Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome

Abstract

Background: Polycystic ovary syndrome (PCOS) represents a moving spectrum of hormonal to metabolic abnormalities, as women with the syndrome are aging. Hormonal abnormalities, anovulation, and hyperandrogenic signs were predominant during the early years of PCOS and fade away with the years. Metabolic abnormalities and insulin resistance (IR) remain throughout the PCOS life cycle; however, it is unclear as to how they change, as women with the syndrome are aging. Objective: To evaluate the changes in IR and its associations with clinical, biochemical, hormonal, and ultrasound findings in a large cohort of women with PCOS and controls, as they are aging. Design: A cross-sectional study was carried out to evaluate the diverse impacts of aging on IR. Setting: An outpatient clinic was chosen for the study. Participants: A total of 1345 women with PCOS (Rotterdam criteria) and 302 controls of Caucasian origin and Greek ethnicity comprised the study group. Main outcome and measures: The impact of age on IR, as calculated using homeostasis model assessment of IR (HOMA-IR) index, and several PCOS characteristics were evaluated. Results: In PCOS, age (K0.045G0.008) was negatively, and BMI positively (0.18G0.007) associated with HOMA-IR (R 2 Z0.36).

Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

“…(Boudreaux et al, 2006;Espinos-Gomez et al, 2009;Gambineri et al, 2012). Normal weight women with PCOS have been reported to be insulin resistant (Stepto et al, 2013), but it has also been reported that insulin resistance ameliorates during aging in non-obese women with PCOS, possibly due to decreasing androgen levels (Livadas et al, 2014). We do, however, acknowledge that the numbers of subjects with disturbances of glucose homoeostasis in this subgroup of PCOS women was relatively small.…”

Matrix metalloproteinases 2 and 9 and MMP9/NGAL complex activity in women with PCOS

“…We have also showed that circulatory concentrations of TC, TAG, HDL-C, LDL-C, E 2 , SHBG, insulin and HOMA-IR index did not differ between healthy subjects and women with PCOS. It is plausible that age and BMI are the main players in determining the aforementioned biochemical and hormonal features; therefore, differences in the mean age or BMI of patients (in different studies) may lead to inconsistent results, as seen for insulin resistance which is higher in overweight and obese women than in lean individuals (Livadas et al 2014, Moran et al 2015.…”

A Study of Association of Sex Hormones With Insulin Resistance and Obesity for Diabetes Mellitus Risk in Adult Women

“…The mean age and serum testosterone of Sarantis Livadas et al study was 32.21 ± 14.40 and 1.36 ± 0.47 nmol/L respectively. (5) Hypoandrogenaemia in men and hyperandrogenaemia in women are associated with increased risk of CAD, but also with visceral obesity, IR, low HDL-C and elevated TG and LDL-C. (17) High testosterone levels are associated with higher risk of type 2 diabetes in women, but with lower risk in men. (18) Therefore, at physiological levels, T and E2 are thought to be involved in maintaining normal insulin sensitivity.…”

“…(2) In a normal population also the aging process is associated with a gradual increase in obesity, IR and β-cell decompensation leading to DM development. (5) Few studies have prospectively examined endogenous sex hormones as predictors of type 2 diabetes in women. (6) Therefore, the relationship of sex hormones producing metabolic and endocrine imbalances associated with lipid profile and IR will contribute to more awareness in terms of sex-and genderspecific risk factors.…”