Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus (original) (raw)
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Changing patterns of Insulin Resistance in Polycystic Ovary Syndrome
Bangladesh Journal of Obstetrics & Gynaecology, 2016
Objective (s):Aim of the study was to explore the changing patterns of insulin resistance in PCOS women. Methods: The study was conducted at CARE, department of Obstetrics and Gynecology and Biomedical Research Group, BIRDEM hospital. A total number of 103 PCOS women of 15-36 years were included in the present study. They were grouped into NGT (n=68), IGT (n=30), type 2 DM (n=5) according to nature of glucose tolerance. Fasting and glucose stimulated insulin was measured. Results: In IGT group, fasting and glucose-stimulated insulin level were higher when compared with NGT, but no difference between type 2 DM and NGT group was found. Insulin-glucose ratio (after glucose load) was significantly lower in type 2 DM when compared with NGT group (p=0.049), but there was no difference of insulin-glucose ratio (fasting) between type 2 DM and NGT group. PCOS with IGT or Type 2 DM women were more insulin resistant than NGT group. (p=0.015, p=0.042 respectively). Conclusion: Insulin resistance is a major pathophysiologic feature of PCOS with IGT; however â cell secretory defect is associated with type 2 DM in these subjects.
Prevalence of polycystic ovary syndrome in reproductive-aged women with type 2 diabetes
Gynecological Endocrinology, 2008
Background. Women with polycystic ovary syndrome (PCOS) are at higher risk of type 2 diabetes and cardiovascular disease. The present study was conducted to investigate the prevalence of PCOS in type 2 diabetic patients. Methods. Type 2 diabetic women (n ¼ 157) of reproductive age were selected by a convenience sampling method. PCOS was confirmed using the clinical diagnosis criteria proposed in 1990 by the National Institute of Child Health and Human Development Conference of PCOS. The diabetic patients were divided into two groups according to the presence of PCOS. Baseline demographic characteristics were obtained by questionnaire, and body weight, height, waist circumference, blood pressure and some biochemical indices were measured in both groups. Results. The prevalence of PCOS was high (8.3%, 95% confidence interval 4.5-13.4%) in these type 2 diabetic women. The onset of diabetes occurred at a lower age in the PCOS group, who also displayed significantly greater waist circumference and body mass index (p50.05). No difference in lipid profile, glycosylated hemoglobin or blood pressure was observed between the two groups. Conclusions. PCOS is highly prevalent in type 2 diabetic patients. Hence, focusing the treatment on insulin sensitizers in these patients should improve both the metabolic and non-metabolic complications of PCOS.
Insulin Resistance and Polycystic ovary Syndrome: A Review
Journal of Drug Delivery and Therapeutics, 2019
Polycystic Ovary Syndrome (PCOS) is the most common, yet complex, endocrine disorder affecting women in their reproductive years and is a leading cause of infertility. This disease appears to be multifactorial and polygenic in nature involving multisystem dysfunction, namely reproduction, endocrine and metabolic. Hyperandrogenism and insulin resistance appear to be central cause to the pathophysiology of the disease. The glucose and insulin metabolism pathways have been studied and debated to understand whether Insulin Resistance is due to a defect in insulin action or a primary defect in β-cell function or decreased hepatic clearance of insulin, or a combination of all these factors. Numerous studies have demonstrated that obese, normal weight and thin women with PCOS have a form of insulin resistance that is unique and intrinsic to the disorder. Moreover obese women with PCOS possess an additional burden of insulin resistance resulting from their excess adiposity. Hyperinsulinemia leads to increase in androgen production directly by acting as a co-gonadotropin, augmenting Luteinizing Hormone activity within the ovary, and indirectly by increasing serum LH pulse amplitude. Whereas Androgens may in turn contribute at least partially to the insulin resistance state linked with PCOS. In this review, we will briefly study the role of insulin resistance in polycystic ovary syndrome.
Prediction a woman having Polycystic Ovary Syndrome (PCOS) those having Insulin Resistance (IR)
Pakistan Journal of Medical and Health Sciences, 2022
Background: "Polycystic Ovary Syndrome" (PCOS) has been identified as a hazard for growing diabetes. Although it indicates and symptoms of "Polycystic Ovary Syndrome" (PCOS) appear before the signs and symptoms of "Insulin resistance" (IR) first, According to an assumption "Insulin resistance" (IR) may have a part in developing PCOS instead of another factor. Insulin resistance caused by obesity modifies the function of the pituitary gland and hypothalamus in the brain, leading to an increase in the synthesis of androgenic hormones, which correlate to PCOS1. Aim: To analyze outcomes of insulin resistance in women having polycystic ovaries Methodology: A literature search was performed with the use of search engines. The following search engines provided the articles for this systematic review, PubMed, Medscape, NCBI, and Google Scholar. For article searching following keywords were used; Polycystic ovaries, insulin resistance. Results: As a li...
