Incretin levels in polycystic ovary syndrome

Abstract

Objective: Polycystic ovary syndrome (PCOS) has been linked to a high risk of type 2 diabetes mellitus. Disturbances in the secretion of the incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) have been observed in states with impaired glucose regulation. This paper considers the secretion of GIP and GLP-1 after oral glucose load in a group of lean, glucose-tolerant PCOS women in comparison with age-and body mass index (BMI)-matched healthy women. Design: Case control. Methods: PCOS (nZ21, 25.8G4.1 years, BMI 21.6G1.7 kg/m 2 ) and control healthy women (CT, nZ13, 28.5G7.2 years, BMI 20.3G2.5 kg/m 2 ) underwent oral glucose tolerance test (OGTT) with blood sampling for glucose, insulin, C-peptide, total GIP, and active GLP-1. Insulin sensitivity was determined both at fasting and during the test. Statistics: Repeated measures ANOVA. Results: Glucose levels and insulin sensitivity did not differ between PCOS and CT. PCOS had significantly higher levels of C-peptide (P!0.05) and tended to have higher insulin levels. The levels of total GIP were significantly higher in PCOS than in CT (P!0.001). Active GLP-1 levels exhibited a significantly different time-dependent pattern in PCOS (P!0.002 for PCOS versus time interaction). GLP-1 concentrations were similar in PCOS and CT in the early phase of OGTT and then reached significantly lower levels in PCOS than in CT at 180 min (P!0.05). Conclusions: Increased total GIP and lower late phase active GLP-1 concentrations during OGTT characterize PCOS women with higher C-peptide secretion in comparison with healthy controls, and may be the early markers of a pre-diabetic state.

Incretin hormone secretion in women with polycystic ovary syndrome: roles of obesity, insulin sensitivity, and treatment with metformin

“…This is partly in accordance with the findings of Vrbikova et al [30]. They found significantly higher levels of GIP, but significantly lower levels of GLP-1, in the late phases of the OGTT in PCOS compared with controls.…”

“…Few previous studies have addressed the incretin effect in women with PCOS. In a recent study, Vrbikova et al [30] described higher levels of GIP in women with PCOS. The GLP-1 responses were identical in women with and without PCOS in the early phases of an OGTT, but lower levels were found in the late phases of the test [30].…”

Off-label drug use in the treatment of polycystic ovary syndrome

“…Lower active GLP1 levels have been observed in patients with insulinresistant states, such as type 2 diabetes mellitus, PCOS, and lean PCOS (27,28). GLP1 receptor agonists and analogues improve glucose homeostasis and reduce body weight.…”

Advances in Treatment Options for Polycystic Ovary Syndrome

“…61 The 63,64 Recent studies have demonstrated lower GIP levels in obese women with PCOS. 65,66 Given that insulin resistance is of pathophysiological relevance to the endocrine and metabolic dysfunction of PCOS, the therapeutic benefit of incretin therapy in this population is plausible. …”