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Researchers examine relationship between PCOS, insulin-mediated glucose uptake
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According to data from a prospective study, reductions in insulin-mediated glucose uptake among women with polycystic ovary syndrome are not associated with increasing non-insulin-mediated glucose uptake. However, deterioration of non-insulin-mediated glucose uptake was independently related to greater general obesity, subcutaneous adiposity and hyperandrogenism.
“Women with PCOS who have the highest levels of insulin resistance, the greatest difficulty controlling their sugar and the highest risk for diabetes, appear to have a double defect in how glucose is controlled, which affects both the mechanisms that use insulin and those that do not,” study researcher Ricardo Azziz, MD, a reproductive endocrinologist at Georgia Regents University, said in a press release.
Azziz and colleagues sought to compare the relationship between glucose effectiveness (Sg) and insulin sensitivity index (Si) in women with PCOS vs. controls, as well as the role of androgens and fat distribution. Patients included 28 women with PCOS and 28 women without (aged 22 to 43 years), as well as a subset of 16 patients with PCOS and 16 matched controls (aged 21 to 44 years) who underwent abdominal CT.
According to data, patients with PCOS displayed lower mean Si and similar Sg and abdominal fat distribution compared with controls. The researchers wrote that patients with Si below the PCOS median demonstrated lower mean Sg compared with controls with Si above the control median. Further data indicate BMI, free T, modified Ferriman-Gallwey score and waist-to-hip ratio predicted Sg, whereas Si did not.
After adjusting for subcutaneous adipose tissue, researchers wrote that the association between Sg and visceral adipose tissue in patients with PCOS was lost. Instead, visceral adipose tissue was found to be the stronger independent determination of Si in patients with PCOS, they wrote.
“If the fat is not as sensitive to insulin, that obviously means blood sugar levels, and probably fat and cholesterol levels as well, increase and the pancreas responds by producing more insulin,” Azziz said in the release. “Fat abnormalities can have a tremendous impact on how we feel and how we function.”
The researchers wrote that further studies are needed to confirm this relationship between Sg and subcutaneous adiposity.
Disclosure:The researchers report no relevant financial disclosures.
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