Hyperinsulinemia and uterine perfusion in patients with polycystic ovary syndrome.
OBJECTIVE
To determine whether hyperinsulinemia has a negative effect on uterine blood supply in patients with polycystic ovary syndrome (PCOS).


METHODS
Sixty-three patients with normal body mass index were included prospectively in the study: 48 had clinical and hormonal features of PCOS and 15 were normo-ovulatory. All patients underwent Doppler flow measurement of the uterine artery, and determination of serum concentrations of luteinizing hormone, follicle stimulating hormone, prolactin, estradiol, androgens, insulin and C-peptide during the early follicular phase of the menstrual cycle. The 48 PCOS-patients were divided into two groups according to the pulsatility index (PI) value of the uterine artery: Group 1, PI < 3; Group 2, PI >or= 3 and the groups were compared.


RESULTS
The mean PI of the uterine artery (3.01 +/- 1.0 vs. 1.93 +/- 0.3, respectively) and fasting levels of insulin (50.9 +/- 9.3 vs. 40.3 +/- 10.9) and C-peptide (366.9 +/- 118.4 vs. 243.6 +/- 120.3) of PCOS-patients were significantly higher than those of the control group. No correlation was found between insulinemia and C-peptide and PI of the uterine artery and no significant difference was found in insulin and C-peptide levels among the two groups of PCOS-affected patients. Only the serum level of dehydroepiandrosterone sulfate was significantly higher in Group 2, and a direct correlation was found between PI values of the uterine artery and DHEAS plasma levels.


CONCLUSIONS
Insulin and C-peptide do not seem to interfere with uterine perfusion in PCOS-affected patients.
Ajossa
S
S
Department of Obstetrics and Gynecology of the University of Cagliari, Cagliari, Italy. gineca.sajossa@tiscali.it
Guerriero
S
S
Paoletti
A M
AM
Orrù
M
M
Melis
G B
GB
D002096:C-Peptide / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology*; D010477:Perfusion; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D014599:Uterus / Q000098:blood supply*
D002096:C-Peptide