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Serum Androgens Are Independent Predictors of Insulin Clearance but Not of Insulin Secretion in Women With PCOS.

Authors
  • Tosi, Flavia1
  • Dal Molin, Francesca1
  • Zamboni, Federica1
  • Saggiorato, Enrica1
  • Salvagno, Gian Luca2
  • Fiers, Tom3
  • Kaufman, Jean-Marc3
  • Bonora, Enzo1
  • Moghetti, Paolo1
  • 1 Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. , (Italy)
  • 2 Clinical Chemistry Laboratory, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. , (Italy)
  • 3 Laboratory for Hormonology and Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. , (Belgium)
Type
Published Article
Journal
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Publication Date
May 01, 2020
Volume
105
Issue
5
Identifiers
DOI: 10.1210/clinem/dgaa095
PMID: 32119099
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In insulin-resistant individuals, hyperinsulinemia is a key compensatory mechanism, aimed at maintaining glucose homeostasis. Increased secretion and reduced clearance of insulin may both potentially contribute to this phenomenon. Insulin resistance and hyperinsulinemia are common findings in women with polycystic ovary syndrome (PCOS). While there is some information on insulin secretion, very few studies have investigated metabolic clearance rate of insulin (MCRI) in these women. Moreover, there is paucity of data on the relationships between MCRI and the pathophysiological characteristics of PCOS. The aim of the study was to explore these issues. One hundred ninety women with PCOS, diagnosed according to the Rotterdam criteria, with normal glucose tolerance. Assessment of MCRI and clinical, hormonal, and metabolic characteristics of subjects. MCRI and insulin sensitivity were measured by the hyperinsulinemic euglycemic clamp. Serum androgens were assessed by liquid chromatography-mass spectrometry and equilibrium dialysis. A historical sample of healthy women was used to define the corresponding reference intervals. MCRI was impaired in about two-thirds of women with PCOS. Subjects with low MCRI differed from those with normal MCRI for a number of anthropometric, metabolic, and endocrine features. In multivariate analysis, the degree of adiposity, estimates of insulin secretion, and serum androgen concentrations were independent predictors of MCRI. Conversely, age, adiposity, MCRI, and insulin sensitivity, but not serum androgens, were independent predictors of insulin secretion. In women with PCOS, metabolic clearance of insulin is reduced, contributing to generating hyperinsulinemia. Serum androgens are independent predictors of this phenomenon. © Endocrine Society 2020. All rights reserved. For permissions, please e-mail: [email protected]

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