Human Reproduction, Vol 13, 542-546, Copyright © 1998 by Oxford University Press
G Paradisi, AM Fulghesu, S Ferrazzani, S Moretti, C Proto, L Soranna, A Caruso and A Lanzone
To elucidate the mechanism of metabolic adaptation of women with polycystic
ovary syndrome (PCOS) during pregnancy, the endocrino- metabolic features
of a group of PCOS patients with or without gestational diabetes were
studied longitudinally during the three trimesters of gestation. Oral
glucose tolerance test (OGTT, 100 g) and hyperinsulinaemic-euglycaemic
clamp were performed throughout the study. Plasma concentrations of insulin
and glucose were determined by radioimmunoassay and glucose oxidase
technique, respectively. Five of 13 PCOS patients developed gestational
diabetes (GD) at the third trimester (PCOS-GD), while the other eight
patients did not develop any alteration of glucose metabolism (PCOS-nGD).
Both fasting glucose and insulin plasma concentrations did not change
significantly during pregnancy and no difference was seen between the two
groups. On the contrary PCOS-GD group early exhibited higher values of area
under the curve (AUC) for glucose and insulin response to OGTT with respect
to those found in PCOS-nGD group. This difference was already significant
in the first gestational trimester. Moreover insulin sensitivity value (M)
was significantly lower in the first trimester of gestation in PCOS- GD as
compared with that found in PCOS-nGD group. However, as gestation
proceeded, M value decreased in PCOS-nDG group and the difference from PCOS
patients developing gestational diabetes was not sustained into the second
and third trimesters. Both groups had similar body mass index values and
AUC insulin increase from first to third trimester of gestation. It is
concluded that early alteration of insulin sensitivity and secretion
constitute specific risk factors in PCOS patients for the development of
abnormalities of glucose tolerance.
ARTICLES
Endocrino-metabolic features in women with polycystic ovary syndrome during pregnancy
Department of Obstetrics and Gynecology, Universita Cattolica del Sacro Cuore, Rome, Italy.
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