Clinical Impact of Insulin Resistance in Women with Polycystic Ovary Syndrome
Polycystic Ovarian Syndrome [Working Title]
Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder characterized by multiple hormonal imbalances, reflecting on the clinical presentation. Among them, the insulin resistance (IR), defined as a metabolic state characterized by a decrease in cellular ability to respond to insulin signaling, is a key feature of PCOS independently of obesity. Thus, IR occurs in more than 70% of obese PCOS women and in 30-50% of lean ones. Compensatory high insulin levels are both a symptom and an underlying physiopathological driver of PCOS. Insulin appears to disrupt all components of the hypothalamic-pituitary-ovarian axis, and ovarian tissue IR results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia. The latter is the main culprit of the clinical picture in PCOS. Testing for IR can be helpful to rule out other conditions that are commonly misdiagnosed as PCOS and to recommend an appropriate treatment for the different PCOS phenotypes.
Divergences in Insulin Resistance Between the Different Phenotypes of the Polycystic Ovary Syndrome
The Journal of Clinical Endocrinology & Metabolism, 2013
Context/Objective: Current diagnostic criteria for polycystic ovary syndrome (PCOS) have generated distinct PCOS phenotypes, based on the different combinations of diagnostic features found in each patient. Our aim was to assess whether either each single diagnostic feature or their combinations into the PCOS phenotypes may predict insulin resistance in these women.
Insulin Resistance in Polycystic Ovary Syndrome
Paripex Indian Journal Of Research, 2016
Polycystic ovary syndrome (PCOS) is a common endocrine disease with metabolic, reproductive and psychological consequences effecting reproductive age women. In addition to the clinical features of oligo-anovulation, infertility and hyperandrogenism, PCOS is closely interrelated with insulin resistance (IR) and hyperinsulinemia, with a high prevalence. IR is also suggested to have a role in the pathogenesis of PCOS. Post-receptor defects, as well as genetic susceptibility has been held responsible for underlying mechanisms of IR. Assessment of IR includes tests of fasting insulin and blood glucose levels. In especially obese women with PCOS, oral glucose tolerance tests are recommended for screening. To overcome IR, reducing body fat and weight with a healthy diet is the initial step. Therapeutic approach includes insulin-sensitizing agents. The prevention of long-term consequences of IR in PCOS, like cardiovascular disease, type 2 diabetes and endometrium cancer, through appropriate...
American Journal of Obstetrics and Gynecology, 2004
Objective: This study was undertaken to compare clinical and biochemical characteristics of the insulin resistant (IR) and non-IR subphenotypes of polycystic ovary syndrome (PCOS). Study design: Infertile PCOS women were classified as IR (n = 32) or non-IR (n = 46) on the basis of fasting glucose and insulin levels. The incidence of acanthosis nigricans (AN), hirsutism, and ovulation in response to clomiphene citrate (CC) was compared between the 2 groups, along with serum levels of gonadotropins, and sex steroids. Blood samples from 28 PCOS patients and 8 controls were analyzed by enzymatic immunoassay for autophosphorylated insulin receptor (APIR) and total insulin receptor (TIR) content. Results: Insulin resistance was associated with obesity (odds ratio [OR] = 3.5, P!.05), AN (OR = 6.0, P!.05), hirsutism (OR = 3.1, P!.05), and resistance to CC (OR = 5.0, P!.05). Mean levels of LH, LH/FSH ratios, and testosterone were lower in women with IR (11.5 G 6.8 mIU/mL, 2.0 G 1.0, and 56.6 G 29.0 ng/dL, respectively) compared with women without IR (15.0 G 13.4 mIU/mL, 2.4 G 1.5, and 72.5 G 29.8 ng/dL, respectively) (P!.05). Mean APIR/ TIR ratios in IR women were lower than in non-IR women (P!.05 at 100 nmol/L of insulin) and controls (P!.01 at 1, 10 and 100 nmol/L insulin). Conclusion: Patients with IR are more likely to be obese and have AN, hirsutism, resistance to CC, and lower LH, LH/FSH ratios, and testosterone levels. Furthermore, IR patients appear to have defective autophosphorylation of the insulin receptor, a key element in insulin action, and a possible mechanism for IR in PCOS.