Effects of caloric intake timing on insulin resistance and hyperandrogenism in lean women with polycystic ovary syndrome

2013 ◽  
Vol 125 (9) ◽  
pp. 423-432 ◽  
Author(s):  
Daniela Jakubowicz ◽  
Maayan Barnea ◽  
Julio Wainstein ◽  
Oren Froy
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Therapeutic Option ◽  
Caloric Intake ◽  
Area Under The Curve ◽  
Ovulation Rate ◽  
Sex Hormone Binding Globulin ◽  
Ovary Syndrome ◽  
Meal Timing

In women with PCOS (polycystic ovary syndrome), hyperinsulinaemia stimulates ovarian cytochrome P450c17α activity that, in turn, stimulates ovarian androgen production. Our objective was to compare whether timed caloric intake differentially influences insulin resistance and hyperandrogenism in lean PCOS women. A total of 60 lean PCOS women [BMI (body mass index), 23.7±0.2 kg/m2] were randomized into two isocaloric (~1800 kcal; where 1 kcal≈4.184 J) maintenance diets with different meal timing distribution: a BF (breakfast diet) (980 kcal breakfast, 640 kcal lunch and 190 kcal dinner) or a D (dinner diet) group (190 kcal breakfast, 640 kcal lunch and 980 kcal dinner) for 90 days. In the BF group, a significant decrease was observed in both AUCglucose (glucose area under the curve) and AUCinsulin (insulin area under the curve) by 7 and 54% respectively. In the BF group, free testosterone decreased by 50% and SHBG (sex hormone-binding globulin) increased by 105%. GnRH (gonadotropin-releasing hormone)-stimulated peak serum 17OHP (17α-hydroxyprogesterone) decreased by 39%. No change in these parameters was observed in the D group. In addition, women in the BF group had an increased ovulation rate. In lean PCOS women, a high caloric intake at breakfast with reduced intake at dinner results in improved insulin sensitivity indices and reduced cytochrome P450c17α activity, which ameliorates hyperandrogenism and improves ovulation rate. Meal timing and distribution should be considered as a therapeutic option for women with PCOS.

scholarly journals A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome

2012 ◽  
Vol 166 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Wei Wei ◽  
Hongmin Zhao ◽  
Aili Wang ◽  
Ming Sui ◽  
Kun Liang ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Area Under The Curve ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Sex Hormone Binding Globulin ◽  
Metabolic Effects ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Insulin Sensitizer

ObjectivePolycystic ovary syndrome (PCOS) is a frequent reproductive and metabolic disorder associated with insulin resistance (IR). Berberine (BBR) is an isoquinoline derivative alkaloid extracted from Chinese medicinal herbs that has been used as an insulin sensitizer. BBR may have a potential therapeutic value for PCOS. The aim of this study was to evaluate the effects of BBR in comparison to metformin (MET) on the metabolic features of women with PCOS.Design and methodsEighty-nine subjects with PCOS and IR subjects were randomized into one of three treatment groups: BBR+compound cyproterone acetate (CPA; n=31), MET+CPA (n=30), and placebo+CPA (n=28) for 3 months. Clinical characteristics of the women and metabolic and hormonal parameters were assessed before and after the period of treatment.ResultsTreatment with BBR in comparison to MET showed decrease in waist circumference and waist-to-hip ratio (WHR; P<0.01), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDLC; P<0.05) as well as increase in high-density lipoprotein cholesterol (HDLC) and sex hormone-binding globulin (SHBG; P<0.05). Similarly, treatment with BBR in comparison to placebo showed decrease in WHR, fasting plasma glucose, fasting insulin, homeostasis model assessment for IR, area under the curve of insulin, TC, LDLC, and TG (P<0.05) as well as increase in HDLC and SHBG (P<0.01).ConclusionsIntake of BBR improved some of the metabolic and hormonal derangements in a group of treated Chinese women with PCOS. Main effects could be related to the changes in body composition in obesity and dyslipidemia. Further controlled studies are needed for the assessment of the potential favorable metabolic effects of BBR in women with PCOS.

scholarly journals Racial and Ethnic Differences in Metabolic Disease in Adolescents With Obesity and Polycystic Ovary Syndrome

