Human Reproduction, Vol. 18, No. 12, 2683-2688,
December 2003
© 2003 European Society of Human Reproduction and Embryology
Proinsulin serum concentrations in women with polycystic ovary syndrome: a marker of 
-cell dysfunction?
1 Laboratory of Endocrinology, Department of Medicine, San Juan de Dios Hospital, School of Medicine, University of Chile, 2 Department of Clinical Research, J.J.Aguirre Hospital, University of Chile and 3 Food Technology Institute (INTA), University of Chile, Santiago, Chile
4 To whom correspondence should be addressed at: Laboratory of Endocrinology, Department of Medicine W. Division, School of Medicine, Las Palmeras 299, Interior Quinta Normal, Casilla 33052, Correo 33, Santiago, Chile. e-mail: tsir{at}machi.med.uchile.cl
BACKGROUND: The aim of this study was to establish the effect of polycystic ovary syndrome (PCOS) adjusted for adiposity on proinsulin concentrations. METHODS: Ninety-one women with PCOS and 72 normal cycling (NC) women were recruited. A 2 h, 75 g oral glucose tolerance test was performed. Glucose and insulin were measured in each sample. Proinsulin and C-peptide were determined at 0 and 30 min and the fasting proinsulin/insulin ratio (PI/I) was calculated. Insulin sensitivity was estimated by insulin sensitivity index (ISI) composite, and 
-cell function was estimated by insulinogenic index. RESULTS: Insulin, proinsulin and C-peptide concentrations were higher in women with PCOS than in NC women (P < 0.05). PI/I and insulinogenic index were similar in both groups. Proinsulin concentrations increased with body mass index (P < 0.05) only in women with PCOS; therefore, proinsulin concentrations were higher in obese PCOS patients compared with obese control women (P < 0.05). Moreover, a positive association between proinsulin concentrations and waist diameter adjusted for C-peptide (P < 0.05) and a negative association between proinsulin concentrations and ISI composite values were observed in PCOS patients (P < 0.05). CONCLUSIONS: Data suggest that in PCOS patients an elevated proinsulin concentration could reflect insulin resistance more than -cell dysfunction. However, the elevated concentration of proinsulin in these patients could also result from impaired -cell function resulting from intra-abdominal obesity independently of insulin resistance.
Key words: -cell function/polycystic ovary syndrome/proinsulin
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