scholarly journals Association between the serum estrone-to-estradiol ratio and parameters related to glucose metabolism and insulin resistance in women with polycystic ovary syndrome

2021 ◽  
Vol 48 (4) ◽  
pp. 374-379
Author(s):  
Nayoung Kim ◽  
Sungwook Chun
Keyword(s):  
Insulin Resistance ◽  
Glucose Metabolism ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Postprandial Glucose ◽  
Serum Glucose ◽  
Clinical Variable ◽  
Fasting Insulin ◽  
Ovary Syndrome ◽  
Glucose Levels

Objective: We aimed to evaluate associations between the ratio of serum estrone (E1) to estradiol (E2) and parameters related to serum glucose metabolism and insulin resistance in women with polycystic ovary syndrome (PCOS). Methods: In total, 133 women between the ages of 18 and 33 diagnosed with PCOS were enrolled in this study. All participants with PCOS underwent blood tests to determine hormonal and biochemical metabolic parameters and a standard 2-hour 75-g oral glucose tolerance test. They were divided into two groups according to the serum E1-to-E2 ratio: group 1 (E1/E2 ratio <2.0) and group 2 (E1/E2 ratio ≥2.0). Results: In the comparative analysis, the waist-to-hip ratio (WHR) was the only clinical variable that was significantly different between the two groups. Patients with a higher E1/E2 ratio showed higher fasting insulin levels, homeostasis model for insulin resistance, and postprandial glucose levels at 2 hours (PPG2). In a correlation analysis, only PPG2 was significantly related to the serum E1/E2 ratio. However, after controlling for the confounding effects of body mass index (BMI) and WHR, fasting glucose was also significantly correlated with the serum E1/E2 ratio. Conclusion: Women with PCOS with a higher serum E1/E2 ratio were found to be more likely to show higher fasting insulin and postprandial glucose levels. Significant correlations were found between the serum E1/E2 ratio and both fasting and postprandial serum glucose levels after adjusting for BMI and WHR in women with PCOS.

scholarly journals Obesity and Insulin Resistance Are the Main Determinants of Postprandial Lipoprotein Dysmetabolism in Polycystic Ovary Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Tommy Kyaw Tun ◽  
Anne McGowan ◽  
Niamh Phelan ◽  
Neuman Correia ◽  
Gerard Boran ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Polycystic Ovary Syndrome ◽  
Apolipoprotein B ◽  
Polycystic Ovary ◽  
Density Lipoprotein ◽  
Premenopausal Women ◽  
Postprandial Glucose ◽  
Ovary Syndrome ◽  
Mixed Meal

Postprandial dyslipidaemia may be a plausible mechanism by which polycystic ovary syndrome (PCOS) increases cardiovascular risk. We sought to investigate whether the postprandial glucose and insulin and lipid and lipoprotein responses, including that of apolipoprotein B-48 (apoB-48) containing chylomicrons, to a mixed meal are different in obese PCOS women when compared to obese control subjects and whether differences, if any, are related to obesity, insulin resistance (IR), hyperandrogenaemia, or PCOS status. 26 women with PCOS (age30.4±1.2years (mean ± SEM), body mass index (BMI)36.8±1.5 kg/m2) and 26 non-PCOS subjects (age34.1±0.9years, BMI31.5±1.0 kg/m2) were studied before and up to 8 hours following a standard mixed meal. AUC-triglyceride (AUC-TG) was higher and AUC-high-density lipoprotein (AUC-HDL) lower in PCOS women. These differences were not apparent when BMI was accounted for. Insulin sensitivity (SI), AUC-apoB-48, and AUC-apolipoprotein B (AUC-apoB) were found to be independent predictors of AUC-TG, accounting for 55% of the variance. Only AUC-insulin remained significantly elevated following adjustment for BMI. Obesity related IR explains postprandial hypertriglyceridaemia and hyperinsulinaemic responses. Management of obesity in premenopausal women with PCOS is likely to reduce their cardiovascular risk burden.

scholarly journals Predictors of abnormal glucose metabolism in women with polycystic ovary syndrome

2006 ◽  
Vol 154 (2) ◽  
pp. 295-301 ◽  
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.

scholarly journals Metformin improves polycystic ovary syndrome symptoms irrespective of pre-treatment insulin resistance

2007 ◽  
Vol 157 (5) ◽  
pp. 669-676 ◽  
Author(s):  
Susanne Tan ◽  
Susanne Hahn ◽  
Sven Benson ◽  
Tiina Dietz ◽  
Harald Lahner ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Fasting Glucose ◽  
Polycystic Ovary ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Ovary Syndrome ◽  
Insulin Levels ◽  
Outcome Parameters ◽  
Pre Treatment

