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Ciampelli M; Fulghesu AM; Murgia F; Guido M; Cucinelli F; Apa R; Caruso A; Lanzone A 《Human reproduction (Oxford, England)》1998,13(4):847-851
In order to evaluate the acute insulin response after i.v. injection of
glucagon in polycystic ovary syndrome (PCOS), 35 women affected by PCOS and
11 normo-ovulatory controls underwent a 75 g oral glucose tolerance test
(OGTT) and, 2 days later, a glucagon test (1 mg i.v.). Patients were
analysed according to their degree of obesity; the insulin release after
glucagon injection for lean PCOS subjects and control women was not
statistically significantly different. Conversely obese PCOS patients had
higher insulin secretion after both i.v. glucagon and OGTT when compared to
the other groups. Moreover the insulin secretory patterns were
heterogeneously represented in lean and obese PCOS women. When the patients
were analysed according to their insulinaemic response to OGTT,
normoinsulinaemic PCOS women and control subjects had a similar insulin
response to i.v. glucagon whereas the hyperinsulinaemic PCOS group had a
higher insulin response (P < 0.0001). Moreover, a highly significant
relationship was found between the insulin response to OGTT and to glucagon
administration in the PCOS population (P < 0.0001; r = 0.73), which was
maintained also after controlling for obesity. Our results are consistent
with the hypothesis that PCOS patients could have an insulin hyper-response
to glucagon administration, that is partially independent from obesity and
related to their insulinaemic status. Moreover, the glucagon test could
represent an effective alternative to OGTT in screening insulin disorders
of PCOS patients (at least in the absence of other risk factors), due to
its reliability, simplicity, and speed of performance.
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M Ciampelli G Muzj F Leoni D Romualdi C Belosi R M Cento A Lanzone 《The Journal of clinical endocrinology and metabolism》2001,86(11):5324-5329
To evaluate the effects of acute lowering of FFAs on glucose-induced insulin secretion and GH response to GHRH in polycystic ovary syndrome (PCOS), 27 PCOS subjects (11 lean and 16 obese) and 17 body mass index-matched controls (8 lean and 9 obese) were investigated. Patients underwent an oral glucose tolerance test and a GHRH test before and after administration of the antilipolytic drug acipimox (250 mg orally 3 h and 1 h before the starting of the tests). Blood samples were collected for 2 h after GHRH bolus and for 4 h after the oral glucose tolerance test. Serum concentrations of GH, insulin, glucose, and c-peptide were assayed in each sample, and the results were expressed as area under the curve (AUC). No significant differences were found as to glucose, insulin, and c-peptide AUC before and after acute FFA plasma reduction in any of the investigated groups. Basally, lower GH-AUC was found in lean PCOS compared with body mass index-matched controls and in obese vs. lean controls; no significant differences were found as to the same variable between the two obese groups. The acipimox induced FFA suppression elicited in the four groups a sustained increase in the GH response to its trophic hormone; indeed, the GH-AUC nearly doubled with respect to basal evaluation in all the studied groups. However, the antilipolytic drug was not able to abolish the differences found between lean groups in basal conditions. In conclusion, the presented data confirm that FFAs have a main role in regulating GH secretion at the pituitary level; however, it does not seem that they could explain the GH as well as insulin dysfunction of PCOS. 相似文献