Hum. Reprod. Advance Access published online on March 29, 2008
Human Reproduction, doi:10.1093/humrep/den097
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Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositols metabolism
1 Department of Medicine, Universite Sherbrooke, Sherbrooke, Canada J1H 5N4 2 Department of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA 3 Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA 23298, USA 4 Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA 5 Endocrine unit of First Department of Medicine, University of Athens Medical School, Mikras Asias 75, Goudi 115-27, Athens, Greece
6 Correspondence address. Division of Endocrinology and Metabolism, Medical College of Virginia, Virginia Commonwealth University, PO Box 980111, Richmond, VA 23298-0111, USA. Tel: +1-804-828-9695; Fax: +1-804-828-8389; E-mail: jnestler{at}mcvh-vcu.edu
BACKGROUND: We have shown that American women with polycystic ovary syndrome (PCOS) have decreased glucose-stimulated release of a putative mediator of insulin action, D-chiro-inositol (DCI)-containing inositolphosphoglycan (DCI-IPG), and increased urinary clearance of DCI (uClDCI), which was associated with hyperinsulinemia.
METHODS: DCI levels and the release of insulin and DCI-IPG during an oral glucose tolerance test (AUCs) were assessed in 27 Greek PCOS and 10 normal Greek women.
RESULTS: PCOS women were heavier than controls (BMI = 28.4 versus 23.7 kg/m2, P = 0.05) with higher waist-to-hip ratios (WHR = 0.78 versus 0.71, P = 0.009) and increased free testosterone (P = 0.048) and AUCinsulin (P = 0.04). In PCOS women, incremental AUCDCI-IPG was significantly decreased by 59% (2158 versus 5276%·min, P = 0.01), even after correction for BMI and WHR. Finally, increased uClDCI (r = 0.35, P = 0.04) and decreased AUCDCI-IPG (r = 0.46, P = 0.004) were significantly associated with hyperinsulinemia in all women together, even after correction for BMI and WHR (Ps = 0.02 and 0.007), and regardless of PCOS status.
CONCLUSIONS: Greek women, with or without PCOS, display increased uClDCI and decreased AUCDCI-IPG in association with higher insulin levels but independent of adiposity. Increased clearance of inositols might reduce tissue availability of DCI and decrease the release of DCI-IPG mediator, which could contribute to insulin resistance and compensatory hyperinsulinemia in Greek women, as previously described in American women.
Key words: polycystic ovary syndrome/inositols/inositolphosphoglycans/insulin resistance/hyperinsulinemia
Submitted on November 13, 2007; resubmitted on February 24, 2008; accepted on March 4, 2008.