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Stanley Andrisse ◽  
Yesenia Garcia-Reyes ◽  
Laura Pyle ◽  
Megan M Kelsey ◽  
Kristen J Nadeau ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
General Population ◽  
Polycystic Ovary Syndrome ◽  
Race And Ethnicity ◽  
Polycystic Ovary ◽  
Sex Hormone Binding Globulin ◽  
Oral Glucose ◽  
Model Assessment ◽  
Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is common and associated with metabolic syndrome. In the general population, metabolic disease varies by race and ethnicity. Objective This work aimed to examine in depth the interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth. Methods A secondary analysis was conducted of data from girls (age 12-21 years) with overweight or obesity (&gt; 90 body mass index [BMI] percentile) and PCOS. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test (OGTT), and magnetic resonance imaging for hepatic fat. Groups were categorized by race or ethnicity. Results Participants included 39 non-Hispanic White (NHW, age 15.7 ± 0.2 years; BMI 97.7 ± 0.2 percentile), 50 Hispanic (HW, 15.2 ± 0.3 years; 97.9 ± 0.3 percentile), and 12 non-Hispanic Black (NHB, 16.0 ± 0.6 years; 98.6 ± 0.4 percentile) adolescents. Hepatic markers of insulin resistance were worse in NHW, including lower sex hormone–binding globulin and higher triglycerides over high-density lipoprotein cholesterol (TGs/HDL-C) ratio (P = .002 overall, HW vs NHB [P = .009] vs NHW [P = 0.020]), although homeostasis model assessment of estimated insulin resistance was worst in NHB (P = .010 overall, NHW vs NHB P = .014). Fasting and 2-hour OGTT glucose were not different between groups, although glycated hemoglobin A1c (HbA1c) was lowest in NHW (overall P &lt; .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3 P &lt; .001 vs 5.7 ± 0.4%, P &lt; .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%, P = .032); low HDL-C &lt; 40 mg/dL (HW 82%, NHW 61%, NHB 50%, P &lt; .001) and prediabetes HbA1c 5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%, P &lt; .001) were different between the groups. Conclusion Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.

scholarly journals Evaluation of lipid ratios and triglyceride-glucose index as risk markers of insulin resistance in Iranian polycystic ovary syndrome women

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Asma Kheirollahi ◽  
Maryam Teimouri ◽  
Mehrdad Karimi ◽  
Akram Vatannejad ◽  
Nariman Moradi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Area Under The Curve ◽  
Hdl Cholesterol ◽  
Insulin Level ◽  
Model Assessment ◽  
Iranian Women ◽  
Ovary Syndrome ◽  
Lipid Ratios

Abstract Background Insulin resistance has a vital role in the pathophysiology of polycystic ovary syndrome (PCOS). Previous investigations have shown that some lipid ratios could be a simple clinical indicator of insulin resistance (IR) in some disorders and ethnicities. The present study was conducted to evaluate the correlation between triglyceride to HDL-cholesterol (TG/HDL-C), total cholesterol to HDL-cholesterol (TC/HDL-C), as well as fasting triglyceride-glucose (TyG) indices with IR (as measured by homeostasis model assessment of IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and fasting glucose to insulin ratio (FGIR)) among the Iranian women diagnosed with PCOS. Methods In the current study, a total of 305 women with PCOS were evaluated. TG/HDL-C, TC/HDL-C, and TyG indices were calculated. Fasting insulin level was measured using ELISA technique. IR was defined as a HOMA-IR value of ≥2.63, FG-IR value of < 8.25, and QUICKI value of < 0.33. Results The insulin-resistant (IR) and insulin-sensitive (IS) groups, established by the HOMA-IR, FG-IR, and QUICKI values were different in terms of TG/HDL-C, TC/HDL-C, and TyG indices. These indices were associated with IR even after adjusting for age and BMI. ROC curve analyses showed that TyG, TG/HDL-C, and TC/HDL-C strongly predicted HOMA-IR with area under the curve (AUC) of 0.639, 0.619, and 0.623, respectively (P < 0.05). Further, TC/HDL-C was a good predictor of FG-IR with AUC of 0.614 (P = 0.04). Conclusion TyG, TG/HDL-C, and TC/HDL-C indices might be good indicators of IR among Iranian women diagnosed with PCOS.

scholarly journals The Relationship Between Insulin Resistance and Obesity and Serum Anti-mullerian Hormone Level in Chinese Women With Polycystic Ovary Syndrome: A Case-control Study.

2021 ◽  
Author(s):  
Han Zhao ◽  
Dexin Zhou ◽  
Cong Liu ◽  
Le Zhang
Keyword(s):  
Insulin Resistance ◽  
Linear Regression ◽  
Polycystic Ovary Syndrome ◽  
Multiple Linear Regression ◽  
Polycystic Ovary ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Ovary Syndrome ◽  
The Relationship

