Selected Cytokines Are Associated With Markers Of Insulin Resistance In Polycystic Ovary Syndrome
The polycystic ovary syndrome (PCOS) is associated with features of the insulin resistance syndrome and altered glucose homeostasis. Factors that play an important role in these processes are still emerging. Pro-inflammatory cytokines may be involved in development of insulin resistance in PCOS. The purpose of this study was to determine if a relationship exists between interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), hepatocyte growth factor (HGF), nerve growth factor (NGF), tumor necrosis factor alpha (TNF alpha), fibroblast growth factor-21 (FGF-21) and insulin resistance indices in PCOS. Methods: Fasting insulin, glucose, C-peptide, lipid profile, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, sex hormone binding globulin (SHBG), 17-hydroxyprogesterone, IL-6, IL-8, MCP-1, HGF, NGF, TNF alpha, FGF-21 serum concentrations were analyzed in 19 women with PCOS and 15 age- and weight- matched healthy controls. Homeostasis model assessment insulin resistance (HOMA-IR) was calculated. Statistics: Mann Whitney test and partial correlations adjusted for BMI. Results: Fasting insulin and C-peptide were significantly higher in women with PCOS than in control group (P<0.05 for both), HOMA-IR tended to be higher in PCOS (P<0.06). IL-6, MCP-1, HGF, NGF, TNF alpha, FGF-21 levels did not differ between groups. In women with PCOS, after BMI adjustment: (1) MCP-1 and HGF serum concentrations significantly positively correlated with fasting insulin (P<0.01 for both) and HOMA-IR (P<0.05 and P=0.001, resp.), (2) IL-6 and IL-8 serum concentrations significantly negatively correlated with HDL cholesterol (P<0.01 and P<0.05, resp.), (3) IL-6 positively correlated with triglyceride concentrations (P<0.01), (4) FGF Continue reading >>
Molecular Mechanisms Of Insulin Resistance In Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is a common endocrinopathy of unknown aetiology that affects women of reproductive age. During the past ten years, defective insulin activity in PCOS has been demonstrated in target tissues and causes insulin resistance and hyperinsulinaemia. Furthermore, presence of insulin receptors in the ovarian tissue and overproduction of androgens by theca cells leads to characteristic hyperandrogenaemia. Recent data suggest a divergence in post-receptor signalling pathways for insulin in its target tissues (muscle, adipocytes and ovarian tissue), where the metabolic pathway of insulin activity is defective, whereas the activation of steroidogenesis is maintained. Investigators are still searching for clues to understand the cause of this enigmatic syndrome, despite great advances in molecular medicine and genetics. Continue reading >>
Imbalanced Hormones Lead To Pcos
PCOS is the result of a hormonal imbalance, caused by a disorder in a woman’s endocrine, or hormone, system. This system is made up of all the body’s glands: pituitary, pineal, thyroid, parathyroid, thymus, adrenal, and pancreas. Hormones secreted by these glands control such things as growth, metabolism, and reproduction. In women with PCOS, the hormonal system is not working properly. For many years, PCOS was considered a direct result of high levels of male hormones in the body, although it was not understood exactly what caused these high levels. No Single Cause Is Known for PCOS There is currently no known single cause for PCOS but scientists believe there are several factors that play a role in creating this hormonal imbalance. Two factors that seem to play a strong role are insulin resistance and genetics. Insulin Resistance and PCOS Researchers are now just beginning to understand the association between PCOS and the body’s overproduction of insulin. Many women with PCOS have hyperinsulinemia, a higher than normal amount of insulin in their bodies. This condition results from insulin resistance. Insulin resistance happens when the body can’t metabolize sugar very well. As food enters your body, it’s broken down into small components, including glucose – an important sugar that comes from carbohydrates. Glucose is a major source of quick energy for the body. When you eat foods high in carbohydrates, your body detects a rise in glucose and signals the pancreas to produce more insulin. Together, glucose and insulin enter the bloodstream. The insulin fits into special “insulin receptors” in the cells. This allows the excess glucose to enter the cells and be used right away as energy or stored for future use. In the muscles and liver, glucose can be s Continue reading >>
What Causes Insulin Resistance?