AbstractObjectiveInsulin resistance (IR) and obesity are common features of the polycystic ovary syndrome (PCOS). Insulin-sensitizing agents have been shown to improve both reproductive and metabolic aspects of PCOS, but it remains unclear whether it is also beneficial in lean patients without pre-treatment IR. The aim of this study was to determine the influence of metformin on the clinical and biochemical parameters of PCOS irrespective of the presence of basal obesity and IR.DesignThe effect of 6 months of metformin treatment was prospectively assessed in 188 PCOS patients, divided into three groups according to body mass index (BMI; lean: BMI<25 kg/m2, overweight: BMI 25–29 kg/m2, and obese: BMI≥30 kg/m2). Outcome parameters, which were also assessed in 102 healthy controls, included body weight, homeostasis model assessment for IR (HOMA-IR), fasting glucose and insulin levels, area under the curve of insulin response (AUCI), hyperandrogenism, and menstrual irregularities.ResultsIn comparison with the respective BMI-appropriate control groups, only obese but not lean and overweight PCOS patients showed differences in fasting insulin and HOMA-IR. Metformin therapy significantly improved all outcome parameters except fasting glucose levels. Subgroup analyses revealed that in the group of lean PCOS patients without pre-treatment IR, metformin significantly improved HOMA-IR (1.7±1.0 vs 1.1±0.7 μmol/l×mmol/l2) and fasting insulin levels (7.7±4.2 vs 5.4±3.9 mU/l), in addition to testosterone levels (2.6±0.9 vs 1.8±0.7 nmol/l), anovulation rate (2.3 vs 59.5%), and acne (31.8 vs 11.6%; all P<0.017). In the overweight and obese PCOS groups, metformin also showed the expected beneficial effects.ConclusionMetformin improves parameters of IR, hyperandrogenemia, anovulation, and acne in PCOS irrespective of pre-treatment IR or obesity.

scholarly journals Relationship of Insulin Receptor Substrate-1 and -2 Genotypes to Phenotypic Features of Polycystic Ovary Syndrome

2002 ◽  
Vol 87 (9) ◽  
pp. 4297-4300 ◽  
Author(s):  
David A. Ehrmann ◽  
Xu Tang ◽  
Issei Yoshiuchi ◽  
Nancy J. Cox ◽  
Graeme I. Bell
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
African American ◽  
African Americans ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Insulin Receptor Substrate ◽  
Ovary Syndrome ◽  
Glucose Levels

Insulin resistance is a key component in the pathogenesis of polycystic ovary syndrome (PCOS) and type 2 diabetes. Polymorphisms in the genes encoding the insulin receptor substrate (IRS) proteins, IRS-1 (Gly972Arg) and IRS-2 (Gly1057Asp), influence susceptibility to type 2 diabetes. This study was undertaken to assess the influence of these polymorphisms on insulin resistance, glucose tolerance, and androgen levels in nondiabetic PCOS women. We studied 227 PCOS subjects including 126 and 48 nondiabetic white and African-American subjects, respectively. The IRS-1 Gly972Arg allele frequencies were identical in whites and African-Americans [0.95 (Gly) and 0.05 (Arg)]. The IRS-2 Gly1057Asp allele frequencies were 0.85 (Gly) and 0.15 (Asp) in African-Americans and 0.59 (Gly) and 0.41 (Asp) in whites. There was no association of IRS-1 genotype with any clinical or hormonal measure in nondiabetic white or African-American PCOS subjects. However, nondiabetic subjects with the IRS-2 Gly/Gly genotype had significantly higher 2-h oral glucose tolerance test glucose levels compared with those with Gly/Asp and Asp/Asp genotypes in whites or Gly/Asp genotype in African-Americans (there were no Asp/Asp subjects in our modest size African-American sample). These results suggest that the IRS-2 Gly1057Asp polymorphism influences blood glucose levels in nondiabetic white and African-American women with PCOS. Thus, individuals with the common IRS-2 Gly/Gly genotype may be at increased risk of developing type 2 diabetes.

scholarly journals Retinol-binding protein 4 levels are elevated in polycystic ovary syndrome women with obesity and impaired glucose metabolism

2007 ◽  
Vol 157 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Susanne Hahn ◽  
Manuel Backhaus ◽  
Martina Broecker-Preuss ◽  
Susanne Tan ◽  
Tiina Dietz ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Metabolism ◽  
Polycystic Ovary Syndrome ◽  
Body Fat ◽  
Polycystic Ovary ◽  
Retinol Binding Protein ◽  
Healthy Controls ◽  
Impaired Glucose Metabolism ◽  
Ovary Syndrome ◽  
Retinol Binding Protein 4

