Ethnicity and polycystic ovary syndrome are associated with independent and additive decreases in insulin action in Caribbean-Hispanic women.
This study was conducted to determine the impact of polycystic ovary syndrome and ethnicity on insulin action. Thirteen Caribbean-Hispanic and 10 non-Hispanic white polycystic ovary syndrome women were compared with 5 Caribbean-Hispanic and 8 non-Hispanic white normal women matched for age, weight, and body composition. All subjects underwent a 2-h 75 g oral glucose tolerance test and euglycemic glucose clamp study with a 40 mU.m-2 x min-1 insulin dose. Hepatic glucose production was determined basally and throughout the euglycemic clamp study. Polycystic ovary syndrome was associated with significant increases in fasting insulin levels (P < 0.05) and in 2-h postglucose-load glucose and insulin levels (P < 0.001). Ethnicity was not associated with any changes in these parameters. Polycystic ovary syndrome but not ethnicity was also associated with hepatic insulin resistance, because significant (P < 0.05) residual hepatic glucose production occurred during the euglycemic clamp in the polycystic ovary syndrome women. However, significant independent effects existed for both polycystic ovary syndrome (P < 0.01) and ethnicity (P < 0.05) that resulted in decreased insulin-mediated glucose disposal. Similarly, significant independent effects of polycystic ovary syndrome (P < 0.005) and ethnicity (P < 0.05) occurred, resulting in increased steady-state insulin levels during the euglycemic clamp. This appeared to be, in part, secondary to a decrease in the metabolic clearance rate of insulin associated with ethnicity (P < 0.05). We conclude that polycystic ovary syndrome and ethnicity result in independent and additive decreases in insulin sensitivity in Caribbean-Hispanic women.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, Mt. Sinai School of Medicine, New York.
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Dunaif
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Sorbara
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Delson
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Green
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000735:Androstenedione / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D001835:Body Weight; D004293:Dominican Republic / Q000208:ethnology; D005260:Female; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000032:analysis; D008657:Metabolic Clearance Rate; D011085:Polycystic Ovary Syndrome / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D011647:Puerto Rico / Q000208:ethnology; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D014481:United States / Q000453:epidemiology
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione