scholarly journals Changes in Metabolic Profile in the Women with a History of PCOS—A Long-Term Follow-Up Study

2020 ◽  
Vol 9 (10) ◽  
pp. 3367
Author(s):  
Małgorzata Jacewicz-Święcka ◽  
Irina Kowalska
Keyword(s):  
Cell Function ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Normal Weight ◽  
High Rate ◽  
Sex Hormone Binding Globulin ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Free Androgen Index

Data concerning metabolic consequences in women with polycystic ovary syndrome (PCOS) are delivered mainly by cross-sectional studies. In this research, we re-examined 31 Caucasian PCOS women after a median period of 120.9 months to evaluate the changes in metabolic syndrome components. Clinical examination, oral glucose tolerance test with estimations of glucose and insulin, lipids, sex hormone-binding globulin (SHBG) and sex hormones assessments were performed on two occasions. Additionally, the euglycaemic hyperinsulinaemic clamp technique was used at the baseline to assess insulin sensitivity (M-clamp value). In the end, the median age of participants was 35. We observed an increase in glucose concentrations, a decrease in insulin concentrations and no changes in insulin resistance markers. Final mean glucose, mean insulin, Matsuda index and body mass index (BMI) were correlated with baseline M-clamp value and SHBG (p < 0.01). During the follow-up, no one in the sample developed diabetes. The annualised incidence rate for conversion from normoglycaemia to prediabetes totalled 4.5%. Baseline BMI, free androgen index, fasting glucose and M-clamp value were identified as prediabetes predictors in young PCOS women (respectively, OR = 1.17, OR = 1.42, OR = 1.2, OR = 0.73, p < 0.05). Prediabetes appeared in 76.47% of the women with a final BMI of ≥ 25 kg/m2 and in 7.14% of the normal-weight women (p = 0.0001). In conclusion, we report a high rate of adverse change in glucose metabolism in overweight and obese participants, a deterioration in β-cell function and strong correlations between metabolic parameters assessed in the third and the fourth decade in PCOS women, emphasising the role of early intervention to prevent cardiometabolic diseases.

scholarly journals Diagnosis and follow-up of type 2 diabetes in women with PCOS: a role for OGTT?

2018 ◽  
Vol 179 (3) ◽  
pp. D1-D14 ◽  
Author(s):  
Marianne Andersen ◽  
Dorte Glintborg
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Glucose Tolerance ◽  
Polycystic Ovary ◽  
Normal Weight ◽  
Oral Glucose ◽  
Diagnostic Purpose ◽  
Glycemic Status

Polycystic ovary syndrome (PCOS) is common in premenopausal women. The majority of women with PCOS have insulin resistance and the risk of type 2 diabetes mellitus (T2D) is higher in women with PCOS compared to controls. In non-pregnant women with PCOS, glycemic status may be assessed by oral glucose tolerance test (OGTT), fasting plasma glucose (FPG) or HbA1c. OGTT has been reckoned gold standard test for diagnosing T2D, but OGTT is rarely used for diagnostic purpose in other non-pregnant individuals at risk of T2D, apart from PCOS. OGTT has questionable reproducibility, and high sensitivity of the 2-h glucose value is at the expense of relatively low specificity, especially regarding impaired glucose tolerance (IGT). Furthermore, lean women with PCOS are rarely diagnosed with T2D and only few percent of normal-weight women have prediabetes. Glycemic status is necessary at diagnosis and during follow-up of PCOS, especially in women with high risk of T2D (obesity, previous gestational diabetes (GDM)). We suggest that OGTT should be used in the same situations in PCOS as in other patient groups at risk of T2D. OGTT is indicated for diagnosing GDM; however, OGTT during pregnancy may not be indicated in lean women with PCOS without other risk factors for GDM.

scholarly journals Inflammatory mediators in morbidly obese subjects: associations with glucose abnormalities and changes after oral glucose

2009 ◽  
Vol 161 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Dag Hofsø ◽  
Thor Ueland ◽  
Helle Hager ◽  
Trond Jenssen ◽  
Jens Bollerslev ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Inflammatory Mediators ◽  
Interleukin 1 ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Normal Weight ◽  
Morbidly Obese ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Normal Glucose

