Ghrelin levels are suppressed and show a blunted response to oral glucose in women with polycystic ovary syndrome.

ObjectiveAbnormal ghrelin regulation may influence the development of obesity-associated conditions including polycystic ovary syndrome (PCOS). Our aim was to compare ghrelin regulation between PCOS cases and controls.DesignWe compared serum ghrelin (total) levels, fasting and 30-min post-oral (75 g) glucose load, between 50 PCOS cases and 28 female controls, including 22 body mass index (BMI)/fat mass-matched pairs. All subjects were of UK British/Irish origin.MethodsMeasurements included serum ghrelin (RIA technique (LINCO Research, St Charles MO, USA)), fat mass, serum testosterone, fasting serum insulin and plasma glucose levels. Insulin sensitivity was calculated as the homeostasis model assessment of insulin resistance (HOMA2 IR).ResultsFasting serum ghrelin levels were significantly lower in PCOS cases versus BMI/fat mass-matched controls (geometric mean (s.d. range), 1104 pg/ml (764–1595) vs 1756 pg/ml (1314–2347) respectively; P=2.3×10−4). Ghrelin suppression following oral glucose load was significantly blunted in PCOS cases versus BMI/fat mass-matched controls (geometric mean ghrelin suppression (s.d. range), 160 pg/ml (88–289) vs 424 pg/ml (220–818) respectively; P=2.0×10−4). Whole-group comparisons (50 PCOS cases versus 28 controls) adjusted for fat mass and age revealed similar results. In PCOS cases, there was a significant negative correlation between fasting serum ghrelin and HOMA2 IR (r2=−0.40, P=5.7×10−3). Following adjustment for HOMA2 IR, fat mass and age, comparisons between the whole groups of PCOS cases and controls revealed attenuated but significant differences in fasting serum ghrelin (P=1.3×10−3) and ghrelin suppression (P=1.8×10−3).ConclusionsIn women with PCOS, serum ghrelin levels are suppressed, showing a negative relationship with HOMA2 IR and a blunted response to oral glucose.

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Inositol administration reduces oxidative stress in erythrocytes of patients with polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje-11-0840 ◽

2012 ◽

Vol 166 (4) ◽

pp. 703-710 ◽

Cited By ~ 40

Author(s):

Gabriella Donà ◽

Chiara Sabbadin ◽

Cristina Fiore ◽

Marcantonio Bragadin ◽

Francesco L Giorgino ◽

...

Keyword(s):

Oxidative Stress ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Serum Insulin ◽

Band 3 ◽

Oral Glucose ◽

Fasting Serum ◽

Ovary Syndrome ◽

Inflammatory Status ◽

Before And After

ObjectivePossibly due to a deficiency of insulin mediators, polycystic ovary syndrome (PCOS) is often associated with insulin resistance (IR) and hyperinsulinemia, likely responsible for an elevated production of reactive oxygen species. We investigated oxidative-related alterations in erythrocytes and anti-inflammatory effects of inositol in women with PCOS before and after treatment with myo-inositol (MYO).MethodsTwenty-six normal-weight PCOS patients were investigated before and after MYO administration (1200 mg/day for 12 weeks;n=18) or placebo (n=8) by evaluating serum testosterone, serum androstenedione, fasting serum insulin, fasting serum glucose, insulin area under the curve (AUC), and glucose AUC after oral glucose tolerance test and homeostasis model of assessment–IR. In erythrocytes, band 3 tyrosine phosphorylation (Tyr-P) level, glutathione (GSH) content, and glutathionylated proteins (GSSP) were also assessed.ResultsData show that PCOS patients' erythrocytes underwent oxidative stress as indicated by band 3 Tyr-P values, reduced cytosolic GSH content, and increased membrane protein glutathionylation. MYO treatment significantly improved metabolic and biochemical parameters. Significant reductions were found in IR and serum values of androstenedione and testosterone. A significant association between band 3 Tyr-P levels and insulin AUC was found at baseline but disappeared after MYO treatment, while a correlation between band 3 Tyr-P and testosterone levels was detected both before and after MYO treatment.ConclusionsPCOS patients suffer from a systemic inflammatory status that induces erythrocyte membrane alterations. Treatment with MYO is effective in reducing hormonal, metabolic, and oxidative abnormalities in PCOS patients by improving IR.

