Maternal Overweight vs. Polycystic Ovary Syndrome: Disentangling Their Impact on Insulin Action in Pregnancy—A Prospective Study

Background: To investigate insulin sensitivity and glucose metabolism in pregnant lean and overweight polycystic ovary syndrome (PCOS) patients vs. lean and overweight controls without PCOS. Methods: Prospective cohort study on 67 pregnant women (31 with PCOS and 36 controls, subdivided into overweight or obese and normal weight). All women underwent a 2h-OGTT including glucose, insulin, and C-peptide in early- and mid-gestation and were followed-up until delivery. Results: Insulin sensitivity and glucometabolic parameters were comparable between PCOS patients and controls, whereas marked differences were observed between overweight/obese and lean mothers. Impaired whole-body insulin sensitivity at early pregnancy is mainly a consequence of higher BMI (body mass index; p < 0.001) compared to PCOS (p = 0.216), whereby no interaction between overweight/obesity and PCOS was observed (p = 0.194). Moreover, overweight was significantly associated with gestational diabetes (p = 0.0003), whereas there were no differences between women with and without PCOS (p = 0.51). Birth weight was inversely related to whole-body insulin sensitivity (rho = −0.33, p = 0.014) and positively associated with higher pregestational BMI (rho = 0.33, p = 0.012), whereas there was no association with PCOS. Conclusions: Impaired insulin action was mainly a consequence of overweight rather than PCOS. Our data suggest that overweight is more relevant than PCOS for the effects on insulin sensitivity and impaired glucose metabolism.

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Mechanisms underlying absent training-induced improvement in insulin action in lean, hyperandrogenic women with polycystic ovary syndrome (PCOS)

10.2337/figshare.12860540 ◽

2020 ◽

Author(s):

Ada Admin ◽

Solvejg L. Hansen ◽

Kirstine N. Bojsen-Møller ◽

Anne-Marie Lundsgaard ◽

Frederikke L. Hendrich ◽

...

Keyword(s):

Skeletal Muscle ◽

Blood Flow ◽

Exercise Training ◽

Polycystic Ovary Syndrome ◽

Glucose Uptake ◽

Insulin Action ◽

Polycystic Ovary ◽

Whole Body ◽

Ovary Syndrome ◽

Leg Blood Flow

Women with polycystic ovary syndrome (PCOS) have been shown to be less insulin sensitive compared with control women, independent of BMI. Training is associated with molecular adaptations in skeletal muscle improving glucose uptake and metabolism in both healthy and type 2 diabetic individuals. In the present study, lean, hyperandrogenic women with PCOS (n=9) and healthy controls (CON, n=9) completed 14 weeks of controlled and supervised exercise training. In CON, the training intervention increased whole body insulin action by 26% and insulin-stimulated leg glucose uptake by 53%, together with increased insulin-stimulated leg blood flow and a more oxidative muscle fiber type distribution. In PCOS, no such changes were found, despite similar training intensity and improvements in maximal oxygen uptake. In skeletal muscle of CON, but not PCOS, training increased GLUT4 and HKII mRNA and protein expressions. These data suggest that the impaired increase in whole body insulin action in women with PCOS with training is caused by an impaired ability to upregulate key glucose handling proteins for insulin-stimulated glucose uptake in skeletal muscle, and insulin-stimulated leg blood flow. Still, other important benefits of exercise training appeared in women with PCOS, including an improvement of the hyperandrogenic state.

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The Altered Mononuclear Cell-Derived Cytokine Response to Glucose Ingestion Is Not Regulated by Excess Adiposity in Polycystic Ovary Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-2046 ◽

2014 ◽

Vol 99 (11) ◽

pp. E2244-E2251 ◽

Cited By ~ 16

Author(s):

Frank González ◽

Chang Ling Sia ◽

Marguerite K. Shepard ◽

Neal S. Rote ◽

Judi Minium

Keyword(s):

Body Composition ◽

Adipose Tissue ◽

Insulin Sensitivity ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Normal Weight ◽

Cytokine Release ◽

Ovary Syndrome ◽

Excess Adiposity ◽

Glucose Ingestion

Context: Excess adipose tissue is a source of inflammation. Polycystic ovary syndrome (PCOS) is a proinflammatory state and is often associated with excess abdominal adiposity (AA) alone and/or frank obesity. Objective: To determine the effect of glucose ingestion on cytokine release from mononuclear cells (MNC) in women with PCOS with and without excess AA and/or obesity. Design: A cross-sectional study. Setting: Academic medical center. Patients: Twenty-three women with PCOS (seven normal weight with normal AA, eight normal weight with excess AA, eight obese) and 24 ovulatory controls (eight normal weight with normal AA, eight normal weight with excess AA, eight obese). Intervention: Three-hour 75-g oral glucose tolerance test (OGTT). Main Outcome Measures: Body composition was measured by dual energy x-ray absorptiometry. Insulin sensitivity was derived from the OGTT (ISOGTT). TNFα, IL-6, and IL-1β release was measured in supernatants of cultured MNC isolated from blood samples drawn while fasting and 2 hours after glucose ingestion. Results: Insulin sensitivity was lower in obese subjects regardless of PCOS status and in normal-weight women with PCOS compared with normal-weight controls regardless of body composition status. In response to glucose ingestion, MNC-derived TNFα, IL-6, and IL-1β release decreased in both normal-weight control groups but failed to suppress in either normal-weight PCOS group and in obese women regardless of PCOS status. For the combined groups, the cytokine responses were negatively correlated with insulin sensitivity and positively correlated with abdominal fat and androgens. Conclusions: Women with PCOS fail to suppress MNC-derived cytokine release in response to glucose ingestion, and this response is independent of excess adiposity. Nevertheless, a similar response is also a feature of obesity per se. Circulating MNC and excess adipose tissue are separate and distinct sources of inflammation in this population.