Insulin Resistance has many factors that contribute to its presence in the body. In essence, our environment and lifestyles have evolved too rapidly for our bodies to keep pace. We are still genetically “wired” to thrive on the entrenched habits of our ancestors who consumed different, nutrient-rich foods, a diet low in carbohydrates, and also sustained greater levels of movement and exercise. Some women might also have a genetic predisposition to Insulin Resistance. Others develop Insulin Resistance through unhealthy lifestyles. Over time, the above factors have damaged the complex ability of our bodies’ cells to properly utilize insulin to convert glucose to energy. Unhealthy diets cause the pancreas to overproduce insulin that then overwhelms the cells reducing their sensitivity to insulin and impairing the vital process whereby glucose passes through the cell membrane to be converted into energy. Effects of Insulin Resistance Left unchecked, Insulin Resistance can cause a number of negative effects in the body: The de-sensitized cell membrane causes the “rejected” insulin to stay in the bloodstream where it causes a variety of conditions, including the unbalanced hormones seen in PCOS (Polycystic Ovarian Syndrome) and initiats the beginning processes for cardiovascular disease. Unable to enter the cell because of the cell membranes’ insulin insensitivity, glucose also stays in the bloodstream and is converted to fat, leading to weight gain which can result in obesity. Eventually many health-related functions can fail and cause numerous serious diseases besides PCOS, such as the cluster of increased risks for a heart attack or stroke called Metabolic Syndrome (Syndrome X) and Pre-Diabetes, which if neglected, can lead to Type 2 Diabetes. Facebook Comments Continue reading >>
Polycystic Ovary Syndrome And Insulin Resistance
Nicolás Mendoza* Department of Obstetrics and Gynecology, University of Granada, Spain Citation: Mendoza N (2012) Polycystic Ovary Syndrome and Insulin Resistance. J Diabetes Metab S2:005. doi:10.4172/2155-6156.S2-005 Copyright: © 2012 Mendoza N. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Keywords Metabolic syndrome; Polycystic ovary syndrome; Insulin resistance Introduction Polycystic ovary syndrome (PCOS) is a complex and heterogeneous disease that involves menstrual dysfunction and reproductive difficulty as well as metabolic problems. The expert conference by the European Society for Human Reproduction and Embryology and the American Society for Reproduction Medicine recommended that PCOS be defined when at least two of the following three features were present [1]: • oligo- and/or anovulation • hyperandrogenism • polycystic ovaries These criteria also recognize that other causes of androgen excess and related disorders should be excluded before confirming the diagnosis of PCOS. This definition is more generic and will probably increase its already high prevalence: it is the most common endocrinopathy in women and affects 7-14% of women of childbearing age worldwide [2]. It was proposed that insulin resistance (IR) is the pathophysiological basis for this syndrome. The primary interest in diagnosing these patients is not to assist in conception but to prevent possible future medical complications, including diabetes mellitus and cardiovascular disease [3]. IR refers to a decrease in the capacity of ins Continue reading >>
Pcos Basics: Insulin & Insulin Resistance
Description: One of the major symptoms of PCOS is elevated insulin levels. Elevated insulin levels in the body is considered a key indicator in acquiring insulin resistance (IR) which, unchecked, eventually leads to diabetes. This article will provide you with ample information with regards to insulin resistance and how you can help treat it without relying on drugs like Metformin. What is Insulin? Insulin is a hormone secreted by our pancreas. Its purpose is to take the glucose (sugar) from the carbohydrates you eat and use it for energy or store it for future use in the muscles, fat, and liver. This storage reduces the amount of glucose in the blood and signals the body to slow insulin production. Insulin’s main function is to keep your blood sugar levels from getting too high. In this way, the pancreas works in conjunction with the liver which adds glucose to the bloodstream to keep blood sugar levels from dipping too low. Together, they keep blood sugar levels even. This constant balancing of blood sugar is key to giving our bodies the energy they need to function. Insulin is also responsible for regulating carbohydrate, fat, and protein metabolism, as well as promoting healthy cell growth. When this hormone is out of whack, it can increase the risk of gestational diabetes, as well as produce symptoms like weight gain, anxiety, brain fog, and fatigue. Insulin plays a critical role in many functions of the body, so anything that makes it less effective will cause negative effects on our health. One of the most common “insulin issues” is insulin resistance (IR), a symptom women with PCOS know all too well. What is Insulin Resistance? Insulin resistance is an impairment of your body’s ability to control your blood sugar levels. Just like it sounds, your body’ Continue reading >>
The Role Of Insulin Resistance In Polycystic Ovary Syndrome.
Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenic chronic anovulation and is the most common endocrinopathy among reproductive-age women. The syndrome is not to be confused with the presence of polycystic ovaries (PCO), which has a varied etiology and is not specific to the syndrome. PCOS is associated with significant insulin resistance as well as with defects in insulin secretion. A defect in insulin mediated receptor autophosphorylation has been found in a substantial proportion of PCOS women. This defect is unique to PCOS and is not found in other common states of insulin resistance. These abnormalities, combined with obesity, predispose PCOS women to developing non-insulin dependent diabetes mellitus. Another long-term sequelae that may be related to insulin resistance is cardiovascular disease. There is unfortunately no readily available clinical test at present to diagnose insulin resistance in PCOS women. Treatment considerations for improving insulin sensitivity in PCOS women should focus on weight loss regimens and the avoidance of interventions that worsen insulin sensitivity. The initial investigational use of insulin-sensitizing agents in these women has shown favorable responses. (C) Lippincott-Raven Publishers. Continue reading >>
Insulin Resistance In Polycystic Ovary Syndrome: Progress And Paradoxes
Abstract Over the past 20 years, it has been clearly documented that 1) polycystic ovary syndrome (PCOS) has major metabolic sequelae related to insulin resistance and 2) insulin resistance plays an important role in the pathogenesis of the reproductive abnormalities of the disorder. Women with PCOS are at significantly increased risk of developing type 2 diabetes mellitus (DM). Studies in isolated adipocytes and in cultured skin fibroblasts from PCOS women have demonstrated intrinsic postbinding defects in insulin-mediated glucose metabolism. In fibroblasts, the mitogenic pathway of insulin action is intact, consistent with a selective defect in insulin signaling. While PCOS skeletal muscle is resistant to insulin in vivo, cultured muscle cells have normal insulin sensitivity, consistent with a major role of extrinsic factors in producing insulin resistance in this tissue. Excessive serine phosphorylation of the insulin receptor or downstream signaling proteins may be involved in the pathogenesis of insulin resistance in PCOS. The putative serine kinase is extrinsic to the insulin receptor but its identity is unknown. The explanations for tissue-specific and signaling pathway-specific differences in insulin action in PCOS are unknown but may involve differential roles of insulin receptor substrate (IRS)-1 and IRS-2 in insulin signal transduction. Continue reading >>
Metabolic Disorders Associated With Biological Insulin Resistance In Congolese Woman With Polycystic Ovary Syndrome (pcos)
Metabolic Disorders Associated with Biological Insulin Resistance in Congolese Woman with Polycystic Ovary Syndrome (PCOS) We aimed to identify metabolic disorders associated with insulin resistance (IR) in Congolese women affected by polycystic ovary syndrome (PCOS). Fifty‐four PCOS women and 40 controls from three hospitals of Kinshasa were enrolled to our case‐control study. Blood samples were collected, and concentrations of high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL) cholesterol, triglycerides (TG), fasting insulin, and glucose levels were measured. IR under basal conditions was evaluated with homeostasis model assessment (HOMA‐IR). Dyslipidemia was observed in 37.5 controls and 55.6% PCOS women (p < 0.05). The two main lipoproteins concerned were HDL and LDL; nevertheless, the difference in LDL levels between PCOS and controls was not significant. Higher TG (>150 mg/dl) was not found in the two groups, whereas TG levels in PCOS patients were significantly higher than in controls (p < 0.05). Impaired glucose tolerance (IGT) and metabolic syndrome were observed, respectively, in 1.9% of PCOS patients. Insulin resistance is associated with metabolic disorders in Congolese woman with PCOS. Dyslipidemia (55.6%), mainly due to low HDL levels, is the most common metabolic disorder. Impaired glucose tolerance and metabolic syndrome represent a small proportion. 1. Introduction Polycystic ovary syndrome (PCOS) characterized by androgen excess with or without clinical evidence of hyperandrogenism is one of the most common endocrine dysfunctions that affects 5–10% of women of reproductive age [1, 2]. Literature data revealed that PCOS is associated with several metabolic complications, including insulin resistance (IR) with compensatory hyper Continue reading >>
Polycystic Ovarian Syndrome And Insulin Resistance