Abstract BackgroundAnti-Mullerian Hormone (AMH) has an important role in the pathophysiological process of polycystic ovary syndrome (PCOS) by regulating follicular development and is closely related to the severity of PCOS. Previous studies have suggested that AMH levels in PCOS is related to hyperandrogenemia levels and are affected by obesity and insulin resistance. however, the exact relationship between AMH levels and obesity and insulin resistance remains unclear. We aimed to elucidate the relationship between insulin resistance and obesity and serum AMH levels in women with PCOS. MethodsWe conducted a retrospective study of 220 women with PCOS who had undergone an assortment of physical, endocrine, and metabolic assessments. AMH levels and various other indicators of PCOS in patients with different body mass indices (BMI) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels were compared. Independent sample t-tests were performed to compare two groups. Pearson correlation analysis was performed to study the correlation between AMH and age, obesity, IR, and other indicators of PCOS, and multiple linear regression analysis was performed to determine the factors influencing AMH. Bilateral tests were performed for all statistical tests. The data were analysed using SPSS v25.0. Statistical significance was defined as a two-sided P-value of less than 0.05.ResultsWe found that >50% of patients with PCOS had insulin resistance, obesity, hyperandrogenemia, and abnormal glucose tolerance. AMH, testosterone (T), and HOMA-IR levels were affected by age, and older participants had lower AMH, HOMA-IR, and androgen levels (P < 0.05). Glycated hemoglobin levels were higher and AMH, luteinizing hormone (LH)/follicle-stimulating hormone (FSH), and LH levels were lower in non-obese individuals than in obese individuals (both P < 0.05). Participants in the non-insulin resistant (IR; NIR) group were older than those in the IR group (P < 0.05). AMH, LH, LH/FSH, and T levels in the IR group were significantly higher than those in the NIR group (P < 0.05). AMH levels were positively correlated with LH, LH/FSH, T, fasting insulin (FINS), and HOMA-IR levels as well as the free androgen index and negatively correlated with age, BMI, and sex hormone binding globulin levels (P < 0.05). Through multiple linear regression, we found that AMH levels could be explained by T, LH/FSH, FINS, sex hormone binding globulin, LH levels, and BMI.ConclusionsSerum AMH levels were closely related to metabolic abnormalities in PCOS. In patients with PCOS, AMH levels were positively correlated with HOMA-IR levels and negatively correlated with BMI. Thus, AMH combined with BMI and HOMA-IR levels could help determine the severity of PCOS.

scholarly journals Use of Metformin in Clomiphene Citrate (CC) Resistant Polycystic Ovary Syndrome (PCOS)

2009 ◽  
Vol 1 (1) ◽  
pp. 1-9
Author(s):  
Mosammat Rashida Begum ◽  
Laila Arjumand Banu ◽  
Ratu Rumana Binte Rahman ◽  
Farhana Dewan ◽  
Salma Rouf
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Hepatic Glucose Production ◽  
Insulin Level ◽  
Sex Hormone Binding Globulin ◽  
Ovary Syndrome ◽  
Metabolic Derangement ◽  
Peripheral Tissues ◽  
Characteristic Appearance

Abstract Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting between 4% and 8% of reproductive aged women. Although the symptoms and signs of PCOS are very heterogeneous, the syndrome usually presents with any combination of the following, menstrual irregularities (usually oligomenorrhea or amenorrhea), signs of hyperandrogenism (hirsutism, acne, alopecia) a characteristic appearance of the ovaries on ultrasound examination and an endocrine disturbance often involving high serum concentrations of LH and androgens. There is a well established association between PCOS, insulin resistance and hyperinsulinemia. Insulin resistance is a pivotal defect in PCOS probably counts as one of the most important advances in the battle to control the disorder. This metabolic abnormality leads to a compensatory increase in circulating insulin and this elevated insulin level directly stimulates the ovary to produce excess androgens. It also decreases hepatic sex hormone binding globulin (SHBG), so increasing biologically available free testosterone concentration in the circulation. This metabolic derangement leads to oligomenorrhea and anovulation. Different insulin sensitizers are used to revert the hyperinsulinemic condition. Metformin is top of them, which proved to enhance ovulation in insulin resistant PCOS when used with different ovulation inducing agents. Metformin reduces insulin resistance of peripheral tissue and allows muscle and adipose cells to take in glucose at normal insulin levels. It inhibits hepatic glucose production, decreases intestinal absorption and promotes glucose uptake, utilization by peripheral tissues at the postreceptor level. In this way it reduces insulin level and subsequently androgen level. It is easily available, safe and no teratogenic or adverse fetal outcome were reported by any researcher. It can be used safely in clomiphene resistant PCOS patients.

scholarly journals Effects of Mixed of a Ketogenic Diet in Overweight and Obese Women with Polycystic Ovary Syndrome

2021 ◽  
Vol 18 (23) ◽  
pp. 12490
Author(s):  
Raffaele Ivan Cincione ◽  
Francesca Losavio ◽  
Fabiana Ciolli ◽  
Anna Valenzano ◽  
Giuseppe Cibelli ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Adipose Tissue ◽  
Polycystic Ovary Syndrome ◽  
Ketogenic Diet ◽  
Polycystic Ovary ◽  
Therapeutic Option ◽  
Significant Risk ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Metabolic Complications

