Insulin resistance and lipid profile in women with polycystic appearing ovaries: implications with regard to polycystic ovary syndrome

The aim of this study was to investigate carbohydrate and lipid profiles in women with polycystic appearing ovaries (PCO) on ultrasound examination who did not fulfill the criteria for polycystic ovary syndrome (PCOS). We sonographically evaluated and biochemically diagnosed 35 patients with PCO, 31 women with PCOS and 23 healthy controls. We performed oral glucose tolerance tests (OGTT) and calculated the quantitative insulin sensitivity check index (QUICKI) and the homeostatic model assessment (HOMAIR) scores. Serum fasting insulin levels, 1-h insulin response, HOMAIR and QUICKI scores were significantly higher in the PCO and PCOS groups than in the controls. However, serum fasting glucose levels, fasting insulin levels, HOMAIR and QUICKI scores were similar in women with PCO and PCOS. In women with PCO, high-density lipoprotein (HDL) levels were higher, and very-low-density lipoprotein (VLDL) and triglyceride levels were lower compared with women with PCOS. Furthermore, insulin responses to OGTT, HOMAIR and QUICKI scores and lipid values correlated with serum androgen levels and body mass index (BMI) in PCO patients. In conclusion, women with PCO who do not fulfill the criteria for PCOS have abnormal insulin sensitivity and insulin resistance. The finding of similar insulin abnormalities in women with PCO to those in women with PCOS confirms that women with PCO have similar metabolic characteristics to those with PCOS.     

Insulin resistance and lipid profile in women with polycystic appearing ovaries: implications with regard to polycystic ovary syndrome.

The aim of this study was to investigate carbohydrate and lipid profiles in women with polycystic appearing ovaries (PCO) on ultrasound examination who did not fulfill the criteria for polycystic ovary syndrome (PCOS). We sonographically evaluated and biochemically diagnosed 35 patients with PCO, 31 women with PCOS and 23 healthy controls. We performed oral glucose tolerance tests (OGTT) and calculated the quantitative insulin sensitivity check index (QUICKI) and the homeostatic model assessment (HOMAIR) scores. Serum fasting insulin levels, 1-h insulin response, HOMAIR and QUICKI scores were significantly higher in the PCO and PCOS groups than in the controls. However, serum fasting glucose levels, fasting insulin levels, HOMAIR and QUICKI scores were similar in women with PCO and PCOS. In women with PCO, high-density lipoprotein (HDL) levels were higher, and very-low-density lipoprotein (VLDL) and triglyceride levels were lower compared with women with PCOS. Furthermore, insulin responses to OGTT, HOMAIR and QUICKI scores and lipid values correlated with serum androgen levels and body mass index (BMI) in PCO patients. In conclusion, women with PCO who do not fulfill the criteria for PCOS have abnormal insulin sensitivity and insulin resistance. The finding of similar insulin abnormalities in women with PCO to those in women with PCOS confirms that women with PCO have similar metabolic characteristics to those with PCOS.     

Are polycystic ovaries associated with cardiovascular disease risk as polycystic ovary syndrome?

AIM: Our aim was to assess C-reactive protein (CRP) levels and insulin resistance in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO). METHODS: The study population included 30 women with PCOS, 30 with PCO and 30 healthy controls. CRP and insulin resistance index (IRI) (fasting glucose/insulin) were measured. A receiver-operator characteristic (ROC) curve was constructed to determine the cut-off value of CRP to predict increased cardiovascular risk. RESULTS: There were no statistically significant differences between the three groups with regard to age and body mass index. IRI was significantly lower in the PCOS group than in the PCO and control groups. No difference existed between the PCO and control groups. Median CRP levels in the control, PCO and PCOS groups were 0.75, 1.3 and 1.5 mg/l, respectively (p = 0.005). CRP could differentiate between women with and without increased cardiovascular risk at a cut-off value of 2.42 mg/l, with a sensitivity of 79% and a specificity of 81%. CONCLUSION: As in PCOS patients, women with PCO have higher serum CRP levels than healthy control women. This may contribute to increased cardiovascular disease risk in patients with PCO.     

Serum calcitonin gene-related peptide levels in women with polycystic ovary syndrome

Purpose

Calcitonin gene-related peptide (CGRP) is an amino acid neuropeptide with widespread expression. It has potent effects on lipid and energy metabolism. It induces insulin resistance. This study was planned to determine CGRP levels in women with polycystic ovary syndrome (PCOS).

