Insulin sensitivity in women with polycystic ovary syndrome: relationship to hyperandrogenemia.
OBJECTIVE
To evaluate the extent of decreased insulin sensitivity in relation to body mass index and its relationship to serum androgens in women with polycystic ovarian syndrome (PCOS).


METHODS
Comparative study of endogenous glucose disposal and serum insulin responses to oral glucose load with endocrine parameters in PCOS.


METHODS
Fertility and Endocrine Clinics, North Staffordshire Hospital Centre.


METHODS
Forty-nine obese and 16 nonobese women with PCOS were compared with 18 obese and 16 nonobese control women with regular ovulatory cycles and no features of PCOS.


METHODS
Basal concentrations of serum LH, FSH, T, androstenedione, sex hormone-binding globulin (SHBG), and free T index. Measurements of insulin sensitivity by rate of endogenous glucose disposal after i.v. bolus injection of insulin and glucose mediated insulin responses.


RESULTS
Obese women with PCOS showed decreased insulin sensitivity and hyperinsulinemia to an extent greater than can be explained by obesity alone. Serum insulin showed inverse correlation with SHBG, and therefore hyperinsulinemia increased the bioavailability of androgens in obese PCOS. In nonobese PCOS, this method of assessment failed to reveal insulin resistance.


CONCLUSIONS
Hyperandrogenemia and insulin resistance are independent features of PCOS. Hyperinsulinemia enhances expression of hyperandrogenemia by increasing bioavailability of androgens.
Rajkhowa
M
M
Department of Medicine, School of Postgraduate Medicine, Keele University, Stoke-on-Trent, United Kingdom.
Bicknell
J
J
Jones
M
M
Clayton
R N
RN
D019326:17-alpha-Hydroxyprogesterone; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D009765:Obesity / Q000097:blood / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000503:physiopathology*; D011374:Progesterone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
D000728:Androgens; D001786:Blood Glucose; D006908:Hydroxyprogesterones; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D011374:Progesterone; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone