Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Controlled Clinical Trial
. 2013 Apr;98(4):1541-8.
doi: 10.1210/jc.2012-2937. Epub 2013 Feb 28.

Effects of endogenous androgens and abdominal fat distribution on the interrelationship between insulin and non-insulin-mediated glucose uptake in females

Uche Ezeh  1 , Marita Pall, Ruchi Mathur, Damini Dey, Daniel Berman, Ida Y Chen, Daniel A Dumesic, Ricardo Azziz
Affiliations
Controlled Clinical Trial

Effects of endogenous androgens and abdominal fat distribution on the interrelationship between insulin and non-insulin-mediated glucose uptake in females

Uche Ezeh et al. J Clin Endocrinol Metab. 2013 Apr.

Abstract

Background: Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and insulin resistance. Glucose disposal occurs via noninsulin-mediated glucose uptake (NIMGU) and insulin-mediated glucose uptake (IMGU). It is unknown whether in PCOS NIMGU increases to compensate for declining IMGU and whether androgens and fat distribution influence this relationship.

Objectives: The objective of the study was to compare in women with PCOS and controls the interrelationship between NIMGU [ie, glucose effectiveness (Sg)] and IMGU [ie, the insulin sensitivity index (Si)] and the role of androgens and fat distribution.

Participants: Twenty-eight PCOS (by National Institutes of Health 1990 criteria) and 28 control (age, race, and body mass index matched) women were prospectively studied. A subset of 16 PCOS subjects and 16 matched controls also underwent abdominal computed tomography.

Main outcome measures: Glucose disposal (by a frequently sampled iv glucose tolerance test), circulating androgens, and abdominal fat distribution [by waist to hip ratio and visceral (VAT) and sc (SAT) adipose tissue content] were measured.

Results: PCOS women had lower mean Si and similar Sg and abdominal fat distribution compared with controls. PCOS women with Si below the PCOS median (more insulin resistant) had a lower mean Sg than controls with Si above the control median (more insulin sensitive). In PCOS only, body mass index, free T, modified Ferriman-Gallwey score, and waist to hip ratio independently predicted Sg, whereas Si did not. In PCOS, VAT and SAT independently and negatively predicted Si and Sg, respectively.

Conclusion: The decreased IMGU in PCOS is not accompanied by a compensatory increase in NIMGU or associated with excessive VAT accumulation. Increased general obesity, SAT, and hyperandrogenism are primary predictors of the deterioration of NIMGU in PCOS.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Levels of Si (A) and Sg (B) in PCOS and controls showing defects in NIMGU and IMGU. A, Comparison of Si in PCOS vs controls, showing Si being significantly lower in 28 PCOS women compared with 28 control females, confirming insulin resistance in the PCOS group (P < .0378). B, Comparison of Sg in 14 most insulin-resistant PCOS vs 14 most insulin-sensitive controls, showing Sg significantly lower in PCOS (P < .0286).
Figure 2.
Figure 2.
Correlation between Si with Sg in PCOS (A) vs controls (B).
See this image and copyright information in PMC

References

    1. Azziz R, Carmina E, Dewailly D, et al. Task Force on the Phenotype of the Polycystic Ovary Syndrome of the Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91:456–488 - PubMed
    1. Farah-Eways L, Reyna R, Knochenhauer ES, Bartolucci AA, Azziz R. Glucose action and adrenocortical biosynthesis in women with polycystic ovary syndrome. Fertil Steril. 2004;281:120–125 - PubMed
    1. Bergman RN. Lilly lecture. Toward physiological understanding of glucose tolerance. Minimal-model approach. Diabetes. 1989;38:1512–1517 - PubMed
    1. Best JD, Kahn SE, Ader M, Watanabe RM, Ni TC, Bergman RN. Role of glucose effectiveness in the determination of glucose tolerance. Diabetes Care. 1996;19:1018–1030 - PubMed
    1. Kahn SE, Prigeon RL, McCulloch DK, et al. The contribution of insulin-dependent and insulin-independent glucose uptake to intravenous glucose tolerance in healthy human subjects. Diabetes. 1994;43:587–592 - PubMed

Publication types

MeSH terms