Methods

Forty-seven women with PCOS and 34 healthy controls were evaluated in this controlled clinical study. Serum lipid sub-fractions, postprandial and fasting glucose, insulin and other hormones (gonadotropins, androgens) and CGRP levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance.

Results

Waist measurements, postprandial and fasting glucose and fasting insulin levels and free androgen index and HOMA-IR were significantly higher in subjects with PCOS. However, the women with PCOS had considerably lower high-density lipoprotein cholesterol levels than healthy subjects. Serum CGRP levels were higher in study subjects than in controls, although it was statistically insignificant.

Conclusions

Serum CGRP level was not related with insulin resistance, ovarian hyperandrogenism and dyslipidemia in abdominally obese women with PCOS. These outcomes propose that CGRP may not play a pivotal role in the pathogenesis of PCOS.     

Serum Fetuin-A levels,insulin resistance and oxidative stress in women with polycystic ovary syndrome

Abstract

This study was designed to determine serum Fetuin-A levels and establish whether serum Fetuin-A level is related with insulin resistance, oxidative stress, ovarian hyperandrogenism and dyslipidemia in women with polycystic ovary syndrome (PCOS). Twenty-two patients with PCOS and twenty-one healthy control women were evaluated in this controlled clinical study. Serum Fetuin-A, lipid fractions, glucose, insulin, malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), superoxide dismutase (SOD) and other hormone (gonadotropins, androgens) levels were measured. The estimate of insulin resistance was calculated by homeostasis model assessment (HOMA-R). The women with PCOS had significantly higher serum fasting glucose, insulin, luteinizing hormone (LH), MDA, Fetuin-A levels, and LH/follicle-stimulating hormone (FSH) ratio, free androgen index (FAI), HOMA-IR than healthy women. However, sex hormone-binding globulin (SHBG) and GSH levels were significantly lower in patients with PCOS compared with controls. Fetuin-A was positively correlated with insulin, HOMA-IR and FAI. Multiple regression analysis revealed that FAI was strong predictor of serum Fetuin-A level. Serum Fetuin-A level was related with insulin resistance and ovarian hyperandrogenism in women with PCOS. These results suggest that Fetuin-A may have a role in triggering the processes leading to insulin resistance and androgen excess in PCOS.     

The association of bone mineral density with insulin resistance in patients with polycystic ovary syndrome

OBJECTIVE: The aim of the study was to compare the bone mineral density (BMD) measurements between the patients with polycystic ovary syndrome (PCOS) and age and the body mass index (BMI) matched healthy controls, and to examine whether insulin resistance was associated with BMD. STUDY DESIGN: Twenty-nine consecutive patients with PCOS and seventeen, age and BMI matched healthy control women were included in the study. Blood samples were obtained for follicle stimulating hormone, luteinizing hormone, estradiol, dehydroepiandrosterone-sulfate, 17 hydroxy-progesterone, free testosterone, sex hormone binding globulin, insulin, and glucose levels and BMD measurements were performed for total body, lumbar spine (L2-L4), and femoral neck for each participant. Insulin resistance was estimated by fasting insulin level, fasting glucose/insulin ratio and 75 g of glucose tolerance test for 2 h. Differences between the groups were analyzed by Student's t-test and Mann-Whitney U-test where appropriate. Correlation analysis between the parameters concerning insulin resistance and BMD measurements were performed in patients with PCOS using Pearson's correlation coefficient (r). Correlation analysis was also performed between serum hormone levels and BMD measurements in the PCOS group. Partial correlation coefficients were calculated for these parameters, using age and BMI as covariates. RESULTS: Free testosterone and 17 hydroxy-progesterone levels were significantly high in patients with PCOS compared to the control women (P = 0.001 and 0.04, respectively). Fasting insulin was significantly higher and fasting glucose/insulin ratio was significantly lower in the PCOS group compared to the controls (P = 0.021 and 0.008, respectively). BMD measurements did not differ between the groups (P > 0.05). There were significant correlations between fasting insulin and total BMD (r = 0.424, P < 0.05) and fasting glucose/insulin ratio and L2-L4 BMD (r = -0.401, P < 0.05) after controlling for age and BMI. CONCLUSION: BMD measurements are not different between the patients with polycystic ovary syndrome and healthy control women and hyperinsulinemia, and insulin resistance might play a role in the preserved BMD.     

