Journal of Endocrinological Investigation

, Volume 30, Issue 10, pp 820–827 | Cite as

Total ghrelin levels during acute insulin infusion in patients with polycystic ovary syndrome

  • D. Micic
  • M. Sumarac-Dumanovic
  • A. Kendereski
  • G. Cvijovic
  • S. Zoric
  • D. Pejkovic
  • J. Micic
  • N. Milic
  • C. Dieguez
  • F. F. Casanueva
Original Articles


Controversial data were reported concerning fasting ghrelin (decreased, normal or elevated) in polycystic ovary syndrome (PCOS). The aim of our study was to clarify ghrelin levels in non-obese, overweight, and obese PCOS patients; to investigate the effect of acute insulin infusion on ghrelin in PCOS as a chronic insulin-resistant state, with and without the impact of obesity, and to examine ghrelin-androgen interaction. In that order, we evaluated 1) ghrelin levels among 8 non-obese patients with PCOS [body mass index (BMI): 20.52±1.31 kg/m2], 8 overweight and obese patients with PCOS (BMI: 34.36±6.53 kg/m2) and their respective controls, 2) ghrelin suppression during euglycemic hyperinsulinemic clamp, and 3) ghrelin-androgen interrelationship. After overnight fast, 2-h euglycemic hyperinsulinemic clamp, was performed in all investigated women. Fasting ghrelin was significantly lower in non-obese PCOS than in controls (64.74±25.69 vs 108.36±52.60; p<0.05) as well as in overweight and obese PCOS in comparison with controls (38.71 ± 14.18 vs 98.77± 40.49; p<0.05). Insulin infusion significantly suppressed ghrelin in all subgroups of investigated women. Analysis of variance for repeatable measures confirmed that there was no significant difference in pattern of response between PCOS and controls. In conclusion, women with PCOS had lower fasting ghrelin and decreased insulin sensitivity independently of their BMI, compared to the controls. In addition, there were no differences between fasting ghrelin levels among non-obese, overweight, and obese women with PCOS. During euglycemic hyperinsulinemic clamp, ghrelin decreased in all studied groups to a similar extent, implying that, compared to chronic hyperinsulinemia, acute hyperinsulinemia reduces ghrelin levels independently of the degree of insulin resistance.


Ghrelin PCOS euglycemic clamp insulin SHBG 


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Copyright information

© Italian Society of Endocrinology (SIE) 2007

Authors and Affiliations

  • D. Micic
    • 1
  • M. Sumarac-Dumanovic
    • 1
  • A. Kendereski
    • 1
  • G. Cvijovic
    • 1
  • S. Zoric
    • 1
  • D. Pejkovic
    • 1
  • J. Micic
    • 2
  • N. Milic
    • 3
  • C. Dieguez
    • 4
  • F. F. Casanueva
    • 4
  1. 1.Center for Metabolic Disorders in Endocrinology, Institute of Endocrinology, Diabetes and Diseases of MetabolismClinical Center of SerbiaBelgradeSerbia
  2. 2.Institute of Gynecology, and Obstetrics, Clinical Center of SerbiaUniversity of BelgradeBelgradeSerbia
  3. 3.Institute of Medical Statistics, School of MedicineUniversity of BelgradeBelgradeSerbia
  4. 4.Department of EndocrinologyUniversity of Santiago de CompostelaSantiago de CompostelaSpain

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