International Journal of
Reproductive Biomedicine
Wed, Apr 24, 2024
[Archive]
Volume 14, Issue 4 (4-2016)
IJRM 2016, 14(4): 263-270 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Layegh P, Mousavi Z, Farrokh Tehrani D, Parizadeh S M R, Khajedaluee M. Insulin resistance and endocrine-metabolic abnormalities in polycystic ovarian syndrome: Comparison between obese and non-obese PCOS patients. IJRM 2016; 14 (4) :263-270
URL: http://ijrm.ir/article-1-743-en.html
URL: http://ijrm.ir/article-1-743-en.html
Parvin Layegh1 
, Zohreh Mousavi * 2, Donya Farrokh Tehrani3 , Seyed Mohammad Reza Parizadeh4 , Mohammad Khajedaluee5
, Zohreh Mousavi * 2, Donya Farrokh Tehrani3 , Seyed Mohammad Reza Parizadeh4 , Mohammad Khajedaluee5
1- Endocrine Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Endocrine Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran , MosaviZ@mums.ac.ir
3- Vascular and Endovascular Research Center, Imam Reza Hospital Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4- Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5- Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Endocrine Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran , MosaviZ@mums.ac.ir
3- Vascular and Endovascular Research Center, Imam Reza Hospital Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4- Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5- Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract: (2874 Views)
Background: Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome (PCOS). Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients.
Objective: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women.
Materials and Methods: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese (BMI ≥25) and 45 patients were non-obese (BMI <25). Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant.
Results: There was no significant difference in presence of insulin resistance (HOMA-IR >2.3) between two groups (p=0.357). Waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic (p<0.001) and diastolic (p<0.001) blood pressures, fasting blood sugar (p=0.003) and insulin (p=0.011), HOMA-IR (p=0.004), total cholesterol (p=0.001) and triglyceride (p<0.001) were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone (p=0.634) and androstenedione (p=0.736) between groups whereas Dehydroepiandrotendione sulfate (DHEAS) was significantly higher in non-obese PCOS women (p=0.018). There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively.
Conclusion: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients.
Objective: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women.
Materials and Methods: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese (BMI ≥25) and 45 patients were non-obese (BMI <25). Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant.
Results: There was no significant difference in presence of insulin resistance (HOMA-IR >2.3) between two groups (p=0.357). Waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic (p<0.001) and diastolic (p<0.001) blood pressures, fasting blood sugar (p=0.003) and insulin (p=0.011), HOMA-IR (p=0.004), total cholesterol (p=0.001) and triglyceride (p<0.001) were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone (p=0.634) and androstenedione (p=0.736) between groups whereas Dehydroepiandrotendione sulfate (DHEAS) was significantly higher in non-obese PCOS women (p=0.018). There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively.
Conclusion: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients.
Type of Study: Original Article |
References
1. Leo V, Marca A, Petraglia F. Insulin-lowering agents in the management of polycystic ovary syndrome. Endocrine Rev 2003 ; 24: 633-667. [DOI:10.1210/er.2002-0015]
2. Morales AJ, Laughlin GA, Butzow T, Matteshwari H, Baumann G, Yen SSC. Insulin, somatotropic and luteinizing hormone axes in lean and obese women with polycystic ovary syndrome: Common and distinct features. J Clin Endocrinol Metab 1996; 81: 2854-2864.
3. Ovesen P, Moller J, Ingerslev HJ, Jorgensen JOL, Mengel A, Schmitz O, et al. Normal basal and insulin -stimulated fuel metabolism in lean women with the polycystic ovary syndrome. J Clin Endocrinol Metab 1993; 77: 1636-1640.
4. Holte J, Bergh T, Berne C, Berglund L, Lithell H. Enhanced insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose tolerance. J Clin Endocrinol Metab 1994; 78: 1052-1055.
5. Morin-Papunen LC, Vauhkonen I, Koivunen RM, Ruokonen A, Tapanainen JS. Insulin sensitivity , insulin secretion, and metabolic and hormonal parameters in healthy women and women with polycystic ovarian syndrome. Hum Reprod 2000; 15: 1266-1274. [DOI:10.1093/humrep/15.6.1266]
6. Dunaif A, Segal KR, Futterweit W, Dobrjansk A. Profound peripheral insulin resistance , independent of obesity in polycystic ovary syndrome. Diabetes 1989; 38: 1165-1174. [DOI:10.2337/diab.38.9.1165]
7. Chang RJ, Nakamura RM, Judd HL, Kaplan SA. Insulin resistance in non-obese patients with polycystic ovarian disease. J Clin Endocrinol Metab 1983; 57: 356-359. [DOI:10.1210/jcem-57-2-356]
8. Morales AJ, Laughlin GA, Butzow T, Maheshwari H, Baumann G, Yen SSC. Insulin, somatotropic and luteinizing hormone axes in lean and obese women with polycystic ovary syndrome : common distinct features. J Clin Endocrinol Metab 1996; 81: 2854-2859.