Are polycystic ovaries associated with cardiovascular disease risk as polycystic ovary syndrome?

Aim. Our aim was to assess C-reactive protein (CRP) levels and insulin resistance in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO).

Methods. The study population included 30 women with PCOS, 30 with PCO and 30 healthy controls. CRP and insulin resistance index (IRI) (fasting glucose/insulin) were measured. A receiver–operator characteristic (ROC) curve was constructed to determine the cut-off value of CRP to predict increased cardiovascular risk.

Results. There were no statistically significant differences between the three groups with regard to age and body mass index. IRI was significantly lower in the PCOS group than in the PCO and control groups. No difference existed between the PCO and control groups. Median CRP levels in the control, PCO and PCOS groups were 0.75, 1.3 and 1.5 mg/l, respectively (p = 0.005). CRP could differentiate between women with and without increased cardiovascular risk at a cut-off value of 2.42 mg/l, with a sensitivity of 79% and a specificity of 81%.

Conclusion. As in PCOS patients, women with PCO have higher serum CRP levels than healthy control women. This may contribute to increased cardiovascular disease risk in patients with PCO.     

Serum vaspin and C-reactive protein levels in women with polycystic ovaries and polycystic ovary syndrome

Objective.?Our aim was to evaluate C-reactive protein (CRP) and serum vaspin levels in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO).

Design.?Twenty-four women with PCOS and 23 women with PCO constituted the study groups. The control group comprised 24 healthy women.

Methods.?Homeostatic model assessment for insulin resistance (HOMA-IR), CRP and serum vaspin levels were measured. The receiver–operating characteristic curve (ROC) of vaspin for prediction of women with increased diabetogenic risk was constructed.

Results.?The three groups did not significantly differ in age and body mass index. HOMA-IR was significantly higher in the PCOS and PCO groups than in control group. Median CRP levels in the control, PCO and PCOS groups were 0.66, 1.28 and 3.2?mg/l, respectively (p?=?0.0001). Women with PCOS had significantly higher serum vaspin levels than the healthy controls [3.52?±?1.38 vs. 0.36?±?0.19?ng/ml, p?=?0.0001]. Serum vaspin could differentiate between women with and without increased diabetogenic risk at a cut-off value of 1.82?ng/ml with a sensitivity of 83.3% and a specificity of 66.1%.

Conclusion.?The results of our study showed that the presence of the increased vaspin, CRP and higher HOMA-IR levels in women with PCOS and PCO could contribute to increased diabetogenic and atherogenic risk in these patients.     

Paraoxonase levels in women with polycystic ovary syndrome

OBJECTIVE: To determine paraoxonase (PON1) levels and whether paraoxonase activity is associated with an increased propensity for the development of cardiovascular disease in women with polycystic ovary syndrome (PCOS). STUDY DESIGN: Thirty-one subjects with PCOS and 33 healthy controls were evaluated in this controlled clinical study. Lipid subfractions, fasting glucose, insulin and other hormone (gonadotropin, androgen) and PON1 levels were measured. Homeostasis model assessment (HOMA-R) was used to estimate insulin resistance. Statistical analysis was made with Student's t test and Pearson correlation analysis. RESULTS: The women with PCOS had significantly lower serum high-density lipoprotein (HDL), apolipoprotein A1, basal PON1, arylesterase and salt-stimulated PON1 (SSP) levels than did the controls. Also, fasting insulin levels and HOMA-R were significantly higher in women with PCOS as compared with healthy subjects. Basal PON1 was positively associated with apolipoprotein A1, arylesterase and SSP but inversely correlated with HOMA-R. HDL was negatively associated with fasting insulin and HOMA-R. CONCLUSION: Decreased PON1 activity might contribute to an increased propensity for the development of cardiovascular disease in women with PCOS in addition to known risk factors, such as insulin resistance, hypertension, dyslipidemia and increased oxidative stress.     

