Hyperinsulinism and insulin resistance in polycystic ovarian syndrome: A verification using oral glucose, i.v. glucose and tolbutamide

Abstract

Twenty-six female in-patients, aged 14-34 years, suffering from polycystic ovarian syndrome (PCOS) were investigated. Sixteen normal women, matched with patients for age and weight, were used as controls. Both glucose and insulin curves and areas, insulin/glucose area ratio [insulin resistance index (IA/GA)] were studied by oral glucose tolerance test (OGTT), i.v. glucose tolerance test (IVGTT) and tolbutamide test (TT). Plasma insulin and insulin area values of the patients were significantly higher than those of controls. Insulin/glucose area ratios were significantly higher in patients when compared to controls. A correlation was found in some patients (subgroup A) between insulin/glucose area ratio and urinary dehydroepiandrosterone output after the TT. The presence of hyperinsulinism and insulin resistance in our patients suffering from PCOS was confirmed even in the absence of obesity. A relationship between androgens and hyperinsulinism and insulin resistance may thus be confirmed in patients with PCOS.

Genetics of the polycystic ovary syndrome

“…In addition to its reproductive features, PCOS also has numerous metabolic consequences, including increased risk of obesity [3], insulin resistance (IR) [4], type 2 diabetes mellitus (T2DM) [5] and premature arteriosclerosis [6]. As such, the impact of this disorder is not just limited to reproductive age, but continues throughout life.…”

Hyporeninemic Hypoaldosteronism Presenting with Hypokalemia

“…To our knowledge, our subject is only the second case presenting with hypokalemia reported in the literature. A similar case has been described else where [3], The possible causes of hypokalemia in our patient may be: (a) decreased dietary K+ intake (because of vomiting with septicemia); (b) vomiting (this may cause hypokalemia -despite the low levels of aldoste rone -by two mechanism: first by external K+ loss, and second by increasing urinary K+ excretion); (c) hypom agnesemia (due to vomiting) [4], We found blood pH between 7.36 and 7.56. This finding probably reflected the sum of the effects of hypoaldosteronism and vomiting: although one would ex pect metabolic acidosis in this syndrome.…”

“…Acquired selective aldosterone deficiency in adult pa tients is a rare clinical entity, in which adrenal production of aldosterone is reduced without associated reduction in production of cortisol [1], Since the original case reported by Hudson et al [2], about 50 additional cases have been described, but there is no case coursing with hypokalemia (instead of hyperkalemia) except that in an Italian jour nal [3] and our case, who was recently detected in our hospital.…”

Evaluating compliance to a low glycaemic index (GI) diet in women with polycystic ovary syndrome (PCOS)

“…The clinical problems include infertility, oligomenorrhoea, obesity and hirsutism and longer term health risks include diabetes, endometrial cancer, and increased cardiovascular morbidity [6-9]. It is thought that insulin resistance is central to the pathophysiology of PCOS [10-12], which underpins the rationale for measures that improve insulin resistance such as dietary modification, exercise and the use of Metformin in the treatment of PCOS and prevention of the long term health risks.…”