ObjectiveTo explore inflammatory mediators in morbidly obese (MO) subjects with various categories of glucose tolerance and to study the changes in these mediators after an oral glucose load.DesignCross-sectional and experimental study.MethodsA total of 144 MO subjects were classified into three categories: normal glucose tolerance (NGT); pre-diabetes; and new onset diabetes mellitus (NODM) were included, as were 27 normal weight normoglycemic controls. Serum osteoprotegerin (OPG), visfatin, leptin, adiponectin, interleukin-1 receptor antagonist (IL-1Ra), and C-reactive protein (CRP) were analyzed during an oral glucose tolerance test (OGTT).ResultsFasting levels of leptin and IL-1Ra were consistently higher in obese persons (P<0.001 and P<0.05). MO subjects with NGT had higher CRP levels (P<0.001) and lower adiponectin levels (P<0.05) compared to controls. Yet when compared with MO subjects with NODM, those with NGT had lower CRP levels and higher adiponectin levels (both P<0.05). Baseline OPG and visfatin levels did not differ between the groups (P=0.326 and P=0.198). During OGTT, OPG levels decreased (P<0.001) and visfatin levels increased transiently (P=0.018). The response in OPG and visfatin did not differ between the groups (P=0.690 and P=0.170). There were minor changes in adiponectin and leptin levels.ConclusionsMorbid obesity and glucose intolerance were associated with lower adiponectin levels and higher CRP levels, thus supporting a relationship between obesity, glucose homeostasis, and inflammation. Oral glucose suppressed OPG levels and transiently enhanced visfatin levels independent of obesity and glucose tolerance status, indicating that glucose may be involved in the acute regulation of these proteins.

scholarly journals Impaired Insulin Action Is Associated With Increased Glucagon Concentrations in Nondiabetic Humans

2017 ◽  
Vol 103 (1) ◽  
pp. 314-319 ◽  
Author(s):  
Anu Sharma ◽  
Ron T Varghese ◽  
Meera Shah ◽  
Chiara Dalla Man ◽  
Claudio Cobelli ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Insulin Action ◽  
Cell Function ◽  
Medical Center ◽  
Academic Medical Center ◽  
Glucagon Secretion ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Cell Dysfunction

Abstract Context Abnormal glucagon concentrations contribute to hyperglycemia, but the mechanisms of α-cell dysfunction in prediabetes are unclear. Objective We sought to determine the relative contributions of insulin secretion and action to α-cell dysfunction in nondiabetic participants across the spectrum of glucose tolerance. Design This was a cross-sectional study. A subset of participants (n = 120) was studied in the presence and absence of free fatty acid (FFA) elevation, achieved by infusion of Intralipid (Baxter Healthcare, Deerfield, IL) plus heparin, to cause insulin resistance. Setting An inpatient clinical research unit at an academic medical center. Participants A total of 310 nondiabetic persons participated in this study. Interventions Participants underwent a seven-sample oral glucose tolerance test. Subsequently, 120 participants were studied on two occasions. On one day, infusion of Intralipid plus heparin raised FFA. On the other day, participants received glycerol as a control. Main Outcome Measure(s) We examined the relationship of glucagon concentration with indices of insulin action after adjusting for the effects of age, sex, and weight. Subsequently, we sought to determine whether an acute decrease in insulin action, produced by FFA elevation, altered glucagon concentrations in nondiabetic participants. Results Fasting glucagon concentrations correlated positively with fasting insulin and C-peptide concentrations and inversely with insulin action. Fasting glucagon was not associated with any index of β-cell function in response to an oral challenge. As expected, FFA elevation decreased insulin action and also raised glucagon concentrations. Conclusions In nondiabetic participants, glucagon secretion was altered by changes in insulin action.

scholarly journals Glucoregulation in normal weight schizophrenia patients treated by first generation antipsychotics

2008 ◽  
Vol 136 (3-4) ◽  
pp. 110-115 ◽  
Author(s):  
Nadja Maric ◽  
Mirjana Doknic ◽  
Aleksandar Damjanovic ◽  
Sandra Pekic ◽  
Miroslava Jasovic-Gasic ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
First Generation ◽  
Dietary Habits ◽  
Tolerance Test ◽  
Normal Weight ◽  
Oral Glucose ◽  
Normal Body Mass Index ◽  
Cross Sectional ◽  
Metabolic Complications ◽  
Insulin Levels