Assessment of insulin resistance in young women with polycystic ovary syndrome

OBJECTIVES: To determine whether serum levels of potential markers could detect insulin resistance (IR) in young women with polycystic ovary syndrome (PCOS). METHODS: Serum levels of fasting glucose, insulin, intact proinsulin, resistin, and adiponectin were measured in 50 women with PCOS and known homeostatic model assessment (HOMA)-IR values (>or=2 indicating IR). The women were all younger than 25 years. RESULTS: Of the 50 women, 49 had undetectable levels of resistin, 50 had intact proinsulin levels within the normal range, and 50 had adiponectin levels of 8.4+/-3.3 mg/L, just below the normal range. When groups were compared, however, the 26 women (52%) with IR (HOMA-IR values >or=2) had significantly higher intact proinsulin levels (3.2+/-2.0 pmol/L vs 1.8+/-1.0 pmol/L; P<0.005) and significantly lower adiponectin levels (7.2+/-2.9 mg/L vs 9.7+/-3.3 mg/L; P<0.01), than the 24 women (48%) without IR. CONCLUSION: Serum levels of intact proinsulin, resistin, or adiponectin were not detectors of IR in individual young women with PCOS.     

Serum visfatin levels in women with polycystic ovary syndrome

The aim of this study is to determine the serum levels of visfatin in patients with polycystic ovary syndrome (PCOS) and to understand its correlations with other metabolic and hormonal parameters. Thirty-seven patients with PCOS and 30 women without concomitant disease were included in this study. Serum visfatin levels were similar in patients with PCOS and control group. Visfatin levels were higher in normal weight PCOS when compared with obese PCOS, but it did not reach statistical significance. Visfatin levels correlated negatively with fasting blood glucose, total cholesterol (TC), low-density lipoprotein (LDL) and lipoprotein-a levels in PCOS patients. CRP levels increased both in obese PCOS and in obese controls. Plasma visfatin levels had no correlation with homeostasis model assessment-insulin resistance and fasting insulin levels, but the negative correlation between plasma visfatin levels and lipoprotein-a, fasting plasma glucose, TC and LDL levels may indicate a role for visfatin in cardiovascular disease independent of insulin resistance.     

Serum visfatin in Asian women with polycystic ovary syndrome

Objective.?To determine serum visfatin levels in Asian polycystic ovary syndrome (PCOS) women and its correlations with various parameters.

Study design.?Case–control study.

Setting.?University hospital.

Subjects.?Eighty women were enrolled in this study. Of these, 40 women were PCOS and 40 age-matched subjects with regular menstrual cycles were controls.

Intervention.?Seventy-five gram oral glucose tolerance tests were performed in all women. Fasting venous blood samples for serum visfatin, insulin and androgen levels were obtained both from the PCOS and the control women.

Main outcome measures.?Serum concentrations of visfatin, fasting insulin (FI), fasting glucose, 2-h post-load glucose (2hPG), homeostasis model assessment insulin resistance, homeostasis model assessment beta cell function, total testosterone, free testosterone, androstenedione and dehydroepiandrosterone sulfate were measured in both groups.

Results.?Women with PCOS had significantly higher serum visfatin levels than the healthy controls [100.39 ± 41.90 vs. 45.09 ± 28.24 mg/ml, p < 0.01]. PCOS women also had significantly higher concentrations of all androgens (p < 0.01). Insulin resistance seemed to be greater in the PCOS than the control groups, but did not reach a statistically significant level. In the PCOS group, serum visfatin levels were positively correlated with 2hPG, and systolic blood pressure and diastolic blood pressure. Serum visfatin levels were negatively associated with FI (r = ?0.80, p = 0.03) and positively associated with systolic and diastolic blood pressure (r = 0.77, p = 0.04, r = 0.79, p = 0.03, respectively) in the sub-group of PCOS women with abnormal glucose tolerance (AGT).

Conclusions.?Asian PCOS women had significantly higher serum visfatin levels than age-matched healthy controls. Their levels were significantly correlated with 2hPG and blood pressure in PCOS women, and with FI and blood pressure in PCOS women with AGT.     