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

Journal of the Endocrine Society ◽

10.1210/jendso/bvab008 ◽

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 (> 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 < .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3 P < .001 vs 5.7 ± 0.4%, P < .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%, P = .032); low HDL-C < 40 mg/dL (HW 82%, NHW 61%, NHB 50%, P < .001) and prediabetes HbA1c 5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%, P < .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.

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Predictors of abnormal glucose metabolism in women with polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje.1.02095 ◽

2006 ◽

Vol 154 (2) ◽

pp. 295-301 ◽

Cited By ~ 17

Author(s):

Matthias Möhlig ◽

Joachim Spranger ◽

Michael Ristow ◽

Andreas F H Pfeiffer ◽

Thilo Schill ◽

...

Keyword(s):

Glucose Metabolism ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Receiver Operating Curve ◽

Oral Glucose ◽

Model Assessment ◽

Fasting Insulin ◽

Ovary Syndrome ◽

Easy Method ◽

Abnormal Glucose Metabolism

Objective: Polycystic ovary syndrome (PCOS) is a risk factor for type 2 diabetes mellitus and screening for abnormal glucose metabolism has been recommended by an oral glucose tolerance test (OGTT). This procedure is time-consuming and inconvenient, limiting its general use. Therefore, an easy method is wanted to separate PCOS women with normal from those with potentially abnormal glucose metabolism. Design: Simple parameters obtained from 101 consecutive PCOS patients were assessed by receiver operating curve analysis for their ability to predict abnormal glucose metabolism. Results: Comparing discriminating parameters at defined sensitivities revealed that, assessed by homeostasis model assessment (HOMA), insulin resistance (HOMA%S) had the highest specificitiy. At a cut-off point of 73.1%, HOMA%S had a sensitivity of 95.5% and a specificity of 51.9%. Applying this cut-off separated 59 women who had a high probability of abnormal glucose metabolism from 42 women who were at low risk (less than 2.5%). Fasting insulin was the second-best parameter and had a similar specificity. A screening strategy which applies HOMA%S or fasting insulin could almost halve the number of OGTTs by directing them to those PCOS women most likely to be suffering from abnormal glucose metabolism. The negative predictive value of this strategy was 97%. The strategy was tested and confirmed in a second and independent cohort of 264 PCOS women. Conclusions: HOMA%S, or to a lesser extent fasting insulin, appears to allow for stratified metabolic screening of PCOS women with OGTT.

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Bone Mineral Density is Unaltered in Women with Polycystic Ovary Syndrome

Hormone and Metabolic Research ◽

10.1055/a-0733-7768 ◽

2018 ◽

Vol 50 (10) ◽

pp. 754-760 ◽

Cited By ~ 2

Author(s):

Mohd Ganie ◽

Semanti Chakraborty ◽

Ashish Sehgal ◽

M. Sreejith ◽

Devasenathipathy Kandasamy ◽

...

Keyword(s):

