Imbalance Between Postprandial Ghrelin and Insulin Responses to an Ad Libitum Meal in Obese Women With Polycystic Ovary Syndrome

Abstract

Obese women with polycystic ovary syndrome (PCOS) may have impairment in the regulation of food intake associated with ghrelin and insulin. In order to compare postprandial ghrelin and insulin responses to an ad libitum meal, we assessed 30 obese women with PCOS and 23 obese women without PCOS (control group). Blood samples were taken under fasting conditions, preprandially, and 15, 45, 75, and 135 minutes after the beginning of an ad libitum meal and ghrelin and insulin concentrations were analyzed. Insulin resistance (IR) was classified using basal insulin, quantitative insulin sensitivity check index, and homeostasis model assessment index. Mean ad libitum food intake was similar between the groups (468 + 150 vs 444 + 165 g, P ¼ .60). The IR was found in 56.6% in PCOS group compared with 30.4% in the control group (P < .01). The postprandial ghrelin response was similar in both the groups but the insulin area under the curve (AUC) tend to be greater in the PCOS group (12807 + 8149.4 vs 8654.4 + 7232.3 mIU/mL/min; P ¼ .057). The ghrelin AUC was negatively correlated with the insulin AUC (r ¼ À.5138; P ¼ .01) only in the control group. The imbalance in the feedback mechanisms between insulin and ghrelin, present in obese women, especially those with IR, may affect food intake throughout the day and that could be a mechanism for the development of obesity in PCOS.

Aberrant Activation of the Hedgehog Signaling Pathway in Granulosa Cells from Patients with Polycystic Ovary Syndrome

“…This study was a matching study and no statistically signi cant difference was found in age, infertile period, or BMI in comparing the two groups as we showed in the Table 1. The PCOS group had higher level of Basal LH and T, which were consisted with their abnormal endocrine results (3)(4)(5)(6). Previous studies have found that PCOS patients were often accompanied with aberrant follicles and unsatisfactory fertilization rate (25)(26)(27).…”

“…The Rotterdam Criteria requires women to conform to two of three following symptom: oligoovulation or anovulation, clinical or biochemical hyperandrogenism and polycystic ovaries (PCO) (2). In the late development stage of PCOS, the complication associated with metabolic diseases such as diabetes, abdominal adiposity, high cholesterol and hypertension most occur (3)(4)(5). Therefore, the PCOS patients need a long term therapy to avoid the consequence.…”

Aberrant activation of the Hedgehog signaling pathway in granulosa cells from patients with polycystic ovary syndrome

“…This study was a matching study and no statistically significant difference was found in age, infertile period, or BMI in comparing the two groups as we showed in the Table 1. The PCOS group had higher level of Basal LH and T, which were consisted with their abnormal endocrine results (Diamanti-Kandarakis, 2008;Japur et al, 2014;Setji and Brown, 2014;Tandulwadkar et al, 2014).…”

“…The Rotterdam Criteria requires women to conform to two of three following symptom: oligoovulation or anovulation, clinical or biochemical hyperandrogenism and polycystic ovaries (PCO) (Rotterdam, 2004). In the late development stage of PCOS, the complication associated with metabolic diseases such as diabetes, abdominal adiposity, high cholesterol and hypertension most occur (Japur et al, 2014;Setji and Brown, 2014;Tandulwadkar et al, 2014). Therefore, the PCOS patients need long term therapy to avoid the consequence.…”

Widding the Use of Insulin Sensitizers to Patients with Polycystic Ovarian Syndrome—A Late, but Wise Decision

“…7,9 A common finding in the literature is the negative correlation between insulin resistance and ghrelin plasma concentrations. [23][24][25] When studying two groups of obese women (PCOS versus non-PCOS), we observed a lower ratio of preprandial ghrelin/insulin in the PCOS group. The postprandial ghrelin response was similar in both groups, and there was a significant negative correlation between ghrelin and insulin in both groups as well.…”