Adiponectin levels in women with polycystic ovary syndrome and severe insulin resistance

OBJECTIVE: Adiponectin is an adipokine that is decreased in obesity and type 2 diabetes. Women with polycystic ovarian syndrome (PCOS) are obese and are at risk for type 2 diabetes. The objective of the current study was to investigate the relationship of adiponectin to obesity and insulin resistance in women with PCOS and severe insulin resistance. METHODS: Thirty women with PCOS and acanthosis nigricans indicating severe insulin resistance were included in the study. Eleven body mass index (BMI)-matched women with normal ovulatory cycles served as controls. Fasting glucose, insulin, and adiponectin levels were measured, and a standard oral glucose tolerance test (OGTT) with insulin levels was performed. To further investigate the role of insulin sensitivity on adiponectin levels, 10 women with PCOS were treated with 4 mg rosiglitazone daily for 6 months and adiponectin levels were measured before and after treatment. RESULTS: Fasting insulin levels (33.5 +/- 3.8 microU/mL; P <.001) and insulin area under the curve (AUC) during OGTT (536.2 +/- 70.5 microU/mL; P <.01) were higher in women with PCOS, while glucose levels were similar to controls. Adiponectin levels were lower (P <.01) in women with PCOS (5.6 +/- 2.6 microg/mL) compared with controls (8.5 +/- 3.9 microg/mL). There was a significant negative correlation between adiponectin levels and fasting insulin levels (r = -0.40, P = .02), insulin AUC during OGTT (r = -0.47, P = .008), fasting glucose levels (r = -0.45, P = .01), and glucose AUC during OGTT (r = -0.51, P = .003). There was no correlation between BMI and serum adiponectin (r = -0.12, P = .508) in women with PCOS, while there was a negative correlation (r = -0.746, P = .013) in controls. There was a significant (P <.01) increase in adiponectin levels when treated with rosiglitazone, despite unchanged BMI. CONCLUSION: These results indicate that in women with PCOS and severe insulin resistance, insulin sensitivity appears to be the major determinant of adiponectin levels rather than adiposity. Low adiponectin levels may predict women with PCOS who are at high risk for developing type 2 diabetes.     

Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome

OBJECTIVE: To investigate the relation between intra-abdominal fat distribution and metabolic disorders in nonobese patients with the polycystic ovary syndrome (PCOS). DESIGN: Prospective case-control study. SETTING: University-based hospital. PATIENT(S): Thirty nonobese patients with PCOS and 30 lean women with regular menstrual cycles (controls). All participants had a body mass index < 25kg/m(2). MAIN OUTCOME MEASURES: Subcutaneous and intra-abdominal visceral and preperitoneal fat thicknesses were assessed by ultrasonography. Glucose tolerance and insulin sensitivity were evaluated by standard 75-g oral glucose tolerance test and area-under-the-curve analysis. Serum hormones and lipid profile were measured. RESULT(S): The mean preperitoneal and visceral fat thicknesses were significantly greater in nonobese patients with PCOS. Subcutaneous fat mass was similar between the PCOS and control groups. Nonobese patients with PCOS had glucose intolerance, hyperinsulinemia, and dyslipidemia, manifested by high serum levels of triglyceride, total cholesterol, and high-density lipoprotein (HDL) levels and low serum low-density lipoprotein (LDL) levels. No correlation existed between subcutaneous fat thickness and the metabolic variables in nonobese patients with PCOS. However, serum triglyceride levels correlated with visceral fat and preperitoneal fat thickness. The mean HDL level correlated negatively with visceral fat and preperitoneal fat thickness. The area under the curve for insulin and mean fasting insulin levels correlated positively with visceral fat thickness. In multiple regression analysis, visceral fat thickness contributed significantly to high serum triglyceride and fasting insulin levels. CONCLUSION(S): Intra-abdominal preperitoneal and visceral fat accumulation may contribute to the development of glucose and lipid metabolism disorders in nonobese patients with PCOS.     