Introduction Schizophrenia patients are at greater risk of obesity, diabetes mellitus (DM), lipid abnormalities and cardiovascular disorders. The metabolic complications in patients are associated with several risk factors: family history of DM, lifestyle, smoking, dietary habits, physical inactivity, but also with antipsychotic medication. In literature, most publications have been focused on the effects of the second generation antipsychotics (SGA) on glucose metabolism. However, less attention has been paid to abnormality in glucoregulation, patients with schizophrenia treated with the first generation antipsychotics (FGA). Objective The present study evaluated glucose metabolism in normal weight schizophrenia patients treated with FGA. METHOD The cross-sectional study included 18 patients (FGA treated) and 20 healthy controls with neither group differences in sex distribution, age, nor in BMI. Inclusion criteria were normal BMI (20-25 kg/m2). The glucose levels, insulin levels and growth hormone levels during oral glucose tolerance test (OGTT) were measured. Results Fasting glucose and insulin levels did not differ significantly between groups. Groups differed in OGTT glucose and insulin peak and area under curve (AUC), level of significance p<0.05 (patients vs. controls: glucose peak 8.3?0.4 vs.6.9?0.5 mmol/l, glucose AUC 758?28 vs. 640?36 mU/l/120 min; insulin peak in patients 92.7?15.6 mU/l; insulin AUC 6060?1016 mU/l/120 min, insulin peak in controls 47.9?6.5 mU/l; insulin AUC 2597?256 mU/l/120 min). Conclusion Patients with schizophrenia, although with normal body mass index, are at high risk of abnormal glucose regulation. Not only SGA increase the risk of impaired glucoregulation and metabolic syndrome, but this may also be due to FGA or schizophrenia per se. .

scholarly journals OGTT Glucose Response Curves, Insulin Sensitivity, and β-Cell Function in RISE: Comparison Between Youth and Adults at Randomization and in Response to Interventions to Preserve β-Cell Function

2021 ◽  
Author(s):  
Silva Arslanian ◽  
Laure El ghormli ◽  
Joon Young Kim ◽  
Ashley H. Tjaden ◽  
Elena Barengolts ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
B Cell ◽  
Cell Function ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Β Cell ◽  
Response Curves ◽  
Glucose Response ◽  
Cross Sectional ◽  
Β Cell Function

<b>Objective:</b> We examined the glucose-response-curves [<b><u>B</u></b>i<b><u>ph</u></b>asic (BPh), <b><u>M</u></b>ono<b><u>ph</u></b>asic (MPh), <b><u>I</u></b>ncessant-<b><u>In</u></b>crease (IIn)], during an oral glucose tolerance test (OGTT), and their relationship to insulin sensitivity (IS) and b-cell function (bCF) in youth vs. adults with IGT or recently diagnosed type 2 diabetes. <p><b>Research Design and Methods:</b> This was both a cross-sectional and longitudinal evaluation of participants in the RISE study randomized to metformin alone for 12 months or glargine for 3 months followed by metformin for 9 months. At baseline/randomization, OGTTs (85 youth, 353 adults) were categorized as BPh, MPh, or IIn. The relationship of the glucose-response-curves to hyperglycemic-clamp-measured IS and bCF at baseline, and the change in glucose-response-curves 12 months after randomization were assessed. </p> <p><b>Results:</b> At randomization, the prevalence of the BPh-curve was significantly higher in youth than adults (18.8% vs. 8.2%), with no differences in MPh or IIn. IS did not differ across glucose-response-curves in youth or adults. However, irrespective of curve type, youth had lower IS than adults (p<0.05). bCF was lowest in IIn vs. MPh and BPh in youth and adults (p <0.05). Yet, compared with adults, youth had higher bCF in BPh and MPh (p<0.005), but not IIn curves. At month 12, the change in glucose-response-curves did not differ between youth and adults, and there was no treatment effect. </p> <p><b>Conclusions:</b> Despite a 2-fold higher prevalence of the more-favorable BPh curve in youth at randomization, RISE interventions did not result in beneficial changes in glucose-response-curves in youth compared with adults. Moreover, the typical b-cell hypersecretion in youth was not present in the IIn curve, emphasizing the severity of b-cell dysfunction in youth with this least- favorable glucose-response-curve.</p>

scholarly journals Lifetime congenital isolated GH deficiency does not protect from the development of diabetes

