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PCOS may be characterized by hyperinsulinism in daughters of women with the disorder
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Daughters of women with polycystic ovary syndrome may be at an increased risk for polycystic ovary syndrome, and it may be characterized by hyperinsulinism in the later stages of puberty, according to recent data.
Researchers from the Penn State College of Medicine in Hershey, Pa. conducted a case-controlled study to determine whether reproductive and metabolic abnormalities are more common in children of women with PCOS.
The study included 32 children of women with PCOS and 38 controls. Researchers separated the children into three groups according to gender and Tanner stage.
The researchers collected medical histories, three-hour timed urinary samples and two-hour oral glucose tolerance. Abdominal ultrasounds were performed in girls only.
Compared with controls, girls born to women with PCOS in the Tanner stage IV-V had lower levels of urine luteinizing hormone (P=.04). Boys born to women with PCOS and in Tanner stage II-III had higher levels of urine testosterone, compared with controls (P=.007).
Using an adult population (n=30), the researchers confirmed the link between salivary and serum insulin levels with a Pearson correlation coefficient of 0.67 (P<.0001). They also confirmed this finding in the children with a Pearson correlation coefficient of 0.72 at baseline (P<.0001) and 0.57 after two hours (P=.0004).
Girls born to women with PCOS in the Tanner stage IV-V had higher levels of mean area under the curve salivary insulin during the later stage of puberty, compared with girls in the control group (P<.02). – by Stacey L. Adams
J Clin Endocrinol Metab. 2008;93:1662-1669.
This study adds knowledge to our information about PCOS and suggests once more that abnormalities of insulin regulation may play a central role in at least some affected individuals. It is clear that PCOS is a very complex disorder and it is likely that there are several etiologies. This small study suggests one possible series of abnormalities and that is in insulin regulation. As the authors note, this is a small, case-controlled study and larger, longitudinal studies are warranted to determine how common abnormalities of insulin are in individuals who subsequently develop PCOS. This is a complicated syndrome; that is what it boils down to and there simply is not one answer. We have known that PCOS arises in puberty and this certainly suggests that some girls who may subsequently develop PCOS may have subtle abnormalities in insulin regulation before the disease is apparent. However, that remains to be seen with longitudinal studies.
– Robert W. Rebar, MD
Endocrine Today Editorial Board member