Differences in low-grade chronic inflammation and insulin resistance in women with previous gestational diabetes mellitus and women with polycystic ovary syndrome.
BACKGROUND
Polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) are both characterized by an increase in insulin resistance. Our goal in the present study was to measure insulin resistance (as estimated by homeostasis model assessment, sex hormone-binding globulin (SHBG) and adiponectin concentrations) and parameters of low-grade inflammation in non-diabetic, non-hyperandrogenic ovulatory women with previous GDM (pGDM) and in non-diabetic women with classic PCOS, characterized by hyperandrogenism and oligo/anovulation.


METHODS
We evaluated 20 women with PCOS, 18 women with pGDM and 19 controls, all matched according to body mass index (BMI). Fasting blood samples were drawn in all women 3-6 days after spontaneous or dydrogesterone-induced withdrawal bleeding. Body fat distribution was assessed using dual-energy X-ray absorptiometry in all women.


RESULTS
After adjusting for age and percent body fat, measures of insulin resistance such as SHBG and adiponectin concentrations were decreased and central obesity was increased in women with PCOS and pGDM compared with controls (all p < 0.05). Parameters of low-grade inflammation such as serum tumor necrosis factor-alpha and highly sensitive C-reactive protein concentrations, white blood cell and neutrophil count were increased only in women with PCOS compared with BMI-matched controls (all p < 0.05).


CONCLUSIONS
Certain markers of insulin resistance are increased in both women with PCOS and women with pGDM, while low-grade inflammation is increased only in PCOS. PCOS and GDM might represent specific phenotypes of one disease entity with an increased risk of cardiovascular disease, whereby women with PCOS demonstrate an augmented cardiovascular risk profile.
Thomann
Robert
R
Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel, Basel, Switzerland.
Rossinelli
Nadia
N
Keller
Ulrich
U
Tirri
Brigitte Frey
BF
De Geyter
Christian
C
Ruiz
Juan
J
Kränzlin
Marius
M
Puder
Jardena J
JJ
D000328:Adult; D050218:Body Fat Distribution; D016022:Case-Control Studies; D002908:Chronic Disease; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000453:epidemiology*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D017584:Reproductive History; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D008055:Lipids; D012738:Sex Hormone-Binding Globulin; D014409:Tumor Necrosis Factor-alpha