Glucose intolerance in Japanese patients with polycystic ovary syndrome

Background Hyperinsulinemia, which is related to obesity, played a pathogenic role in polycystic ovary syndrome (PCOS). However, the incidence of obesity in Japanese women with PCOS is different from that reported in patients with PCOS in Europe and USA. We should determine if insulin resistance occurs in Japanese PCOS. The purpose of this study is to assess the presence of insulin resistance in Japanese PCOS, while also considering obesity as a factor. Methods We divided the patients with polycystic ovary (PCO) into three groups based on body mass index and levels of gonadotropin. Nine obese PCOS, 34 normal body-weighted PCOS (luteinizing hormone (LH)/follicle stimulating hormone (FSH) >1.0) and 11 normal LH (LH/FSH ≤ 1.0), normal body-weighted PCO were studied. We compared those patients to 16 control subjects with normal ovulation or with hypothalamic anovulation. Eleven women in the control were normal body-weighted and five were obese. Patients were given an oral glucose tolerance test. Testosterone, plasma glucose and serum immunoreactive insulin after oral administration of 75 g dextrose were studied. We also compared glucose-intolerance [total plasma glucose (ΣPG) and insulin (ΣIRI), insulinogenic index (I.I.), fasting plasma glucose/immunoreactive insulin (FPG/IRI), homeostasis model assessment of insulin resistance (HOMA-R)] and testosterone among these groups. Results There were no differences in ΣPG, ΣIRI, I.I., FPG/IRI or HOMA-R between PCOS and controls. However, there were significant differences in ΣPG, ΣIRI, FPG/IRI and HOMA-R between obese and normal body-weighted patients. Similarly, there were no differences in ΣPG, ΣIRI, I.I., FPG/IRI or HOMA-R between PCOS and controls in the normal body-weighted group. However, there were significant differences in ΣPG, ΣIRI, FPG/IRI and HOMA-R between the obese and the normal body-weighted PCOS. There were also significant differences in ΣPG and I.I. between LH-dominant, normal body-weighted PCOS and normal LH PCO. Conclusion Japanese PCOS might have insulin-resistance but the factor of obesity had a stronger effect on insulin-resistance than did the existence of PCOS. The possibility of a different type of glucose-intolerance was suggested in the patients with ultrasonographical PCO in whom gonadotropin secretion was abnormal.     

Serum leptin levels in patients with polycystic ovary syndrome

OBJECTIVE: To determine whether polycystic ovary syndrome (PCOS) is related to leptin dysregulation. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology in a university hospital. PATIENT(S): Fifty patients with PCOS (33 nonobese and 17 obese) and 32 control women (19 nonobese and 13 obese) were included in the study. INTERVENTION(S): Serum leptin levels were measured in patients with PCOS and the controls. Correlations between leptin levels and serum hormone levels (FSH, LH, free testosterone, androstenedione, DHEA-S and fasting insulin) were studied. MAIN OUTCOME MEASURE(S): Serum leptin levels and correlations between leptin levels and the hormonal parameters. RESULT(S): Mean serum leptin levels were not significantly higher in patients with PCOS compared to the control group. Leptin levels were found to be significantly higher in the obese subgroups both in patients with PCOS and in the control women. Leptin levels were found to be higher in obese patients with PCOS compared to obese controls; however, when the levels were evaluated again with covariance analysis excluding body mass index, there was no statistically significant difference. Leptin levels had a positive correlation with body mass index, both in patients with PCOS and the controls. CONCLUSION(S): Leptin levels were not higher in patients with PCOS compared to the control group; the leptin level was correlated with the amount of fat tissue not only in patients with PCOS but also in healthy women.     

Hyperinsulinemia does not influence androgens/estrogens ratio in patients with polycystic ovarian syndrome

OBJECTIVE: The ratio of androgens to estrogens in patients with polycystic ovarian syndrome (PCOS) and controls was evaluated in order to investigate whether hyperinsulinemia might induce hyperandrogenemia by decreasing androgen catabolism. STUDY DESIGN: Forty women were divided into four groups according to the presence of PCOS, insulin resistance, and normal or abnormal body mass index (BMI); each group consisted of 10 women. Group I comprised patients with PCOS, insulin resistance, and abnormal BMI. Group II consisted of patients with PCOS, without insulin resistance, and with normal BMI. Group III consisted of healthy women (controls) with abnormal BMI. Group IV consisted of healthy women with normal BMI. RESULTS: We found that: (1) the mean fasting insulin levels of groups II, III, and IV were significantly lower than those of group I (P < .001); (2) serum testosterone levels were significantly lower in groups III and IV than in group I and II; (3) there were no significant differences in serum estradiol and estrone levels between women of all groups; (4) women of groups III and IV had significantly lower ratios of testosterone to estradiol at time 0 compared to patients of groups I and II. CONCLUSION: Our results support the view that since hyperinsulinemia induces hyperandrogenism, the increase of androgens should not be attributed to the decrease of androgen catabolism.     

