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The insulin resistant subphenotype of polycystic ovary syndrome: clinical parameters and pathogenesis.
Am J Obstet Gynecol. 2004 Jun; 190(6):1654-60.AJ

Abstract

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 +/- 6.8 mIU/mL, 2.0 +/- 1.0, and 56.6 +/- 29.0 ng/dL, respectively) compared with women without IR (15.0 +/- 13.4 mIU/mL, 2.4 +/- 1.5, and 72.5 +/- 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.

Authors+Show Affiliations

University of Southern California Keck School of Medicine, Los Angeles, USA. eliranmor@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15284763

Citation

Mor, Eliran, et al. "The Insulin Resistant Subphenotype of Polycystic Ovary Syndrome: Clinical Parameters and Pathogenesis." American Journal of Obstetrics and Gynecology, vol. 190, no. 6, 2004, pp. 1654-60.
Mor E, Zograbyan A, Saadat P, et al. The insulin resistant subphenotype of polycystic ovary syndrome: clinical parameters and pathogenesis. Am J Obstet Gynecol. 2004;190(6):1654-60.
Mor, E., Zograbyan, A., Saadat, P., Bayrak, A., Tourgeman, D. E., Zhang, C., Stanczyk, F. Z., & Paulson, R. J. (2004). The insulin resistant subphenotype of polycystic ovary syndrome: clinical parameters and pathogenesis. American Journal of Obstetrics and Gynecology, 190(6), 1654-60.
Mor E, et al. The Insulin Resistant Subphenotype of Polycystic Ovary Syndrome: Clinical Parameters and Pathogenesis. Am J Obstet Gynecol. 2004;190(6):1654-60. PubMed PMID: 15284763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The insulin resistant subphenotype of polycystic ovary syndrome: clinical parameters and pathogenesis. AU - Mor,Eliran, AU - Zograbyan,Arus, AU - Saadat,Peyman, AU - Bayrak,Aykut, AU - Tourgeman,David E, AU - Zhang,Chunying, AU - Stanczyk,Frank Z, AU - Paulson,Richard J, PY - 2004/7/31/pubmed PY - 2004/8/20/medline PY - 2004/7/31/entrez SP - 1654 EP - 60 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 190 IS - 6 N2 - 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 +/- 6.8 mIU/mL, 2.0 +/- 1.0, and 56.6 +/- 29.0 ng/dL, respectively) compared with women without IR (15.0 +/- 13.4 mIU/mL, 2.4 +/- 1.5, and 72.5 +/- 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. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/15284763/The_insulin_resistant_subphenotype_of_polycystic_ovary_syndrome:_clinical_parameters_and_pathogenesis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002937804002157 DB - PRIME DP - Unbound Medicine ER -