SUN-020 Waist Circumference Is Associated with Insulin Resistance in Young Korean Women with Polycystic Ovary Syndrome

Abstract Polycystic ovary syndrome (PCOS) is a heterogeneous disorder and associated with metabolic disturbances such as insulin resistance (IR) and obesity which are risk factors for cardiovascular diseases. Many studies have shown that waist circumference (WC) representing abdominal obesity is an important risk factor for IR. However, there were few studies whether WC were associated with IR in young women with PCOS. We aimed to evaluate the role of WC in IR among young Korean women with PCOS. We enrolled age- and body mass index-matched women with PCOS (n = 100) and controls (n = 100). WC was measured and the 75-gram oral glucose tolerance test (OGTT) was performed. Insulin sensitivity was assessed by the Stumvoll index which was calculated from an OGTT. Multiple linear regression analysis was performed to evaluate the association between WC and IR. WC, fasting glucose, post-load 2-hour glucose, fasting insulin, and post-load 2-hour insulin did not differ between women with PCOS and controls. Women with PCOS had lower values of the Stumvoll index than the controls. In correlation analysis, WC was negatively correlated with the Stumvoll index in women with PCOS, however not in controls. In multiple regression analysis, WC was negatively associated with the Stumvoll index even after adjustment for age, total cholesterol, and total testosterone in women with PCOS. In young Korean women with PCOS, WC was negatively associated with insulin sensitivity independent of hyperandrogenemia. Simply measuring of WC could be used to screen the high risk group having IR in young women with PCOS.

Download Full-text

Study of carbohydrate metabolism indices and adipocytokine profile and their relationship with androgens in polycystic ovary syndrome after menopause

Acta Endocrinologica ◽

10.1530/eje-12-0550 ◽

2013 ◽

Vol 168 (1) ◽

pp. 83-90 ◽

Cited By ~ 8

Author(s):

Marios C Markopoulos ◽

George Valsamakis ◽

Evangelia Kouskouni ◽

Anastassios Boutsiadis ◽

Ioannis Papassotiriou ◽

...

Keyword(s):

Insulin Resistance ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Waist Circumference ◽

Polycystic Ovary Syndrome ◽

Carbohydrate Metabolism ◽

Polycystic Ovary ◽

Sensitivity Index ◽

Ovary Syndrome ◽

Hs Crp

ObjectiveHyperandrogenism, insulin resistance, and altered adipocytokine levels characterize polycystic ovary syndrome (PCOS) women of reproductive age. Hyperandrogenism persists in postmenopausal PCOS women. In the latter, this study aimed at investigating carbohydrate metabolism, adipocytokines, androgens, and their relationships.Subjects and methodsBlood sampling from overweight postmenopausal women (25 PCOS and 24 age- and BMI-matched controls) at baseline and during oral glucose tolerance test for measurement of insulin and glucose levels, baseline leptin, adiponectin, visfatin, retinol-binding protein 4, lipocalin-2, androgen, and high-sensitivity C-reactive protein (hs-CRP) levels and for calculation of insulin sensitivity (glucose-to-insulin ratio (G/I), quantitative insulin sensitivity check index, and insulin sensitivity index (ISI)), resistance (homeostasis mathematical model assessment-insulin resistance (HOMA-IR)), secretion (Δ of the area under the curve of insulin (ΔAUCI), first-phase insulin secretion (1st PHIS), and second-phase insulin secretion (2nd PHIS)), and free androgen indices (FAI).ResultsPCOS women had higher insulin secretion indices, hs-CRP, androgen, and FAI levels than controls without differing in baseline glucose, insulin and adipocytokines levels, insulin sensitivity, and resistance indices. In PCOS women, FAI levels correlated positively with baseline insulin, ΔAUCI, HOMA-IR, and ΔAUCG and negatively with G/I; hs-CRP levels correlated positively with ΔAUCI and negatively with ISI. PCOS status, waist circumference, and 17-hydroxyprogesterone (17-OHP) levels were positive predictors for ΔAUCI. In all women, waist circumference was a negative predictor for ISI; 17-OHP and FAI levels were positive predictors respectively for baseline insulin levels and for 1st PHIS and 2nd PHIS.ConclusionsEarly postmenopausal PCOS women are characterized by hyperinsulinemia but attenuated insulin resistance. PCOS status and waist circumference are predictors of hyperinsulinemia while insulin sensitivity correlates negatively with FAI. The differences reported in adipocytokine levels between PCOS and non-PCOS women in reproductive years seem to disappear after menopause.

Download Full-text

Hyperandrogenism and Insulin Resistance, Not Changes in Body Weight, Mediate the Development of Endothelial Dysfunction in a Female Rat Model of Polycystic Ovary Syndrome (PCOS)

Endocrinology ◽

10.1210/en.2015-1159 ◽

2015 ◽

Vol 156 (11) ◽

pp. 4071-4080 ◽

Cited By ~ 17

Author(s):

Amanda Hurliman ◽

Jennifer Keller Brown ◽

Nicole Maille ◽

Maurizio Mandala ◽

Peter Casson ◽

...

