title: Serum insulin in clomiphene responders and nonresponders with polycystic ovarian disease.
abstract: OBJECTIVE
  To investigate insulin levels in women with polycystic ovarian disease (PCOD) who are responders or nonresponders to clomiphene citrate (CC).
  
  
  METHODS
  Open and prospective study.
  
  
  METHODS
  Outpatient infertility clinic of a third level medical institution.
  
  
  METHODS
  Ten healthy women (group 1) and 35 PCOD women classified as responders (group 2 n = 10) or nonresponders (group 3 n = 25) on the basis of serum progesterone > or = 19 nmol/L in response to CC repeatedly administered in doses up to 250 mg/day for five days; they were further subdivided if body mass index (BMI) was below (N) or above (H) mean + 3 SD of group 1.
  
  
  METHODS
  Blood samples were obtained in a 100-g, 2-hours oral glucose tolerance test (OGTT).
  
  
  METHODS
  Serum glucose, insulin, free testosterone (free-T), dehydroepiandrosterone sulphate (DHEA-S), and androstenedione (A) were determined in the samples OGTT and the areas under the curve (AUC) were calculated.
  
  
  RESULTS
  Group 3 had higher BMI, basal LH, and insulin and AUC insulin than groups 1 and 2; free-T was higher in groups 2 and 3 than in group 1, and basal PRL was higher in group 2 compared to groups 1 and 3. When BMI < or = 25.4 kg/m2 (mean + 1 SD of group 1) 77% of the PCOD cases responded (10 out of 13) whereas none with BMI > 25.4 responded to CC (n = 22) irrespectively of basal insulin concentration or AUC insulin.
  
  
  CONCLUSIONS
  Moderate to excessive overweight seems more frequently and closely associated to a negative CC response in women with PCOD than hyperinsulinemia.
authors.affiliation: Endocrine Department, Instituto Nacional de Perinatología, Mexico City, Mexico, D.F.
authors.forename: A
authors.initials: A
authors.lastname: Espinosa de los Monteros
authors.forename: J
authors.initials: J
authors.lastname: Ayala
authors.forename: L C
authors.initials: LC
authors.lastname: Sanabria
authors.forename: A
authors.initials: A
authors.lastname: Parra
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002996:Clomiphene / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005951:Glucose Tolerance Test; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D007328:Insulin / Q000097:blood*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications; D011446:Prospective Studies
chemical_list: D005300:Fertility Agents, Female; D007328:Insulin; D002996:Clomiphene