9. Fauser BC. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19: 41-47. [DOI:10.1093/humrep/deh098]
10. Hosseinpanah F, Barzin M, Keihani S,Ramezani Tehrani F, Azizi F. Metabolic aspects of different phenotypesof polycystic ovary syndrome : Iranian PCOS prevalence study. Clin Endocrinol 2014; 81: 93-99. [DOI:10.1111/cen.12406]
11. Baldani DP, Skrgatić L, Goldstajn MS, Vrcić H, Canić T, Strelec M. Clinical, hormonal and metabolic characteristics of polycystic ovary syndrome among obese and nonobese women in the Croatian population. Coll Antropol 2013; 37: 465-470.
12. Li L, Chen X, He Z, Zhao X, Huang L, Yang D. Clinical and metabolic features of polycystic ovary syndrome among Chinese adolescents. J Pediatr Adolesc Gynecol 2012; 25: 390-395. [DOI:10.1016/j.jpag.2012.07.006]
13. Liou TH, Yang JH, Hsieh CH, Lee CY, Hsu CS, Hsu MI. Clinical and biochemical presentations of polycystic ovary syndrome among obese and nonobese women. Fertil Steril 2009; 92: 1960- 1965. [DOI:10.1016/j.fertnstert.2008.09.003]
14. Siddiqui IA1, Tamimi W, Tamim H, Aleisa N, Adham MA. Study on clinical and sonographic features in obese and nonobese patients with polycystic ovary syndrome. Arch Gynecol Obstet 2010; 281: 467- 471 [DOI:10.1007/s00404-009-1124-y]
15. Silfen ME, Denburg MR, Manibo AM, Lobo RA, Jaffe R, Ferin M, et al. Early endocrine, metabolic, and sonographic characteristics of polycystic ovary syndrome (PCOS): comparison between nonobese and obese adolescents. J Clin Endocrinol Metab 2003; 88: 4682-4688. [DOI:10.1210/jc.2003-030617]
16. Alpa-és M, Luque-Ramírez M, Martínez-García MÁ, Fernández-Durán E, Álvarez-Blasco F, Escobar-Morreale HF. Influence of adrenal hyperandrogenism on the clinical and metabolic phenotype of women with polycystic ovary syndrome. Fertil Steril 2015; 103: 795-801. [DOI:10.1016/j.fertnstert.2014.12.105]
17. Holte J, Bergh T, Berne C, Lithell H. Serum lipoprotein lipid profile in women with the polycystic ovary syndrome: relation to anthropometric, endocrine and metabolic variables. Clin Endocrinol 1994; 41: 463-471 [DOI:10.1111/j.1365-2265.1994.tb02577.x]
18. Singh KB, Mahajan D K, Wortsman J. Effect of obesity on the clinical and hormonal characteristics of the polycystic ovary syndrome. J Reprod Med 1994; 39: 805-808.
19. Dos Reis RM, Foss MS, Dias de Moura M, Ferriani RA, Silva de Sa MF. Insulin secretion in obese and non-obese women with polycystic ovary syndrome and its relationship with hyperandrogenism. Gynecol Endocrinol 1995; 9: 45-50. [DOI:10.3109/09513599509160190]
20. Moran C, Herrera J, Renteria JL, Moran S,Herrera J, Gonzalez S, Bermudez JA. Obesity differentially affects serum levels of androstenedione and testosterone in polycystic ovary syndrome. Fertil Steril 2008; 90: 2310-2317. [DOI:10.1016/j.fertnstert.2007.09.016]
21. Wehr E, Moller R, Horejsi R, Giuliani A, Kopera D, Schweighofer N, et al. Subcutaneous adipos e tissue topography and metabolic disturbances in polycystic ovary syndrome. Wien Klin Wochenschr 2009; 121:262-269. [DOI:10.1007/s00508-009-1162-2]
22. Carmine E. Ovaria n and adrenal hyperandrogenism. Ann NY Acad Sci 2006; 1092:130-137. [DOI:10.1196/annals.1365.011]
23. Carmina E, Lobo RA. Prevalence and metabolic characteristics of adrenal androgen excess in hyperandrogenic women with different phenotypes. J Endocrinol Invest 2007; 30: 1-6. [DOI:10.1007/BF03347408]
24. Moran C, Arriaga M, Arechavaleta-Velasco F, Moran S. Adrenal androgen excess and body mass index in polycystic ovary syndrome. J Clin Endocrinol Metab 2015; 100: 942-950. [DOI:10.1210/jc.2014-2569]
25. Moran C, Knoch enhauer E, Boots LR, Azziz R. Adrenal androgen excess in hyperandrogenism: relation to age and body mass. Fertil Steril 1999; 71: 671-674. [DOI:10.1016/S0015-0282(98)00536-6]
26. Brennan K, Huang A, Azziz R. Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome. Fertil Steril 2009; 91: 1848-1852. [DOI:10.1016/j.fertnstert.2008.02.101]
27. Coleman DL, Leiter EH, Schwizer RW. Therapeutic effects of dehydroepiandrosterone (DHEA) in diabetic mice. Diabetes 1982; 31: 830-833. [DOI:10.2337/diab.31.9.830]
28. Mottl R, Cerman J. A relationship between dehydroepiandrosterone sulfate and insulin resistance in obese men and women. Vnitr Lek 2004; 50: 923-929.
29. Chen MJ, Chen CD, Yang JH, Chen CL, Ho HN, Yang WS, et al. High serum dehydroepiandro sterone sulf ate is associated with phenot ypic acne and a reduced risk of abdominal obesity in women with polycystic ovary syndrome. Hum Reprod 2011; 26: 227-234. [DOI:10.1093/humrep/deq308]
30. Lerchbaum E, Schwetz V, Obermayer-Pietsch B,Giuliani A, Pieber TR. Opposing effects of dehydroepiandrosterone sulfate and free testosterone on metabolic phenotype in women with polycystic ovary syndrome. Fertil Steril 2012; 98:1318-1325. [DOI:10.1016/j.fertnstert.2012.07.1057]
31. Orentreich N, Brind HL, Rixer RL, Vogelman JH. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab 1984;59: 551-555. [DOI:10.1210/jcem-59-3-551]
32. Fink RI, Kolterman OG, Griffin J, Olefsky JM. Mechanism of insulin resistance in aging. J Clin Invest 1983; 71: 1523-1535. [DOI:10.1172/JCI110908]
33. Rowe JW, Minaker KL, Pallotta HA, Flier JS. Characterization of the insulin resistance in aging. J Clin Invest 1983; 71: 1581-1587. [DOI:10.1172/JCI110914]
34. Paolisso G, Ammendola S, Rotandi M, Gambardella A, Rizzo MR, Mazziotti G, et al. Insulin resistance and advancing age: what role for dehydroepiandrosterone sulfate? Metabolism 1997; 46: 1281-1286. [DOI:10.1016/S0026-0495(97)90231-6]
35. Gambarin-Gelwan M, Kinkhabwala SV, Schiano TD, Bodian C, Yeh HC, Futterweit W. Prevalence of nonalcoholic fatty liver disease in women with polycystic ovary syndrome. Clin Gastroenterol Hepatol 2007; 5: 496-501. [DOI:10.1016/j.cgh.2006.10.010]
36. Vassilatou E, Lafoyianni S, Vryonidou A, Ioannidis D, Kosma L, Katsoulis K, et al. Increased androgen bioavailability is associated with non-alcoholic fatty liver disease in women with polycystic ovary syndrome. Hum Reprod 2010; 25: 212-220. [DOI:10.1093/humrep/dep380]
37. Bohdanowicz-Pawlak A, Lenarcik-Kabza A, Brona A, Kuliczkowska-Płaksej J, Łaczmański Ł, Zaleska-Dorobisz U, et al. Non-alcoholic fatty liver disease in women with polycystic ovary syndrome- clinical and metabolic aspects and lipoprotein lipase gene polymorphism. Endokrynol Pol 2014; 65: 416-421. [DOI:10.5603/EP.2014.0058]
38. Dokras A, Bochner M, Hollinrake E, Markham S, Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005; 106: 131-137. [DOI:10.1097/01.AOG.0000167408.30893.6b]
39. Park HR, Choi Y, Lee HJ, Oh JY, Hong YS, Sung YA. The metabolic syndrome in young Korean women with polycystic ovary syndrome. Diabetes Res Clin Pract 2007; 77 (Suppl.): S243-246. [DOI:10.1016/j.diabres.2007.01.065]
40. Li X, Lin JF. Clinical features, hormonal profile, and metabolic abnormalities of obese women with obese polycystic ovary syndrome. Zhonghua Yi Xue Za Zhi 2005; 85: 3266-3271.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