Objective: Insulin resistance and obesity are common features of the polycystic ovary syndrome (PCOS). Retinol-binding protein 4 (RBP4), a new fat-derived adipokine, has been described to be elevated in obesity and type 2 diabetes. The aim of the present study was to investigate whether serum RBP4 levels are correlated with metabolic parameters, indices of insulin resistance, and endocrine variables in German PCOS women. Design: We assessed the correlation between metabolic and endocrine parameters with RBP4 levels in 200 PCOS patients and 64 healthy controls. Methods: Serum RBP4 was measured by enzyme-linked immunosorbent assay (Immundiagnostik AG, Bensheim, Germany). In addition, anthropometric variables, clinical signs of hyperandrogenism, and body fat were evaluated, and a glucose tolerance test was performed to assess parameters of insulin resistance and glucose metabolism. Results: Taking the entire PCOS cohort, RBP4 levels were positively correlated with body mass index (BMI), body fat, waist circumference, fasting glucose, and area under the curve for glucose (all P<0.05), but not with indices of insulin resistance. On the other hand, PCOS women with impaired glucose metabolism had higher RBP4 levels than PCOS women with normal glucose metabolism (median 30.6, range 23.3–73.9 versus median 26.3, range 6.4–61.4, P<0.05). Furthermore, no differences were found in RBP4 levels between lean PCOS women and BMI-matched healthy controls. Conclusion: In German PCOS women, serum RBP4 levels are associated with obesity and parameters of glucose metabolism but not with PCOS per se.

scholarly journals Effect of Psyllium Supplementation on Insulin Resistance and Lipid Profile in Non-diabetic Women With Polycystic Ovary Syndrome: A Randomized Placebo-Controlled Trial

2018 ◽  
Vol 8 (2) ◽  
pp. 184-191
Author(s):  
Fatemeh Pourbehi ◽  
Parvin Ayremlou ◽  
Alireza Mehdizadeh ◽  
Rasoul Zarrin
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Lipid Profile ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Fasting Insulin ◽  
Ovary Syndrome ◽  
Double Blind

Objectives: Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women. In addition, the risk of type2 diabetes mellitus (T2DM), hyperinsulinemia, and insulin resistance is higher among women with PCOS. Psyllium can reduce the levels of fasting blood sugar (FBS), insulin resistance, and lipid profile. Thus, the present study aimed to evaluate the effect of psyllium supplementation on insulin resistance and the lipid profile in non-diabetic women with PCOS. Materials and Methods: In this randomized double-blind placebo-controlled trial, 54 eligible non-diabetic women with PCOS aged 18-45 were recruited from an endocrinology clinic and divided into 2 groups based on their body mass index (BMI) through stratified-block randomization. Participants in intervention and placebo groups received 5 g of psyllium or cellulose microcrystalline twice a day for 8 weeks. Fasting insulin, FBS, and insulin resistance indicators including HOMA1-IR, HOMA2-IR, along with quantitative insulin sensitivity check index (QUICKI) and the lipid profile were evaluated before and after the intervention. Results: In the psyllium group, the FBS, fasting insulin, total cholesterol, low-density lipoprotein cholesterol (LDL-C), HOMA1-IR, and HOMA2-IR indicators decreased significantly (P<0.05) after 8 weeks, but the changes were not significant in the placebo group. The mean changes in LDL-C (0.28±0.58 and 0.11±0.67 in intervention and placebo groups, respectively, P=0.036) and QUICKI (0.01±0.03 and 0.02±0.06 in intervention and placebo groups, respectively, P=0.044) were significant between the two groups from the baseline. Conclusions: Psyllium supplementation decreased FBS, fasting insulin, and the lipid profile while improving insulin resistance in non-diabetic women with PCOS.

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

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.

scholarly journals Age and body mass related changes of cardiovascular risk factors in women with polycystic ovary syndrome

2002 ◽  
Vol 59 (6) ◽  
pp. 593-599 ◽  
Author(s):  
Djuro Macut ◽  
Dragan Micic ◽  
Biljana Parapid ◽  
Goran Cvijovic ◽  
Mirjana Sumarac-Dumanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Glucose Metabolism ◽  
Polycystic Ovary Syndrome ◽  
Lipid Profile ◽  
Cardiovascular Risk Factors ◽  
Polycystic Ovary ◽  
Ovary Syndrome

Polycystic ovary syndrome (PCOS) is considered a metabolic disorder closely related to obesity, insulin resistance (IR), hyperinsulinemia and unfavorable lipid profile, all increasing the risk for the occurrence of cardiovascular diseases. The aim of this study was to assess age and body mass index (BMI) related changes of cardiovascular risk factors in 90 women with PCOS. The cut-off age point was 30 years and for BMI 27.8 kg/m2. In all patients systolic and diastolic blood pressure (BP), metabolic parameters comprising values of glucose and insulin during oral glucose tolerance test (OGTT), and basal lipid values were determined. Significant increase in blood pressure (BP) indices, basal insulin values and insulin resistance (IR) assessed by HOMA model were observed with aging and the increase of BMI, while the parameters of glucose metabolism, total cholesterol and triglycerides were significantly elevated only with aging. However, the correlation between the indices of arterial blood pressure, and lipid and glucose metabolism parameters occurred only in patients over 30 years of age, pointing to the causative relation and the consequent deterioration of IR and lipid profile with aging, influencing cardiovascular function in women with PCOS.

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