title: Insulin-induced capillary recruitment is impaired in both lean and obese women with PCOS.
abstract: BACKGROUND
  Insulin resistance, i.e. impaired insulin-mediated glucose uptake (IMGU), is a major risk factor for type 2 diabetes in women with polycystic ovary syndrome (PCOS). Insulin-induced capillary recruitment (IICR) is considered a significant determinant of IMGU. We investigated whether IICR is a determinant IMGU in obese and lean women with and without PCOS.
  
  
  METHODS
  The study included 36 women with PCOS (20 lean, BMI 21.9 ± 2.3 kg/m(2) and 16 obese, BMI 35.9 ± 6.0 kg/m(2)) and 27 age-matched healthy controls (14 lean, BMI 22.2 ± 1.8 kg/m(2) and 13 obese, BMI 40.5 ± 7.0 kg/m(2)). IICR was evaluated by capillary microscopy during an isoglycemic-hyperinsulinemic clamp. IMGU was expressed as M/I value.
  
  
  RESULTS
  The M/I value was significantly lower in obese PCOS women compared with obese controls [0.5 (0.2-1.1) versus 0.8 (0.3-1.4) (mg kg(-1) min(-1) pmol l(-1)) × 100, P < 0.01], whereas the small difference between lean PCOS and lean control women was non-significant [1.5 (0.5-2.6) versus 1.7 (1.0-3.7) (mg kg(-1) min(-1) pmol l(-1)) × 100, P = 0.17]. Hyperinsulinemia increased capillary recruitment in lean controls (53.5 ± 20.3 versus 64.9 ± 27.4 n/mm(2), P < 0.05), but not in either PCOS group nor in obese controls. IICR and androgens were a determinant of M/I value only in lean women with or without PCOS.
  
  
  CONCLUSIONS
  PCOS per se is associated with impaired IICR. Obese women with PCOS, in part independent of obesity, demonstrated a profound insulin resistance, whereas the difference between lean PCOS women and healthy controls was small and statistically non-significant. IICR was a determinant of IMGU in lean, but not in obese, women regardless of the presence of PCOS.
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, de Boelelaan 1118, Room OZ116.1, 1007 MB Amsterdam,  The Netherlands.
authors.forename: I J G
authors.initials: IJ
authors.lastname: Ketel
authors.forename: E H
authors.initials: EH
authors.lastname: Serné
authors.forename: R G
authors.initials: RG
authors.lastname: Ijzerman
authors.forename: T J M
authors.initials: TJ
authors.lastname: Korsen
authors.forename: J W
authors.initials: JW
authors.lastname: Twisk
authors.forename: P G A
authors.initials: PG
authors.lastname: Hompes
authors.forename: Y M
authors.initials: YM
authors.lastname: Smulders
authors.forename: R
authors.initials: R
authors.lastname: Homburg
authors.forename: L
authors.initials: L
authors.lastname: Vorstermans
authors.forename: C D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: C B
authors.initials: CB
authors.lastname: Lambalk
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002196:Capillaries / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D008833:Microcirculation; D015233:Models, Statistical; D009765:Obesity / Q000378:metabolism*; D011085:Polycystic Ovary Syndrome / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D007328:Insulin