title: Effects of endogenous androgens and abdominal fat distribution on the interrelationship between insulin and non-insulin-mediated glucose uptake in females.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and insulin resistance. Glucose disposal occurs via noninsulin-mediated glucose uptake (NIMGU) and insulin-mediated glucose uptake (IMGU). It is unknown whether in PCOS NIMGU increases to compensate for declining IMGU and whether androgens and fat distribution influence this relationship.
  
  
  OBJECTIVE
  The objective of the study was to compare in women with PCOS and controls the interrelationship between NIMGU [ie, glucose effectiveness (Sg)] and IMGU [ie, the insulin sensitivity index (Si)] and the role of androgens and fat distribution.
  
  
  METHODS
  Twenty-eight PCOS (by National Institutes of Health 1990 criteria) and 28 control (age, race, and body mass index matched) women were prospectively studied. A subset of 16 PCOS subjects and 16 matched controls also underwent abdominal computed tomography.
  
  
  METHODS
  Glucose disposal (by a frequently sampled iv glucose tolerance test), circulating androgens, and abdominal fat distribution [by waist to hip ratio and visceral (VAT) and sc (SAT) adipose tissue content] were measured.
  
  
  RESULTS
  PCOS women had lower mean Si and similar Sg and abdominal fat distribution compared with controls. PCOS women with Si below the PCOS median (more insulin resistant) had a lower mean Sg than controls with Si above the control median (more insulin sensitive). In PCOS only, body mass index, free T, modified Ferriman-Gallwey score, and waist to hip ratio independently predicted Sg, whereas Si did not. In PCOS, VAT and SAT independently and negatively predicted Si and Sg, respectively.
  
  
  CONCLUSIONS
  The decreased IMGU in PCOS is not accompanied by a compensatory increase in NIMGU or associated with excessive VAT accumulation. Increased general obesity, SAT, and hyperandrogenism are primary predictors of the deterioration of NIMGU in PCOS.
authors: Department of Obstetrics and Gynecology and Center for Androgen-Related Disorders, Cedars-SinaiMedical Center, Los Angeles, CA 90048, USA.
authors: Uche
authors: U
authors: Ezeh
authors: Marita
authors: M
authors: Pall
authors: Ruchi
authors: R
authors: Mathur
authors: Damini
authors: D
authors: Dey
authors: Daniel
authors: D
authors: Berman
authors: Ida Y
authors: IY
authors: Chen
authors: Daniel A
authors: DA
authors: Dumesic
authors: Ricardo
authors: R
authors: Azziz
mesh_terms: D050153:Abdominal Fat / Q000187:drug effects*; D061605:Administration, Intravenous; D000328:Adult; D000728:Androgens / Q000097:blood* / Q000378:metabolism / Q000494:pharmacology*; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001823:Body Composition / Q000187:drug effects*; D050218:Body Fat Distribution; D016022:Case-Control Studies; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000378:metabolism; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000728:Androgens; D001786:Blood Glucose; D007328:Insulin; D005947:Glucose