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The association of serum miR-27a and miR-320 level with glucose metabolism and insulin sensitivity in young women with polycystic ovary syndrome

Endocrine Abstracts ◽

10.1530/endoabs.70.aep831 ◽

2020 ◽

Author(s):

Anna Krentowska ◽

Donata Ponikwicka-Tyszko ◽

Agnieszka Lebkowska ◽

Agnieszka Adamska ◽

Gabriela Sokolowska ◽

...

Keyword(s):

Insulin Sensitivity ◽

Glucose Metabolism ◽

Polycystic Ovary Syndrome ◽

Young Women ◽

Polycystic Ovary ◽

Ovary Syndrome

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Accelerated subcutaneous abdominal stem cell adipogenesis predicts insulin sensitivity in normal-weight women with polycystic ovary syndrome

Fertility and Sterility ◽

10.1016/j.fertnstert.2020.10.003 ◽

2020 ◽

Author(s):

Daniel A. Dumesic ◽

Ayli Tulberg ◽

Karen L. Leung ◽

Samantha C. Fisch ◽

Tristan R. Grogan ◽

...

Keyword(s):

Stem Cell ◽

Insulin Sensitivity ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Normal Weight ◽

Ovary Syndrome

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Effect of Whey Protein on Insulin Sensitivity and Glucose Metabolism in Women with and Without Polycystic Ovary Syndrome (PCOS)

Current Developments in Nutrition ◽

10.1093/cdn/nzaa049_053 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 660-660

Author(s):

Lily Sebastian ◽

Shenavia Balcom-Luker ◽

Kayleigh Kaiser ◽

Irene Low ◽

Emily Zumbro ◽

...

Keyword(s):

Gene Expression ◽

Insulin Sensitivity ◽

Glucose Metabolism ◽

Polycystic Ovary Syndrome ◽

Whey Protein ◽

Fasting Glucose ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Glucose Levels ◽

Before And After

Abstract Objectives This study focuses on the metabolic effects of whey protein isolate (WPI) supplementation glucose and insulin metabolism in women with and without Polycystic Ovary Syndrome (PCOS). Affecting up to 20% of post-puberty aged females around the world, PCOS is identified by three main symptoms: increased levels of androgens, irregular cycles, and the presence of ovarian cysts. Women with PCOS tend to be insulin resistant and have faulty insulin signaling. We hypothesize that because WPI has been seen to increase insulin sensitivity in type 2 diabetic populations, it will attenuate blood glucose and insulin levels and in women with PCOS. Methods 15 women with PCOS and 14 women without PCOS (CON) underwent four 150-min oral glucose tolerance tests (OGTT): (i) baseline (no protein), (ii) Day 20 (iii) and Day 40 of WPI preload. Daily, participants consumed 35 g WPI 30 min before glucose load on test days. Plasma levels of glucose and insulin were assessed using a Biolis 24i chemistry analyzer. Additionally, variations in gene expression levels of glucose metabolism regulators, e.g., GLUT-4, were analyzed in 3T3-L1 cells under normal and PCOS-simulated conditions using qt-PCR before and after WPI supplementation. Results At baseline, both PCOS and CON women had similar fasting glucose levels (107.2 ± 19.54 and 101.14 ± 11.03 respectively). After 20 days of WPI supplementation, fasting glucose increased (103.75 ± 0.5 and 117.25 ± 9.60) but was attenuated by Day 40 (91.5 ± 0.71 and 94.5 ± 0.71). Furthermore, the baseline levels of GLUT-4 expression between women with PCOS (2.698 ± 0.145) and CON (2.188, ± 0.062) were not statistically different. Levels of gene expression post-supplementation with WPI are in the process of being measured. And lastly, plasma insulin levels are in the progress of being measured for both populations before and after supplementation. Conclusions Preliminary analysis indicates that upon WPI supplementation, both groups glucose levels increased after 20 days, but was then attenuated by Day 40, with a slightly greater effect in the PCOS group compared to CON. Overall, our data indicates that WPI may be a potential dietary approach to better managing the symptoms of PCOS. Funding Sources Glanbia Nutritionals, Human Nutrition Research Funds, and Texas Woman's University.

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