Introduction Polycystic Ovarian Syndrome (PCOS) is the most common endocrine abnormality in reproductive aged women affecting approximately 5-10% of this population. (NEJM 1995;333:853) The classic triad of this syndrome consists of chronic anovulation, hirsutism, and obesity. PCOS was first discovered by Stein and Leventhal (Am J Obstet Gynecol 1935;29:181) and its management has confused clinicians ever since. The exciting news recently involves understanding the contribution of insulin resistance to the etiology and treatment of PCOS. This newsletter will review the endocrinopathy and medical consequences of PCOS as well as examine the current understanding of insulin resistance and the use of insulin sensitizing agents. PCOS PCOS involves a ‘vicious cycle’ of hormonal imbalance that may begin with a hypersensitivity of the pituitary to GnRH. The pituitary responds with an increase in LH secretion resulting in increased ovarian androgen production by the ovarian thecal cells. This tonic elevation in LH has also been implicated in the well documented, but not well understood increased risk of miscarriage in PCOS patients. The ovarian ‘androgen excess’ of androstenedione and testosterone has several effects: a) inhibiting follicle development and estradiol production; b) increasing the production of dihydrotestosterone (DHT) thereby stimulating excess terminal hair production (hirsutism) and c) increasing peripheral conversion of estradiol to estrone by aromatase. Estrone, although a weaker estrogen, in large amounts has the ability to act on target tissues with similar efficacy as estradiol. Consequently, FSH production is inhibited thereby further preventing follicle development and ovulation. Additionally, estrone proliferates the endometrium unopposed and i Continue reading >>
Polycystic Ovary Syndrome
The exact cause of polycystic ovary syndrome (PCOS) is unknown, but it's thought to be related to abnormal hormone levels. Resistance to insulin Insulin is a hormone produced by the pancreas to control the amount of sugar in the blood. It helps to move glucose from blood into cells, where it's broken down to produce energy. Insulin resistance means the body's tissues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate. High levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation. Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse, because having excess fat causes the body to produce even more insulin. Hormone imbalance Many women with PCOS are found to have an imbalance in certain hormones, including: raised levels of testosterone – a hormone often thought of as a male hormone, although all women usually produce small amounts of it raised levels of luteinising hormone (LH) – this stimulates ovulation, but may have an abnormal effect on the ovaries if levels are too high low levels of sex hormone-binding globulin (SHBG) – a protein in the blood, which binds to testosterone and reduces the effect of testosterone raised levels of prolactin (only in some women with PCOS) – hormone that stimulates the breast glands to produce milk in pregnancy The exact reason why these hormonal changes occur isn't known. It's been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin. Genetics Continue reading >>
Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is common. It can cause period problems, reduced fertility, acne and excess hair growth. Many women with PCOS are also overweight. Treatment includes weight loss (if you are overweight) and lifestyle changes in addition to treating the individual symptoms. There are some long-term health problems which are more likely in women with PCOS, so a healthy lifestyle is particularly important to lower the chance of these problems. Understanding ovaries and ovulation The ovaries are a pair of glands that lie on either side of the womb (uterus). Each ovary is about the size of a large marble. The ovaries make eggs (ova) and various hormones. Hormones are chemicals that are made in one part of the body, pass into the bloodstream and have an effect on other parts of the body. Ovulation normally occurs once a month when you release an egg (ovum) into a Fallopian tube. The tube takes the egg into the uterus. Before an ovum is released at ovulation, it develops within a little swelling of the ovary, called a follicle. (A follicle is like a tiny cyst.) Each month several follicles start to develop but normally just one fully develops and goes on to ovulate. The main hormones that are made in the ovaries are oestrogen and progesterone - the main female hormones. These hormones help with the development of breasts and are the main controllers of the menstrual cycle. The ovaries also normally make small amounts of male hormones (androgens) such as testosterone. On the Forums I was thinking of maybe starting to take the contraceptive pill since me and my bf have decided we're not ready to start having children yet and was wondering if it has any negative effects on... What is polycystic ovary syndrome (PCOS)? PCOS, formerly known as the Stein-Leventhal syn Continue reading >>
How To Avoid Insulin Resistance