Postprandial triglyceride response in patients with polycystic ovary syndrome: relationship with waist-to-hip ratio and insulin

Objective: To examine the postprandial triglyceride response to a high-fat meal in women with polycystic ovary syndrome (PCOS) compared with a matched control group.

Design: Controlled clinical study.

Setting: Department of Endocrinology and Pathophysiology, School of Medicine, Universidad de Los Andes.

Patient(s): 18 Hispanic women with PCOS (nine overweight and nine nonobese) and 9 healthy control women.

Intervention(s): Biometric measures and blood sample collection.

Main Outcome Measure(s): Insulin and glucose levels during a standard oral glucose tolerance test. Plasma triglyceride, cholesterol, and high-density lipoprotein cholesterol levels were measured at baseline and at 4, 5, and 6 h after a high-fat meal.

Result(s): Both obese and nonobese PCOS women had higher waist-to-hip ratios than controls. PCOS women had higher levels of fasting and postglucose insulin and fasting triglyceride and postprandial triglyceride response and had lower levels of postprandial high-density lipoprotein cholesterol response, but no significant differences within PCOS groups were observed.

Conclusion(s): An expanded postprandial hypertriglyceridemia in PCOS women is related to a higher waist-to-hip ratio and insulin resistance, regardless of obesity, and contributes to increase the risk for coronary artery disease.     

Is serum leptin level regulated by thyroid functions, lipid metabolism and insulin resistance in polycystic ovary syndrome?

Our aim was to determine whether serum leptin level is regulated by thyroid hormones, lipid metabolic products and insulin resistance status in women with polycystic ovary syndrome (PCOS). A prospective case-controlled study was carried out in Istanbul University, Cerrahpasa School of Medicine in 25 lean PCOS (L-PCOS) women, 19 obese PCOS (O-PCOS) women and 28 normal women. The diagnosis of PCOS was established according to the clinical, hormonal (elevated luteinizing hormone and serum androgens) and ultrasonographic findings. Fasting serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), fasting glucose, insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C) and leptin were measured and compared in the three groups and the correlations between serum levels of leptin and other parameters were evaluated. Serum leptin levels were higher in the O-PCOS group, while its level was comparable between the L-PCOS and control groups. Serum levels of FT4 were significantly lower in both L-PCOS and O-PCOS groups than the control group. Women in both L-PCOS and O-PCOS groups were found to be significantly hyperinsulinemic and insulin resistant. Serum levels of TC, VLDL-C and TG were significantly higher in the O-PCOS group, while serum HDL-C level was lower. There was a poor correlation between serum leptin, and FT4, TC, TG, HDL-C and VLDL-C levels. A significant correlation was observed between serum leptin levels and both BMI and insulin resistance status in PCOS. We believe that, although thyroid hormones and lipid metabolic products do not seem to participate in the regulation of serum leptin levels, BMI and insulin resistance status may have a key role in women with PCOS.     

Different phenotypes of polycystic ovary syndrome in Turkish women: clinical and endocrine characteristics

Abstract

This study presents the differences in clinical, endocrine and metabolic parameters among different polycystic ovary syndrome (PCOS) phenotypes in Turkish women. Four hundred and ten women with PCOS were evaluated, while 97 healthy women served as controls. PCOS were defined by oligo-anovulation (OA), hyperandrogenism (HA) and polycystic ovaries on ultrasound (PCO). Patients were subdivided into four phenotypes: OA?+?HA?+?PCO (phenotype 1), OA?+?HA (phenotype 2), HA?+?PCO (phenotype 3), OA?+?PCO (phenotype 4). Phenotypes 1–4 were present in 47.1%, 13.2%, 21.2% and 18.5% of patients, respectively. They were also divided into three groups according to the BMI (<25?kg/m²; 25≤ and ≤30?kg/m²; and >30?kg/m²). ANOVA and Tukey post-hoc HSD tests were used. The LH levels and LH/FSH ratio were higher in phenotype 1 and 2 than phenotype 3. The LDL-C levels were higher in women with phenotype 1 and 4 than in women with phenotype 2. Women with BMI <25?kg/m² had higher levels of LH, LH/FSH ratio, and the HDL-C than other two groups. The levels of TG, LDL, fasting insulin and HOMA-IR increased with increasing BMI in four phenotypes. Results suggest that obesity seems to be the primary cause of metabolic disturbances in PCOS women.