Keyword(s):

Insulin Resistance ◽

Body Weight ◽

Weight Gain ◽

Insulin Sensitivity ◽

Endothelial Dysfunction ◽

Polycystic Ovary Syndrome ◽

Rat Model ◽

Polycystic Ovary ◽

Phase 1 ◽

Ovary Syndrome

This study was designed to differentiate the contributions of hyperandrogenism, insulin resistance (IR), and body weight to the development of endothelial dysfunction in polycystic ovary syndrome and determine the effectiveness of insulin sensitization and antiandrogenic therapy after the establishment of vascular and metabolic dysfunction using a rat model of polycystic ovary syndrome. We hypothesized that the observed endothelial dysfunction was a direct steroidal effect, as opposed to changes in insulin sensitivity or body weight. Prepubertal female rats were randomized to the implantation of a pellet containing DHT or sham procedure. In phase 1, DHT-exposed animals were randomized to pair feeding to prevent weight gain or metformin, an insulin-sensitizing agent, from 5 to 14 weeks. In phase 2, DHT-exposed animals were randomized to treatment with metformin or flutamide, a nonsteroidal androgen receptor blocker from 12 to 16 weeks. Endothelial function was assessed by the vasodilatory response of preconstricted arteries to acetylcholine. Serum steroid levels were analyzed in phase 1 animals. Fasting blood glucose and plasma insulin were analyzed and homeostasis model assessment index calculated in all animals. Our data confirm the presence of endothelial dysfunction as well as increased body weight, hypertension, hyperinsulinemia, and greater IR among DHT-treated animals. Even when normal weight was maintained through pair feeding, endothelial dysfunction, hyperinsulinemia, and IR still developed. Furthermore, despite weight gain, treatment with metformin and flutamide improved insulin sensitivity and blood pressure and restored normal endothelial function. Therefore, the observed endothelial dysfunction is most likely a direct result of hyperandrogenism-induced reductions in insulin sensitivity, as opposed to weight gain.

Download Full-text

Insulin resistance in relation to clinical, endocrine and metabolic profile of infertile women with polycystic ovary syndrome

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v14i1.50989 ◽

2021 ◽

Vol 14 (1) ◽

pp. 1-6

Author(s):

Shakeela Ishrat ◽

Marufa Hossain ◽

Subrata Kumar Biswas

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Waist Circumference ◽

Polycystic Ovary Syndrome ◽

Body Mass ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Infertile Women ◽

Significant Difference

The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to the clinical, endocrine and metabolic factors in the infertile women with polycystic ovary syndrome. This study was conducted on 121 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit from January 2017 to December 2017. They were divided into two groups: insulin resistant and insulin sensitive. There was significant difference in body mass index and waist circumference between the two groups. Serum lipids were not associated with insulin resistance. Hyperinsulinemia was significantly associated with metabolic syndrome. Reducing body mass index and waist circumference may improve insulin resistance in infertile women with polycystic ovary syndrome. Screening the infertile women with polycystic ovary syndrome for hyperinsulinemia and insulin resistance and subsequent counseling is recommended to address the long-term risks of metabolic syndrome.

Download Full-text

Obesity in relation to clinical, endocrine and metabolic parameters in infertile women with polycystic ovary syndrome: the South Asian perspective

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v20i4.54146 ◽

2021 ◽

Vol 20 (4) ◽

pp. 864-870

Author(s):

Shakeela Ishrat ◽

Marufa Hossain

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Polycystic Ovary Syndrome ◽

South Asian ◽

Polycystic Ovary ◽

Metabolic Parameters ◽

The South ◽

Ovary Syndrome ◽

Infertile Women

Background: Polycystic ovary syndrome (PCOS) affects 5-10% of reproductive age women and it is a common cause of infertility in young women. Most of the infertile women with PCOS are overweight or obese. Obesity or excess fat aggravates the endocrine and metabolic dysfunction in women with PCOS. Weight management is the first line measure advised to infertile PCOS women who are overweight or obese. The objective of the study was to explore the association of obesity with the clinical, endocrine and metabolic parameters in infertile women with polycystic ovary syndrome in Bangladesh. Methodology: This was a cross sectional study of 126 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit of the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University from January 2017 to December 2017.Obesity groups were defined by BMI thresholds specific for the South Asian population. Results: The mean body mass index (BMI) was 26.58±3.18 kg/m2and mean waist circumference was 91.07±9.5 cm. There was highly significant association of obesity with waist circumference and fasting insulin. BMI at or above 25kg/m2 was significantly associated with acanthosis nigricans, hyperandrogenemia and hyperinsulinemia, whereas BMI at or more than 23kg/m2 was significantly associated, in addition, with insulin resistance and metabolic syndrome. Conclusion: Obesity is associated with hyperandrogenemia, hyperinsulinemia, insulin resistance and metabolic syndrome in infertile women with polycystic ovary syndrome. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.864-870

Download Full-text