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Insulin action in women with polycystic ovary syndrome and its relation to gestational diabetes.
Hum Reprod. 2015 Jun; 30(6):1447-53.HR

Abstract

STUDY QUESTION

How does insulin action change during pregnancy in women with polycystic ovary syndrome (PCOS) who develop gestational diabetes (GDM) compared with women with PCOS who do not?

SUMMARY ANSWER

Women with PCOS who develop GDM already show disturbed insulin action early in pregnancy.

WHAT IS KNOWN ALREADY

Pregnant women with PCOS are at increased risk of developing GDM compared with women without PCOS.

STUDY DESIGN, SIZE, DURATION

This study represents a post hoc analysis of a subgroup of pregnant women with PCOS participating in a multicentre prospective cohort study. A total of 72 women were included.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Women with PCOS and a wish to conceive were included before conception and followed during pregnancy. Insulin, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), sex hormone-binding globulin (SHBG) and testosterone were analysed at three different time points in women who developed GDM and women who did not.

MAIN RESULTS AND THE ROLE OF CHANCE

Seventy-two pregnant women with PCOS were included of which 22 (31%) women developed GDM. Both insulin levels and HOMA-IR were significantly higher at each sampling point in women with PCOS who developed GDM. SHBG levels were significantly lower before conception and in the second trimester compared with women who did not develop GDM. Testosterone concentrations were significantly lower before conception in women who developed GDM. After adjusting for BMI, waist circumference and waist/hip ratio, the differences in insulin, HOMA-IR, SHBG and testosterone levels remained largely the same.

LIMITATIONS, REASONS FOR CAUTION

Selection bias cannot be excluded since only women from one centre with a complete blood sampling set were included in this study.

WIDER IMPLICATIONS OF THE FINDINGS

The knowledge that women with PCOS who develop GDM already have a disturbed insulin action early in pregnancy is likely to be useful in considering the pathophysiology processes underlying this disorder in this specific group of women.

STUDY FUNDING/COMPETING INTERESTS

This study was funded by the Child Health research programme of the University Medical Centre Utrecht. M.A.d.W., A.J.G., S.M.V.-V., A.F. and M.P.H.K. have no conflicts of interest to disclose. M.J.C.E. has received grant support from the following companies (in alphabetic order): Illumina and MSD. B.C.J.M.F. has received fees and grant support from the following companies (in alphabetic order): Ferring, Ova-Science, PregLem SA, Roche and Watson Laboratories. The authors declare complete independence from funders.

TRIAL REGISTRATION NUMBER

Clinicaltrials.gov, number NCT00821379.

Authors+Show Affiliations

Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands m.dewilde-2@umcutrecht.nl.Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.Department of Obstetrics, University Medical Centre Utrecht, 3584 EA Utrecht, The Netherlands.Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands Department of Obstetrics, University Medical Centre Utrecht, 3584 EA Utrecht, The Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25840428

Citation

de Wilde, Marlieke A., et al. "Insulin Action in Women With Polycystic Ovary Syndrome and Its Relation to Gestational Diabetes." Human Reproduction (Oxford, England), vol. 30, no. 6, 2015, pp. 1447-53.
de Wilde MA, Goverde AJ, Veltman-Verhulst SM, et al. Insulin action in women with polycystic ovary syndrome and its relation to gestational diabetes. Hum Reprod. 2015;30(6):1447-53.
de Wilde, M. A., Goverde, A. J., Veltman-Verhulst, S. M., Eijkemans, M. J., Franx, A., Fauser, B. C., & Koster, M. P. (2015). Insulin action in women with polycystic ovary syndrome and its relation to gestational diabetes. Human Reproduction (Oxford, England), 30(6), 1447-53. https://doi.org/10.1093/humrep/dev072
de Wilde MA, et al. Insulin Action in Women With Polycystic Ovary Syndrome and Its Relation to Gestational Diabetes. Hum Reprod. 2015;30(6):1447-53. PubMed PMID: 25840428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin action in women with polycystic ovary syndrome and its relation to gestational diabetes. AU - de Wilde,Marlieke A, AU - Goverde,Angelique J, AU - Veltman-Verhulst,Susanne M, AU - Eijkemans,Marinus J C, AU - Franx,Arie, AU - Fauser,Bart C J M, AU - Koster,Maria P H, Y1 - 2015/04/02/ PY - 2015/01/30/received PY - 2015/03/11/accepted PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2016/2/26/medline KW - PCOS KW - gestational diabetes KW - pregnancy SP - 1447 EP - 53 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 30 IS - 6 N2 - STUDY QUESTION: How does insulin action change during pregnancy in women with polycystic ovary syndrome (PCOS) who develop gestational diabetes (GDM) compared with women with PCOS who do not? SUMMARY ANSWER: Women with PCOS who develop GDM already show disturbed insulin action early in pregnancy. WHAT IS KNOWN ALREADY: Pregnant women with PCOS are at increased risk of developing GDM compared with women without PCOS. STUDY DESIGN, SIZE, DURATION: This study represents a post hoc analysis of a subgroup of pregnant women with PCOS participating in a multicentre prospective cohort study. A total of 72 women were included. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women with PCOS and a wish to conceive were included before conception and followed during pregnancy. Insulin, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), sex hormone-binding globulin (SHBG) and testosterone were analysed at three different time points in women who developed GDM and women who did not. MAIN RESULTS AND THE ROLE OF CHANCE: Seventy-two pregnant women with PCOS were included of which 22 (31%) women developed GDM. Both insulin levels and HOMA-IR were significantly higher at each sampling point in women with PCOS who developed GDM. SHBG levels were significantly lower before conception and in the second trimester compared with women who did not develop GDM. Testosterone concentrations were significantly lower before conception in women who developed GDM. After adjusting for BMI, waist circumference and waist/hip ratio, the differences in insulin, HOMA-IR, SHBG and testosterone levels remained largely the same. LIMITATIONS, REASONS FOR CAUTION: Selection bias cannot be excluded since only women from one centre with a complete blood sampling set were included in this study. WIDER IMPLICATIONS OF THE FINDINGS: The knowledge that women with PCOS who develop GDM already have a disturbed insulin action early in pregnancy is likely to be useful in considering the pathophysiology processes underlying this disorder in this specific group of women. STUDY FUNDING/COMPETING INTERESTS: This study was funded by the Child Health research programme of the University Medical Centre Utrecht. M.A.d.W., A.J.G., S.M.V.-V., A.F. and M.P.H.K. have no conflicts of interest to disclose. M.J.C.E. has received grant support from the following companies (in alphabetic order): Illumina and MSD. B.C.J.M.F. has received fees and grant support from the following companies (in alphabetic order): Ferring, Ova-Science, PregLem SA, Roche and Watson Laboratories. The authors declare complete independence from funders. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov, number NCT00821379. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/25840428/Insulin_action_in_women_with_polycystic_ovary_syndrome_and_its_relation_to_gestational_diabetes_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dev072 DB - PRIME DP - Unbound Medicine ER -