H.A., Sims E.A.H. Evaluation of the obese patients. JAMA 235: 1487, 1979.

    Article  Google Scholar 

  8. Moghissi K.S. Prediction and detection of ovulation. Fertil. Steril. 34: 89, 1980.

    PubMed  CAS  Google Scholar 

  9. Chang R.J., Mandel F.P., Wolfsen A.R., Judd H.L. Circulating levels of plasma adrenocorticotropin in polycystic ovarian disease. J. Clin. Endocrinol. Metab. 54: 1265, 1982.

    Article  PubMed  CAS  Google Scholar 

  10. Woodard T.L., Burghen G.A., Kitabchi A.E., Wilimas J.A. Glucose intolerance and insulin resistance in aplastic anemia treated with oxymetholone. J. Clin. Endocrinol. Metab. 53: 905, 1981.

    Article  PubMed  CAS  Google Scholar 

  11. London J., Wynn V., Samols E. The effect of anabolic steroids on blood sugar and plasma insulin levels in man. Metabolism 12:924, 1963.

    Google Scholar 

  12. Olefsky J.M. The insulin receptor: its role in insulin resistance of obesity and diabetes. Diabetes 25: 1154, 1976.

    Article  PubMed  CAS  Google Scholar 

  13. Kahn C.R., Lier J.S., Archer J.A., Gorden P., Martin M.M., Roth J. The syndromes of insulin resistance and acanthosis nigricans. N. Engl. J. Med. 294: 739, 1976.

    Article  PubMed  CAS  Google Scholar 

  14. Flier J.S. Case records of the Massachusetts General Hospital, case 25-1982. Ed. Scully R.E. N.Engl. J. Med. 306:1537, 1982.

    Article  Google Scholar 

  15. Flier J.S., Kahn C.R., Roth J. Receptor, antireceptor antibodies, and mechanism of insulin resistance. N.Engl. J. Med. 300:413, 1979.

    Article  PubMed  CAS  Google Scholar 

  16. Taylor S.I., Dons R.F., Hernandez E., Roth J., and Gorden P. Insulin resistance associated with androgen excess in women with autoantibodies to the insulin receptor. Ann. Intern. Med. 97:851, 1982.

    Article  PubMed  CAS  Google Scholar 

  17. Flier J.S., Bar R.S., Muggeo M., Kahn C.R., Gorden P. The evolving clinical course of patients with insulin receptor antibodies: spontaneous remission or receptor proliferation with hypoglycemia. J. Clin. Endocrinol. Metab. 47: 985, 1978.

    Article  PubMed  CAS  Google Scholar 

  18. Channing C.P., Tsai V., Sachs D. Role of insulin, thyroxine, and Cortisol in luteinization of porcine granulosa cells grown in chemically defined media. Biol. Reprod. 15:235, 1976.

    Article  PubMed  CAS  Google Scholar 

  19. Mondschein J.S., Scomberg D.W. Growth factors modulate gonadotropin receptor induction in granulosa cell cultures. Science 211:1179, 1981.

    Article  PubMed  CAS  Google Scholar 

  20. Mondschein J.S., Schomberg D.W. Platelet-derived growth factor enhances granulosa cell luteinizing hormone receptor induction by follicle-stimulating hormone and serum. Endocrinology 109: 325, 1981.

    Article  PubMed  CAS  Google Scholar 

  21. Adashi E.Y., Hsueh A.J.W., Yen S.S.C. Insulin enhancement of luteinizing hormone and follicle-stimulating hormone release by cultured pituitary cells. Endocrinology 108:1441, 1981.

    Article  PubMed  CAS  Google Scholar 

  22. Roth J., Grunfeld C. Endocrine systems: mechanism of disease, target cells, and receptors. In: Williams R.H. (Ed.), Textbook of endocrinology. W.B. Saunders Co., Philadelphia, 1981, p. 15.

    Google Scholar 

  23. Rechter M.M., Zapf J., Nissley S.P. Interactions of insulin-like growth factors I and II and multiplication-stimulating activity with receptors and serum carrier proteins. Endocrinology 107: 1451, 1980.

    Article  Google Scholar 

  24. Annos T., Taymor M.L. Ovarian pathology associated with insulin resistance and acanthosis nigricans. Obstet. Gynecol. 58: 662, 1981.

    PubMed  CAS  Google Scholar 

  25. Shoupe D., Lobo R.A. The influence of androgens on insulin resistance. Fertil. Steril. 41: 385, 1984.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Clinica Medica Generale, Università de L’Aquila, V.le Duca degli Abruzzi 3a, 67100, L’Aquila, Italy

    Bernardino Bruno, G. Poccia & A. Fabbrini

  2. Via N. Moscardelli, 16 67100, L’Acquila, Italy

    Bernardino Bruno

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  1. Bernardino Bruno
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  2. G. Poccia
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  3. A. Fabbrini
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Bruno, B., Poccia, G. & Fabbrini, A. Insulin resistance and secretion in polycystic ovarian disease. J Endocrinol Invest 8, 443–448 (1985). https://doi.org/10.1007/BF03348535

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  • DOI: https://doi.org/10.1007/BF03348535

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