Insulin dynamics in young women with polycystic ovary syndrome and normal glucose tolerance across categories of body mass index.
BACKGROUND
Evidence favours insulin resistance and compensatory hyperinsulinemia as the predominant, perhaps primary, defects in polycystic ovary syndrome (PCOS). The aim of the present study was to evaluate insulin metabolism in young women with PCOS but normal glucose tolerance as compared with age, body mass index and insulin resistance-matched controls to answer the question whether women with PCOS hypersecrete insulin in comparison to appropriately insulin resistance-matched controls.


METHODS
Sixty-nine cases were divided according to their body mass index (BMI) in normal-weight (N = 29), overweight (N = 24) and obese patients (N = 16). Controls were 479 healthy women (age 16-49 y). Whole body Insulin Sensitivity (WBISI), fasting, and total insulin secretion were estimated following an oral glucose tolerance test (C-peptide deconvolution method).


RESULTS
Across classes of BMI, PCOS patients had greater insulin resistance than matched controls (p<0.0001 for all the comparisons), but they showed higher fasting and total insulin secretion than their age, BMI and insulin resistance-matched peers (p<0.0001 for all the comparisons).


CONCLUSIONS
Women with PCOS show higher insulin resistance but also larger insulin secretion to maintain normal glucose homeostasis than age-, BMI- and insulin resistance-matched controls.
Research Unit for Multi-factorial Diseases, Obesity and Diabetes, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy.
Melania
M
Manco
Department of Internal Medicine, Catholic University, School of Medicine, Rome, Italy.
Lidia
L
Castagneto-Gissey
Department of Internal Medicine, Catholic University, School of Medicine, Rome, Italy.
Eugenio
E
Arrighi
Department of Internal Medicine, Catholic University, School of Medicine, Rome, Italy.
Annamaria
A
Carnicelli
Research Unit for Multi-factorial Diseases, Obesity and Diabetes, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy.
Claudia
C
Brufani
Research Unit for Multi-factorial Diseases, Obesity and Diabetes, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy.
Rosa
R
Luciano
Department of Internal Medicine, Catholic University, School of Medicine, Rome, Italy.
Geltrude
G
Mingrone
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000378:metabolism*; D055815:Young Adult
D007328:Insulin; D005947:Glucose