Polycystic ovary syndrome (PCOS) is a commonly occurring endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardiovascular and metabolic sequelae, including diabetes and metabolic syndrome. The relationship between central obesity and the development of insulin resistance is widely verified. Adipose tissue excess and the coexistent dysregulation of adipocyte functions directly contribute to the pathogenesis of the metabolic complications observed in women with PCOS. In the light of these evidence, the most therapeutic option prescribed to obese women with PCOS, regardless of the phenotype e from the severity of clinical expression, is lifestyle correction by diet and physical activity. The aim of this study is to evaluate the beneficial effects of ketogenic diet in 17 obese women with PCOS. Our results showed that the ketogenic diet inducing therapeutic ketosis, improves the anthropometric and many biochemical parameters such as LH, FSH, SHBG, insulin sensitivity and HOMA index. In addition, it induces a reduction in androgenic production, whereas the contextual reduction of fat mass reduced the acyclic production of estrogens deriving from the aromatization in the adipose tissue of the androgenic excess, with an improvement of the LH/FSH ratio. This is the first study on the effects of the ketogenic diet on PCOS, however, further studies are needed to elucidate the mechanism underlying ketogenic diet effects.

scholarly journals The Effects of Inositol on Polycystic Ovary Syndrome

2001 ◽  
Vol 71 (3) ◽  
pp. 250-255
Author(s):  
Razvan Popovici ◽  
Antoneta Dacia Petroaie ◽  
Alexandru Carauleanu ◽  
Irina Esanu ◽  
Cringuta Paraschiv ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Therapeutic Option ◽  
Second Messengers ◽  
Reproductive Period ◽  
Blood Levels ◽  
Ovary Syndrome ◽  
Insulin Mimetic ◽  
Enhance Insulin Sensitivity

Polycystic ovary syndrome (PCOS) is the most common endocrine condition in the reproductive period of women. In the last years, significant progress has been made in understanding the etiology and pathophysiological mechanisms of the disease. This multifactorial entity is associated with complex hormonal, infertility and metabolic aspects that require a proper medical approach and a therapeutic strategy. The increased concentration of androgens, ovulation disorders, and polycystic ovarian morphology belong to the classic picture of PCOS. Insulin resistance (IR) and related compensatory hyperinsulinemia in PCOS underlie inositol therapy, known as insulin second messengers. These molecules with insulin-mimetic properties enhance insulin sensitivity, leading to a reduction of glucose and insulin blood levels. Choosing Myo-inositol (MI) and D-chiro-inositol (DCI) as a therapeutic option involves understanding their physiological properties and mechanisms through which they improve insulin resistance. This article focuses on recent data from the literature that supports the effectiveness and safeness of inositol treatment in combating endocrine and metabolic disorders of this syndrome.

scholarly journals Associations of insulin resistance, sex hormone-binding globulin, triglyceride, and hormonal profiles in polycystic ovary syndrome: A cross-sectional study

2021 ◽  
Author(s):  
Bahia Namavar Jahromi ◽  
Niloofar Borzou ◽  
Mohammad Ebrahim Parsanezhad ◽  
Zahra Anvar ◽  
Parvin Ghaemmaghami ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Ovary Syndrome ◽  
Cross Sectional

Background: Insulin resistance (IR) occurs in 50–70% of women with polycystic ovary syndrome (PCOS) and can be applied as a prediabetic feature in PCOS. Objective: In this study, indirect methods including fasting blood sugar (FBS), fasting insulin (FI), FBS/FI ratio, and quantitative insulin sensitivity check index (QUICKI) were compared with the homeostasis model assessment of insulin resistance (HOMA-IR) as a standard technique. The association of IR to sex hormone-binding globulin (SHBG) and several hormones was also analyzed. Materials and Methods: This cross-sectional study was performed on 74 PCOS women. Sensitivity and specificity of each IR method was calculated based on HOMA-IR. Hormonal profiles of the patients were compared between the groups with defined normal and abnormal values of IR. Results: Triglyceride levels had a positive association with FBS and HOMA-IR (p = 0.002 and p = 0.01, respectively) with a negative association to QUICKI and SHBG (p = 0.02 and p = 0.02, respectively). SHBG showed a significant negative association with FBS (p = 0.001). Dehydroepiandrosterone sulfate showed a positive association with FI (p = 0.002). Seven PCOS women showed abnormal SHBG levels (< 36 nmol/L) while expressed normal values of the rest of the studied variables. FI and QUICKI had the highest sensitivity while FBS/FI and QUICKI had the highest specificity when HOMA-IR was applied as a standard test. Conclusion: SHBG and triglyceride had a significant negative and positive association with IR, respectively. HOMA-IR followed by FI and QUICKI is the most sensitive test for the detection of IR. SHBG levels can be a helpful biomarker for the diagnosis of PCOS. Key words: Polycystic ovary syndrome, Insulin resistance, Sex hormone-binding globulin.

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