2013 ◽  
Vol 2 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Taísa A R Vicente ◽  
Ívina E S Rocha ◽  
Roberto Salvatori ◽  
Carla R P Oliveira ◽  
Rossana M C Pereira ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Cell Function ◽  
Gh Deficiency ◽  
Receptor Gene ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulinogenic Index ◽  
Model Assessment ◽  
Cross Sectional

ObjectivesAdult subjects with untreated, lifetime, isolated GH deficiency (IGHD) due to a homozygous GHRH receptor gene mutation (MUT/MUT) residing in Itabaianinha, Brazil, present with lower BMI, higher prevalence of impaired glucose tolerance (IGT), increased insulin sensitivity (IS), and reduced β-cell function (βCF) when compared with non-BMI-matched homozygous normal controls. However, the prevalence of diabetes mellitus (DM) in this cohort is unknown. Comparing their IS and βCF with BMI-matched individuals heterozygous for the same mutation (MUT/N) may be useful to elucidate the role of the GH–IGF1 axis in IS and βCF. The purposes of this work were to verify the prevalence of IGT and DM in adult MUT/MUT subjects from this kindred and to compare IS and βCF in MUT/MUT and MUT/N.DesignCross-sectional study.MethodsWe studied most (51) of the living IGHD adults of this kindred who are GH naive. The oral glucose tolerance test (OGTT) could be performed in 34 subjects, fasting glucose was measured in 15, while two had a previous diagnosis of DM. The OGTT results of 24 MUT/MUT subjects were compared with those of 25 BMI-matched MUT/N subjects. IS was assessed by homeostatic model assessment of insulin resistance (HOMA–IR), quantitative IS check index, and oral glucose IS index for 2 and 3 h. βCF was assayed by HOMA-β, insulinogenic index, and the area under the curve of insulin:glucose ratio.ResultsThe prevalence of DM and IGT in IGHD was 15.68 and 38.23% respectively. IS was increased and βCF was reduced in MUT/MUT in comparison with MUT/N.ConclusionsLifetime, untreated IGHD increases IS, impairs βCF, and does not provide protection from diabetes.

scholarly journals Reproductive Hormones and Anthropometry: A Follow-Up of PCOS and Controls From Perimenopause to Older Than 80 Years

2020 ◽  
Author(s):  
Maria Forslund ◽  
Johanna Schmidt ◽  
Mats Brännström ◽  
Kerstin Landin-Wilhelmsen ◽  
Eva Dahlgren
Keyword(s):  
Polycystic Ovary ◽  
Reproductive Hormones ◽  
University Hospital ◽  
Sex Hormone Binding Globulin ◽  
Control Cohort ◽  
Ovary Syndrome ◽  
Original Cohort ◽  
Free Androgen Index ◽  
Age Range

Abstract Context There is a lack of knowledge about hormonal and anthropometric changes in women with polycystic ovary syndrome (PCOS) after the menopause. Objective This work aimed to study reproductive hormones and anthropometry in women with PCOS older than 80 years. Design and Setting This prospective cohort study was conducted at a university hospital. Patients A well-defined cohort of women with PCOS, previously examined in 1987 and 2008 (21 years) was reexamined in 2019 (11 years). Of the original cohort (n = 37), 22 women were still alive and 21 (age range, 72-91 years) participated. Comparisons were made with age-matched controls (n = 55) from the original control cohort (body mass index [BMI] similar to PCOS women). The results were compared with results from 1987 and 2008. Interventions Hormonal measurements and a physical examination were performed. Main Outcome Measures Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, sex hormone–binding globulin (SHBG), free androgen index (FAI), hirsutism score, BMI, and waist to hip ratio (WHR) were measured. Results At mean age 81 years, FSH levels were lower in women with PCOS (50 vs 70 IU/L) who were still more hirsute than controls (33% vs 4%). No differences were found in FAI, testosterone, SHBG or LH levels, BMI, or WHR. From perimenopausal age until the present age, levels of testosterone and FAI continued to decline in women with PCOS. SHBG levels continued to increase with age. FSH had not changed over time during the last 11 years. Conclusions Women with PCOS at age 72 to 91 had lower FSH levels, remained clinically hyperandrogenic, and had similar FAI and body composition as controls.