Bone Mineral Density ◽

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Bone Mineral ◽

Young Women ◽

Polycystic Ovary ◽

Oral Glucose ◽

Model Assessment ◽

Mineral Density ◽

Ovary Syndrome

Abstract Context The effects of endocrine aberrations associated with polycystic ovary syndrome (PCOS) on bone mineral density (BMD) in young women is a matter of debate. Objectives To compare BMD in young women with PCOS to age and body mass index (BMI) matched controls and to elucidate its correlation to BMI, insulin resistance and serum testosterone. Design and Methods We recruited 60 women with PCOS aged 14-24 years, diagnosed based on Rotterdam 2003 criteria, and 58 age matched controls. BMD was measured by dual energy X-ray absorptiometry. In addition, these subjects underwent biochemical and hormonal analysis including oral glucose tolerance test, calculation of Homeostatic Model Assessment–Insulin Resistance Index, measurement of serum thyroxine, thyrotropin, prolactin, total testosterone, dehydroepiandrosterone sulfate, follicular phase luteinizing hormone and follicle stimulating hormone. Results There was no difference of BMD between women with PCOS and control women (1.103±0.08 vs 1.126±0.083 g/cm2; p=0.122). In subgroup analysis based on BMI, BMD in obese women with PCOS was significantly higher than their overweight and lean counterparts at lumbar spine (p<0.001), neck of femur (p=0.005) and total hip (p<0.001). BMD was not different at any site between oligomenorrheic and non-oligomenorrheic women with PCOS. It positively correlated with BMI, waist and hip circumference in women with PCOS. No correlation was found with HOMA-IR or Testosterone. Conclusions BMI is the most important determinant of BMD in women with PCOS. BMD is not different between healthy young women and those with PCOS.

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STUDY OF GLYCATED HEMOGLOBIN LEVELS IN POLYCYSTIC OVARY SYNDROME

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i5.22729 ◽

2018 ◽

Vol 11 (5) ◽

pp. 191 ◽

Cited By ~ 1

Author(s):

Renuka Pangaluri ◽

Shakthiya T ◽

Vinodhini Vm

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Glycated Hemoglobin ◽

Polycystic Ovary ◽

Resistance Index ◽

Tolerance Test ◽

Oral Glucose ◽

Model Assessment ◽

Ovary Syndrome ◽

Hba1c Levels

Objective: Polycystic ovarian syndrome (PCOS) is often accompanied by insulin resistance, obesity, and cardiometabolic risk factors. Androgen excess-PCOS recommends oral glucose tolerance test or glycated hemoglobin (HbA1C) to evaluate dysglycemia in PCOS subjects. We undertook this study to evaluate the prevalence of elevated HbA1C levels in PCOS women.Methods: The study was carried out among 100 PCOS patients from SRM Hospital, 100 healthy individuals were included as controls. Fasting glucose, HbA1C, Insulin and Homeostasis Model Assessment-Insulin Resistance Index were estimated.Results: Patients with polycystic ovary syndrome showed a significant increase in HbA1C levels (5.799±1.022; 4.96±0.625, p=0.001) when compared to the control group.Conclusion: We found elevated HbA1C levels in PCOS women categorizing 26% as prediabetes and 28% as having type 2 diabetes mellitus.

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Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje-09-0432 ◽

2009 ◽

Vol 161 (4) ◽

pp. 575-582 ◽

Cited By ~ 138

Author(s):

E Wehr ◽

S Pilz ◽

N Schweighofer ◽

A Giuliani ◽

D Kopera ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Oral Glucose ◽

Model Assessment ◽

Metabolic Disturbances ◽

Ovary Syndrome ◽

Glucose Response ◽

The Metabolic Syndrome

ObjectivesWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances, in particular from insulin resistance. Accumulating evidence suggests that vitamin D deficiency may contribute to the development of the metabolic syndrome (MS). Hence, the aim of our study was to investigate the association of 25(OH)D levels and the components of the MS in PCOS women.Methods25(OH)D levels were measured by means of ELISA in 206 women affected by PCOS. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.ResultsThe prevalence of insufficient 25(OH)D levels (<30 ng/ml) was 72.8% in women with PCOS. PCOS women with the MS had lower 25(OH)D levels than PCOS women without these features (17.3 vs 25.8 ng/ml respectively; P<0.05). In multivariate regression analysis including 25(OH)D, season, body mass index (BMI), and age, 25(OH)D and BMI were independent predictors of homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI; P<0.05 for all). In binary logistic regression analyses, 25(OH)D (OR 0.86, P=0.019) and BMI (OR 1.28, P<0.001) were independent predictors of the MS in PCOS women. We found significantly negative correlations of 25(OH)D levels with BMI, waist circumference, waist-to-hip ratio, systolic and diastolic blood pressure, fasting and stimulated glucose, area under the glucose response curve, fasting insulin, HOMA-IR, HOMA-β, triglycerides, and quotient total cholesterol/high-density lipoprotein (HDL) and positive correlations of 25(OH)D levels with QUICKI and HDL (P<0.05 for all).ConclusionWe demonstrate that low 25(OH)D levels are associated with features of the MS in PCOS women. Large intervention trials are warranted to evaluate the effect of vitamin D supplementation on metabolic disturbances in PCOS women.