Insulin resistance is a syndrome at the center of many chronic and serious health problems, including diabetes, obesity, heart disease and polycystic ovary syndrome or PCOS. Insulin is one of the “major” hormones and it has a cascading effect on the rest of your hormones, including the “minor” hormones estrogen, progesterone and testosterone. Insulin resistance occurs because, for many of us, most of our calories come in the form of simple carbohydrates — sugars that quickly enter the bloodstream as glucose. The body has to release high levels of insulin to keep all that glucose in the bloodstream from spiraling out of control. Over time, the cells simply can’t keep up. They stop responding to the insulin signal and the body becomes “insulin resistant.” Now, the body is forced to release even more insulin because it cannot let blood sugar get too high. Having excess insulin in the bloodstream, or hyperinsulinemia, is a serious problem because the body can’t endure prolonged high levels of insulin. Too much insulin disrupts cellular metabolism and spreads inflammation. When your body is unable to keep blood glucose under control, it leads to diabetes, though that is only the most obvious disease caused by insulin resistance. Along the way, there are many other serious negative health effects that can happen before full-blown diabetes takes hold. Diabetes can then spiral into other health problems. You can stop this chain of events by making diet and lifestyle changes. You can start by understanding how insulin can get out of balance in the first place. How imbalanced insulin contributes to other hormonal imbalances Since insulin is considered a “major” hormone, it can affect many other hormone systems, including your “sex” hormones. A woman’s Continue reading >>
Insulin Resistance A Major Cause Of Pcos Symptoms
Although estimates vary, about 30%-80% of women with PCOS have insulin resistance. Hyperinsulinemia (high blood insulin levels) produces hyperandrogenism (excessive levels of male hormones such as testosterone) by stimulating ovarian androgen production and by reducing serum sex-hormone binding globulin (SHBG). This can make PCOS symptoms a lot worse. What Is Insulin Resistance? The hormone insulin performs many essential functions in the body but is primarily known for its role in glucose regulation. Under normal circumstances, insulin assures the efficient transfer of glucose from the bloodstream to the body. Insulin also serves as a signal to the liver to begin or discontinue glucose production. If the level of glucose in the cells is sufficient, insulin levels drop, signaling the liver to slow down glucose production. In contrast, if the cells of the body are not receiving enough glucose, the level of insulin will rise, signaling the liver to produce greater amounts of glucose. Insulin resistance (also known as Syndrome X) is the inability of insulin to perform its job effectively in the body. In early stages of Syndrome X, the body simply compensates by causing the beta cells of the pancreas to produce more insulin. Ultimately in some women, however, the beta cells may wear out and the body ceases to produce insulin in the amounts needed. The resultant condition is Type II diabetes mellitus. What Are the Causes? Insulin dysfunction is thought to be caused by several factors: Genetic abnormalities of one or more proteins of the insulin action cascade Fetal malnutrition Increased fat around the middle. It's thought that perhaps 50% of people have an inherited propensity for this disorder. You may be in this group if you have a family history of diabetes, cardiovascul Continue reading >>
What You Really Need To Know About Pcos & Insulin Resistance
Polycystic ovary syndrome is often described as a circle of symptoms. Symptom A triggers Symptom B, leading to Symptom C, which keeps Symptom A going. Complicating matters further is the fact that, while PCOS affects an estimated 10-20% of women worldwide, the syndrome manifests differently from case to case. For example, not all women diagnosed with PCOS actually have cysts on their ovaries (and many women without PCOS do), leading many in the medical community to call for a new name — one which, as one doctor put it, “reflects the complex interactions that characterize the syndrome.” So far, nobody’s come up with a winner. But there is one symptom which appears more frequently than others: Approximately 65-70% of women with PCOS have insulin resistance. Sometimes referred to as “insulin insensitivity,” this is a condition in which the body fails to properly respond when insulin is released, leading to improper metabolization of carbohydrates and therefore elevated blood glucose. That can lead to things like rapid weight cycling, which can then trigger elevated androgen levels, which, of course, leads right back to greater insulin resistance, and the cycle continues. Here’s the good news: While insulin resistance is one of the most common symptoms of PCOS, there are many ways to manage it — some of which you may have never heard about. Typically, patients are told that medication, weight loss, and carbohydrate restriction (or even elimination) are the only solutions. But, as with everything about PCOS, the answer isn’t simple. When it comes to understanding and treating this particular symptom, it’s a lot more complicated — and hopeful — than you’d think. Continue reading >>