scholarly journals Sagittal Abdominal Diameter, Waist Circumference, and BMI as Predictors of Multiple Measures of Glucose Metabolism: An NHANES Investigation of US Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Shelby A. Firouzi ◽  
Larry A. Tucker ◽  
James D. LeCheminant ◽  
Bruce W. Bailey
Keyword(s):  
Waist Circumference ◽  
Glucose Metabolism ◽  
Fasting Glucose ◽  
Healthcare Providers ◽  
Tolerance Test ◽  
Normal Weight ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Simple Method ◽  
Sagittal Abdominal Diameter

The objective was to compare associations between sagittal abdominal diameter (SAD), waist circumference, and BMI to the oral glucose tolerance test (OGTT), along with fasting glucose, HbA1c, and HOMA-IR, in a nationally representative sample of 3582 US adults. The study also analyzed the effect of multiple covariates on the anthropometric and glucose metabolism associations. A cross-sectional design was used. SAD was assessed using an abdominal caliper. All other data were collected following strict NHANES protocols. The OGTT was the primary variable used to index glucose metabolism. Fasting glucose, HbA1c, and HOMA-IR were also evaluated. Results showed that mean ± SE values were as follows: SAD: 22.3 ± 0.1 cm, waist circumference: 98.0 ± 0.4 cm, BMI: 28.6 ± 0.2 kg/m2, OGTT: 113.9 ± 1.0 mg/dL, fasting glucose: 99.6 ± 0.3 mg/dL, HbA1c: 5.4 ± 0.01%, and HOMA-IR: 3.2 ± 0.1. Compared to waist circumference and BMI, SAD consistently emerged as the best predictor of glucose metabolism, before and after adjusting for the covariates, and with the sample stratified by gender, race, or age. SAD was not a better predictor of OGTT among normal-weight adults or non-Hispanic Black adults. Due to the ease of taking SAD measurements, we recommend that healthcare providers use this simple method to more precisely predict diabetes risk, especially among overweight and obese adults.

scholarly journals Gut Microbiota and the Polycystic Ovary Syndrome: Influence of Sex, Sex Hormones, and Obesity

2018 ◽  
Vol 103 (7) ◽  
pp. 2552-2562 ◽  
Author(s):  
María Insenser ◽  
Mora Murri ◽  
Rosa del Campo ◽  
M Ángeles Martínez-García ◽  
Elena Fernández-Durán ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Gut Microbiota ◽  
Bacterial Diversity ◽  
Sex Hormones ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Ovary Syndrome ◽  
Cross Sectional

Abstract Context Gut microbiota play a major role in health and disease by influencing physiology, metabolism, nutrition, and immune function. Objective To evaluate the composition of gut microbiota in women with polycystic ovary syndrome (PCOS), focusing on the influence of sex, sex hormones and obesity on the associations found. Design Cross-sectional study. Setting Academic hospital. Participants We recruited 15 women with PCOS, 16 nonhyperandrogenic control women, and 15 control men. Participants were classified as nonobese (&lt;30 kg/m2) or obese (≥30 kg/m2) according to their body mass index. Interventions Standardization of diet for 3 consecutive days (at least 300 g of carbohydrates per day) followed by fecal sampling and a standard 75-g oral glucose tolerance test. Main Outcome Measures Analysis of bacterial abundance and composition of gut microbiota by massive sequencing of 16S ribosomal DNA amplicons in a MiSeq platform (Illumina). Results α Bacterial diversity was reduced in women compared with men, and β diversity was reduced particularly in obese patients with PCOS. Women with PCOS presented with specific abnormalities in gut microbiota consisting of an increased abundance of the Catenibacterium and Kandleria genera. When all participants as a whole were considered, indexes of bacterial diversity and the abundance of several bacterial genera correlated positively with serum androgen concentrations and negatively with estradiol levels. Conclusions The diversity and composition of the gut microbiota of young adults are influenced by the combined effects of sex, sex hormone concentrations, and obesity, presenting with specific abnormalities in women with PCOS.

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