Smoking is associated with increased free testosterone and fasting insulin levels in women with polycystic ovary syndrome, resulting in aggravated insulin resistance

Cupisti, S.; Häberle, Lothar; Dittrich, Ralf; Oppelt, Patricia G.; Reißmann, C.; Kronawitter, Desiree; Beckmann, Matthias W.; Mueller, Andreas

doi:10.1016/j.fertnstert.2009.03.062

Cited by 53 publications

(36 citation statements)

References 38 publications

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“…Furthermore, independent variables, such as smoking, which has been associated with increased insulin levels, and other as yet unidentified variables may play a role in IR. 32 In our study, we did not find any differences in insulin levels or IR related to smoking (data not shown). Differences in the incidence of IR in women with PCOS have been identified among various ethnic and racial groups.…”

Section: Discussionmentioning

confidence: 42%

Assessment of Insulin Resistance and Impaired Glucose Tolerance in Lean Women with Polycystic Ovary Syndrome

Stovall

Bailey

Pastore

2011

Journal of Women's Health

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Objective: To analyze insulin resistance (IR) and determine the need for a 2-hour oral glucose tolerance test (OGTT) for the identification of IR and impaired glucose tolerance (IGT) in lean nondiabetic women with polycystic ovary syndrome (PCOS). Methods: This was a cross-sectional analysis of treatment-naive women with PCOS who enrolled in a universitybased clinical trial. Nondiabetic women with PCOS based on the Eunice Kennedy Shriven National Institute of Child Health and Human Development (NICHD) definition, aged 18-43 years and weighing 113 kg, were evaluated. Glucose and insulin levels were assessed at times 0, 30, 60, 90, and 120 minutes after a 75-g glucose load. Lean was defined as body mass index (BMI) <25 kg=m 2 . Multiple linear regression was performed. Results: A cohort of 78 women was studied. The prevalence of IR was 0% among lean women vs. 21% among nonlean subjects based on fasting insulin I 0 and 40%-68% based on two different homeostatic model assessment (HOMA) cutoff points ( p < 0.005). All women with IR had a BMI ! 28. Controlling for age and race, BMI explained over 57% of the variation in insulin fasting (I o ), glucose fasting=Io (G o =I o ), the qualitative insulin sensitivity check index (QUICKI), and HOMA and was a highly significant predictor of these outcomes ( p < 0.0001). Only 1 of 31 (3%) of the lean PCOS women had IGT based on a 2-hour OGTT, and no lean subjects had IGT based on their fasting blood glucose. Conclusions: Diabetes mellitus, IGT, and IR are far less common in young lean women with PCOS compared with obese women with PCOS. These data imply that it is unnecessary to routinely perform either IR testing or 2-hour OGTT in lean women with PCOS; however, greater subject accumulation is needed to determine if OGTT is necessary in lean women with PCOS. BMI is highly predictive of both insulin and glucose levels in women with PCOS.

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Section: Discussionmentioning

confidence: 42%

Assessment of Insulin Resistance and Impaired Glucose Tolerance in Lean Women with Polycystic Ovary Syndrome

Stovall

Bailey

Pastore

2011

Journal of Women's Health

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“…Lifestyle interventions are usually required for long term sustainable results. PCOS women who smoke have higher free androgen levels and IR as measured by HO MAIR, QUICKI and the insulin sensitivity index foll owing 75 g OGTT [104] . Thus PCOS women who smoke have an additional reason to stop smoking.…”

Section: Treatmentmentioning

confidence: 99%

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

Traub¹

2011

WJD

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Polycystic ovarian syndrome (PCOS) is a highly pre valent hormonal and metabolic disorder among repro ductive aged women worldwide. Women with PCOS have widely varying phenotypes and seek medical care for differing reasons. In addition to concern for men strual cycle function, ovulation, hirsutism and acne, many PCOS women have abnormal glucose metabolism. While diabetes mellitus and impaired glucose tolerance are easily diagnosed, the diagnosis of and concern for insulin resistance as a precursor disorder is under appreciated. Insulin resistance may be the first im portant marker of metabolic disease in PCOS women at risk for metabolic syndrome and coronary artery di sease.

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“…Research has shown that individuals with lower SES are more at risk for engaging in adverse health behaviors, including smoking, lack of physical activity, and poor nutritional diet 11,12 ; among women, obesity is associated with low SES. 13,14 Studies have also shown that smoking and obesity can exacerbate insulin resistance, 15 which is a condition highly correlated with and part of the pathogenesis of PCOS. 16 Moreover, there is clear evidence of an association between low SES and cardiovascular disease (CVD), [17][18][19][20] as well as the metabolic syndrome and its various components.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Status and Polycystic Ovary Syndrome

Merkin

Azziz

Seeman

et al. 2011

Journal of Women's Health

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Background: Polycystic ovary syndrome (PCOS) is a common metabolic-endocrine disorder in women and is associated with a number of metabolic morbidities. We examined the association of PCOS and its components with socioeconomic status (SES) over the life course to explore the role of the environment on the development of PCOS. Conclusions:Our results indicate that women who experienced low childhood SES are at increased risk of PCOS, but this risk is limited to those who have personally attained a high level of education. More research is needed to determine the childhood socioeconomic factors that might influence this risk and whether conditions associated with upward life mobility play a role or if this group of at-risk women is simply more likely to recall the symptoms that define PCOS.

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Smoking is associated with increased free testosterone and fasting insulin levels in women with polycystic ovary syndrome, resulting in aggravated insulin resistance

Cited by 53 publications

References 38 publications

Assessment of Insulin Resistance and Impaired Glucose Tolerance in Lean Women with Polycystic Ovary Syndrome

Assessment of Insulin Resistance and Impaired Glucose Tolerance in Lean Women with Polycystic Ovary Syndrome

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

Socioeconomic Status and Polycystic Ovary Syndrome

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