Evidence of subpopulations with different levels of insulin resistance in women with polycystic ovary syndrome

Vigil, Pilar; Contreras, P; Alvarado, Jorge L.; Godoy, A.J.; Salgado, Ana María Abad; Cortés, Manuel E.

doi:10.1093/humrep/dem302

Cited by 36 publications

(28 citation statements)

References 44 publications

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“…Improvement of hyperinsulinemia and hyperandrogenemia in PCOS women by treatment with insulin sensitizer metformin occurs through different mechanisms in obese and lean women (41), which again supports the notion that the pathogenic mechanism is different in these two groups. A recent study reported the presence of three subpopulations with distinct levels of insulin resistance in PCOS women with significantly different BMI (39). With our present data, it is not possible to identify such subpopulations.…”

Section: Discussioncontrasting

confidence: 77%

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Genetic variation in exon 17 of INSR is associated with insulin resistance and hyperandrogenemia among lean Indian women with polycystic ovary syndrome

Mukherjee

Shaikh

Khavale

et al. 2009

European Journal of Endocrinology

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Objective: Polycystic ovary syndrome (PCOS) is a multigenic disorder, and insulin resistance is one of its hallmark features. Polymorphisms in exon 17 of insulin receptor (INSR) gene are reported to be associated with PCOS. We investigated this association in Indian women and its putative relationship with PCOS associated traits, which has not been explored so far. Methods: In this case control study, the polymorphisms were investigated by direct sequencing in 180 women with PCOS and 144 age matched controls. Clinical, anthropometric, biochemical, and hormonal parameters were also estimated. Results: The silent C/T polymorphism at His1058 in exon 17 of INSR was found to be present in our study population. The polymorphic genotype (CTCTT) was significantly associated with PCOS in lean women (c 2 Z8.493, dfZ1, PZ0.004). It showed association with higher fasting insulin levels (PZ0.02), homeostasis model assessment of insulin resistance (PZ0.005), free androgen index (PZ0.03), and lower quantitative insulin sensitivity check index (PZ0.004) in lean PCOS women. No other novel or known polymorphism was identified in exon 17 in this cohort. Conclusions: The study shows significant association of C/T polymorphism at His1058 of INSR with PCOS in the lean rather than obese Indian women. Its association with indices of insulin resistance and hyperandrogenemia is also seen in the same group. The findings strengthen the concept that pathogenesis of PCOS is different in lean and obese women.

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Section: Discussioncontrasting

confidence: 77%

“…A similar Korean study had not found any such association (27). It is known that insulin resistance is present in PCOS women irrespective of obesity (38,39, Mukherjee unpublished observations). However, in the present study, an association of this polymorphism in INSR with PCOS only in lean women was observed.…”

Section: Discussionmentioning

confidence: 85%

Genetic variation in exon 17 of INSR is associated with insulin resistance and hyperandrogenemia among lean Indian women with polycystic ovary syndrome

Mukherjee

Shaikh

Khavale

et al. 2009

European Journal of Endocrinology

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“…We recommend the use of the euglycemic-hyperinsulinemic clamp, considered the gold standard in the assessment of insulin sensitivity (Greenfield et al 1981), or alternatively the insulin suppression test (Pei et al 1994), which is highly correlated (r = 0.93) with the euglycemichyperinsulinemic clamp (Greenfield et al 1981), and has proved useful even in the identification of women subpopulations regarding insulin sensitivity (Vigil et al 2007). In case of determining a deleterious effect on glycemic homeostasis, research should aim at identifying the underlying specific mechanisms altered at molecular, cellular, and physiological level.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Hormonal Contraceptives on Glycemic Regulation

Cortés

Alfaro²

2014

Linacre Q

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A number of side effects have been linked to the use of hormonal contraceptives, among others, alterations in glucose levels. Hence, the objective of this mini-review is to show the main effects of hormonal contraceptive intake on glycemic regulation. First, the most relevant studies on this topic are described, then the mechanisms that might be accountable for this glycemic regulation impairment as exerted by hormonal contraceptives are discussed. Finally, we briefly discuss the ethical responsibility of health professionals to inform about the potential risks on glycemic homeostasis regarding hormonal contraceptive intake.

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“…Obesity, insulin resistance, and consequent hyperinsulinemia are highly prevalent co-morbidities of PCOS and can impair ovulation (Pauli et al 2011). Elevated insulin levels are present in about half of these patients and are correlated to body mass index (BMI), but not all PCOS patients are insulin resistant (Vigil, Contreras et al 2007). High insulin levels further increase androgen production by stimulating ovarian theca cells to produce more androgens which lead to premature follicular atresia and even anovulation (Diamanti-Kandarakis 2006).…”

Section: Ovulatory Dysfunction and Underlying Health Disordersmentioning

confidence: 99%

Ovulation, A Sign of Health

Vigil

Lyon²,

Flores³

et al. 2017

Linacre Q

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The concept of the ovarian continuum can be understood as a process that occurs during a woman's lifetime and begins during intrauterine life with fertilization. Women start their reproductive years with approximately five hundred thousand follicles containing oocytes, of which only around five hundred will be released during ovulation. Ovulation has been recognized as an event linked with reproduction; however, recent evidence supports the role of ovulation as a sign of health. The use of biomarkers that help women recognize ovulation enables them to identify their health status. This knowledge helps medical healthcare providers in the prevention, diagnosis, and treatment of different pathologies related with endocrine disorders, gynecological abnormalities, autoimmune, genetic, and neoplastic diseases, as well as pregnancy-related issues. The knowledge of the ovarian continuum and the use of biomarkers to recognize ovulation should be considered a powerful tool for women and medical professionals. Summary:The ovarian continuum is a process that occurs during a woman's lifetime. It begins during intrauterine life with fertilization and ends with menopause. This process can be greatly affected by different conditions such as changes in hormonal levels and illnesses. Therefore, understanding and promoting the knowledge and use of biomarkers of ovulation in women is a key aspect to consider when evaluating their health status. The knowledge and education about the ovarian continuum should be taken into account as a powerful tool for women and medical professionals.

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Evidence of subpopulations with different levels of insulin resistance in women with polycystic ovary syndrome

Abstract: insulin sensitivity in our patients exhibited a discontinuous distribution, implying that PCOS is a heterogeneous disorder possessing subpopulations regarding IR.

Cited by 36 publications

References 44 publications

Genetic variation in exon 17 of INSR is associated with insulin resistance and hyperandrogenemia among lean Indian women with polycystic ovary syndrome

Genetic variation in exon 17 of INSR is associated with insulin resistance and hyperandrogenemia among lean Indian women with polycystic ovary syndrome

The Effects of Hormonal Contraceptives on Glycemic Regulation

Ovulation, A Sign of Health

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