The role of hyperinsulinemia in the development of lipid disturbances in nonobese and obese women with the polycystic ovary syndrome

Abstract

In order to establish the role of insulin in the pathogenesis of lipid abnormalities in hyperandrogenic women with the polycystic ovary syndrome (PCO) 49 women aged 18 to 35 yr with a normal glucose tolerance test were studied. They were divided into two groups: 27 women with PCO (9 obese and 18 nonobese), and 22 healthy women (12 with simple obesity and 10 with normal body weight). In the PCO group, the fasting insulin levels and the insulin response to oral glucose load were higher than in the matched controls. Significantly lower levels of HDL2-cholesterol and higher levels of apolipoprotein B were observed in obese and non nonobese PCO patients. In obese women with PCO this was associated with lower levels of HDL-cholesterol and apolipoprotein A-I (Apo A-I), whereas the levels of total triglycerides and VLDL-triglycerides (VLDL-TG) were increased. Multiple regression analysis in PCO women, after adjustment for age, body mass index and the levels of insulin and sex hormones, showed a strong positive correlation between the fasting insulin levels and total triglycerides and VLDL-TG, while a negative correlation was found between fasting insulin levels and apo A-I. These results indicate that hyperinsulinemia may play a role in the development of lipid disturbances in women with the PCO.

Effects of metformin and ethinyl estradiol–cyproterone acetate on lipid levels in obese and non-obese women with polycystic ovary syndrome

“…Thus, the present observations that the serum levels of HDL cholesterol, LDL cholesterol, triglycerides and the total cholesterol:HDL cholesterol ratio correlated significantly to wellknown indicators of insulin resistance, i.e. BMI and WHR, strengthen the concept that obesity (mostly abdominal obesity) and insulin resistance are the main contributors to the development of lipid and metabolic disturbances in PCOS (4,23,24). Accordingly, women with PCOS have been shown to be at greater risk of CVD compared with age-matched controls (25,26).…”

Dehydroepiandrosterone Stimulates Phosphorylation of FoxO1 in Vascular Endothelial Cells via Phosphatidylinositol 3-Kinase- and Protein Kinase A-dependent Signaling Pathways to Regulate ET-1 Synthesis and Secretion

“…DHEA (100 nM, 30 min) and ␤-estradiol (20 nM, 5 min) both stimulated phosphorylation of FoxO1 when compared with vehicle-treated control cells (Fig. 2, A and B, lanes [1][2][3]. Pretreatment of cells with ICI182780 only blocked the effect of ␤-estradiol, but not DHEA, to stimulate phosphorylation of FoxO1 (Fig.…”

Vascular Dysfunction in Women with Recurrent Pregnancy Loss

“…Common genetic risk factors might explain the link between birthweight and risk of ischemic heart disease in both the mother and the child (Smith et al, 2001). A genetic link would be consistent with the much stronger association between birthweight and ischemic heart disease in the mother (11-fold) (Smith et al, 2001) than in the offspring (1.5-2.0-fold) (Barker et al, 1989). Maternal genes might modulate fetal growth both by affecting the intrauterine environment, for instance by effects on uterine blood flow, and by inheritance of genes from the mother that regulate fetal growth directly.…”

“…There have been various reports on association between pregnancy loss and coronary heart disease risk or pregnancy loss and stroke risk, which are inconclusive La Vecchia et al, 1987;Smith et al, 2001). …”

“…Fathers of lowbirthweight babies are at increased risk of coronary heart disease, hypertension, and diabetes (Smith et al, 2001). Children and their mothers, who experienced RPL, may have common genetic factors linked to cardiovascular diseases.…”