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Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje-11-0134 ◽

2011 ◽

Vol 164 (5) ◽

pp. 741-749 ◽

Cited By ~ 92

Author(s):

Elisabeth Wehr ◽

Olivia Trummer ◽

Albrecht Giuliani ◽

Hans-Jürgen Gruber ◽

Thomas R Pieber ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Insulin Sensitivity ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Oral Glucose ◽

Model Assessment ◽

Ovary Syndrome ◽

Vitamin D Metabolism ◽

Endocrine Parameters

IntroductionWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances including insulin resistance (IR), which might be related to vitamin D metabolism. We aimed to investigate the association of polymorphisms in the vitamin D receptor (VDR) gene as well as vitamin D level-associated genes with metabolic and endocrine parameters in PCOS women. Moreover, we examined whether there are associations with PCOS susceptibility.MethodsMetabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed in 545 PCOS and 145 control women. Genotyping of VDR (Cdx2, Bsm-I, Fok-I, Apa-I, and Taq-I), GC, DHCR7, and CYP2R1 polymorphisms was performed.Results25-Hydroxyvitamin D (25(OH)D) levels showed significant negative correlation with IR and positive correlation with insulin sensitivity (P<0.05 for all) in PCOS women. In PCOS women, the VDR Cdx2 ‘AA’ genotype was associated with lower fasting insulin (P=0.039) and homeostatic model assessment-IR (P=0.041) and higher quantitative insulin-sensitivity check index (P=0.012) and MATSUDA index (P=0.003). The VDR Apa-I ‘AA’ genotype was associated with lower testosterone (P=0.028) levels. In PCOS women, 170 women (31.2%) presented with 25(OH)D levels <20 ng/ml. PCOS women carrying the GC ‘GG’ genotype and the DHCR7 ‘GG’ genotype had a significantly higher risk for 25(OH)D levels <20 ng/ml (OR 2.53 (1.27–5.06), P=0.009, and OR 2.66 (1.08–6.55), P=0.033 respectively) compared with PCOS women carrying the GC ‘TT’ genotype and DHCR ‘TT’ genotype in multivariate analyses. We observed no association of genetic variations and PCOS susceptibility.ConclusionVDR and vitamin D level-related variants are associated with metabolic and endocrine parameters including 25(OH)D levels in PCOS women.

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Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

Acta Endocrinologica ◽

10.1530/eje.1.02207 ◽

2006 ◽

Vol 155 (2) ◽

pp. 337-345 ◽

Cited By ~ 71

Author(s):

Dorte Glintborg ◽

Marianne Andersen ◽

Claus Hagen ◽

Jan Frystyk ◽

Veronica Hulstrøm ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Composition ◽

Polycystic Ovary Syndrome ◽

Fat Mass ◽

Polycystic Ovary ◽

Geometric Mean ◽

Whole Body ◽

Ovary Syndrome ◽

The Metabolic Syndrome ◽

Increased Risk

Objective: Polycystic ovary syndrome (PCOS) patients are abdominally obese and are at increased risk of developing the metabolic syndrome. Low adiponectin and ghrelin levels in PCOS patients could be caused by insulin resistance as well as high testosterone levels. Design: Adiponectin and ghrelin levels were evaluated in 51 hirsute PCOS patients referred to the outpatient clinic of an academic, tertiary care medical centre and in 63 weight-matched female controls. Relationships between adiponectin, ghrelin, leptin, body composition, testosterone and insulin were examined. Methods: Measurements of body composition including waist-hip-ratio (WHR), body mass index (BMI) and whole body dual-energy X-ray absorptiometry scan measures of body fat mass. Measurements of fasting levels of adiponectin, ghrelin, leptin, androgen status, oestradiol, lipid variables and insulin during follicular phase. Results: Adiponectin levels were significantly decreased in obese PCOS patients compared with weight-matched controls (geometric mean (−2 to 2 s.d.) 5.3 (2.5–11.1) vs 7.3 (3.0–17.4) mg/l, P<0.05). Mean ghrelin was significantly lower in hirsute PCOS patients than in controls (0.6 (0.3 to 1.4) vs 0.8 (0.4 to 1.7) μg/l, P<0.001) and this remained significant after subdividing subjects according to waist circumference and BMI. During multiple regression analysis, testosterone correlated positively with adiponectin and negatively with ghrelin independent of BMI, WHR and total fat mass. Conclusion: Obese hirsute PCOS patients demonstrated significantly lower adiponectin levels than weight-matched controls suggesting a very high risk for the metabolic syndrome. Furthermore, ghrelin levels were decreased in hirsute PCOS patients and showed a significant, negative correlation with testosterone independent of body composition.

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Osteocalcin Levels on Oral Glucose Load in Women being Investigated for Polycystic Ovary Syndrome

Endocrine Practice ◽

10.4158/ep13110.or ◽

2014 ◽

Vol 20 (1) ◽

pp. 5-14 ◽

Cited By ~ 12

Author(s):

Verena Schwetz ◽

Elisabeth Lerchbaum ◽

Natascha Schweighofer ◽

Nicole Hacker ◽

Olivia Trummer ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Oral Glucose ◽

Oral Glucose Load ◽

Glucose Load ◽

Ovary Syndrome

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High prevalence of polycystic ovary syndrome characteristics in girls with euthyroid chronic lymphocytic thyroiditis: a case–control study

Acta Endocrinologica ◽

10.1530/eje-09-1012 ◽

2010 ◽

Vol 162 (6) ◽

pp. 1117-1122 ◽

Cited By ~ 28

Author(s):

Mohd Ashraf Ganie ◽

Raman Kumar Marwaha ◽

Rashmi Aggarwal ◽

Satveer Singh

Keyword(s):

Polycystic Ovary Syndrome ◽

Case Control Study ◽

Polycystic Ovary ◽

Case Control ◽

Oral Glucose ◽

Model Assessment ◽

Chronic Lymphocytic Thyroiditis ◽

Ovary Syndrome ◽

Lymphocytic Thyroiditis ◽

Control Study

ObjectiveThe aim was to find the prevalence of polycystic ovary syndrome (PCOS) phenotype in adolescent euthyroid girls with chronic lymphocytic thyroiditis (CLT).DesignThis was a prospective case–control study as part of an ongoing community-wide thyroid survey in Indian schools.MethodsOne hundred and seventy-five girls with euthyroid CLT and 46 age-matched non-CLT girls underwent clinical, biochemical, hormonal, and ultrasonographic evaluation for diagnosis of PCOS by Rotterdam 2003 criteria. All subjects underwent serum sampling for LH, FSH, testosterone, DHEAS, free thyroxine, TSH, and anti-thyroid peroxidase (TPO) antibodies. Oral glucose tolerance test (OGTT) was undertaken for plasma glucose and insulin.ResultsSignificantly higher prevalence of PCOS was noted in girls with euthyroid CLT when compared to their control counterparts (46.8 vs 4.3%, P=0.001). The CLT girls had higher body mass index, waist circumference, and systolic blood pressure (P=0.001). Mean number of menstrual cycles/year was 8.4±3.5 vs 10.1±1.4, and mean Ferriman–Gallwey score was 11.9±3.5 vs 3.0±2.4 (P=0.001) in cases versus controls respectively. The fasting and postprandial glucose and serum cholesterol were also higher in the cases (P=0.001). Homeostasis model assessment-insulin resistance was 4.4±4.2 vs 2.3±2.7 in the cases versus controls (P=0.001).ConclusionHigher prevalence of PCOS characteristics in euthyroid CLT girls when compared to controls suggest possible role of autoimmune phenomenon in the etiopathogenesis of PCOS. Further studies are required to understand the pathogenic link between these two disorders.

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