Key result
PCOS adipocytes exhibit ~42% lower maximal insulin-stimulated glucose uptake despite normal insulin sensitivity.
Case-Control (n=10)
Absolute Event Rate: 2.2% vs 3.8%
p-value: p=0.02
Subcutaneous adipocytes from obese women with PCOS exhibit normal insulin sensitivity but reduced maximal insulin responsiveness, suggesting a qualitatively different insulin resistance mechanism compared to type 2 diabetes.
PCOS adipocytes show normal sensitivity but blunted maximal response; leaves open distinct mechanisms from type 2 diabetes.
BACKGROUND: Polycystic ovary syndrome (PCOS) has a high prevalence in women and is often associated with insulin resistance and hence with aspects of the so-called metabolic syndrome. METHODS: Ten women diagnosed with PCOS were consecutively included (aged 21-39 years, average 30.2 +/- 1.9 years; body mass index 28.4-42.5 kg/m2, average 37.5 +/- 1.7 kg/m2 (mean +/- s.e.)). Adipocytes were isolated from the subcutaneous fat and, after overnight incubation to recover from insulin resistance due to the surgical cell isolation procedures, they were analyzed for insulin sensitivity. RESULTS: The patients with PCOS exhibited marked clinical hyperinsulinemia with 3.6-fold higher blood levels of C-peptide than a healthy lean control group (1.7 +/- 0.2 and 0.5 +/- 0.02 nmol/l respectively, P < 0.0001). The patients with PCOS also exhibited 2.4-fold higher concentrations of serum triacylglycerol (2.1 +/- 0.3 and 0.9 +/- 0.06 mmol/l respectively, P < 0.0001), but only slightly elevated blood pressure (118 +/- 12/76 +/- 6 and 113 +/- 7/72 +/- 6 mmHg respectively, P = 0.055/0.046). However, insulin sensitivity for stimulation of glucose transport in the isolated adipocytes was indistinguishable from a non-PCOS, non-diabetic control group, while the maximal insulin effect on glucose uptake was significantly lower (2.2 +/- 0.2- and 3.8 +/- 0.8-fold respectively, P = 0.02). CONCLUSIONS: Subcutaneous adipocytes from patients with PCOS do not display reduced insulin sensitivity. The findings show that the insulin resistance of PCOS is qualitatively different from that of type 2 diabetes.
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Lystedt et al. (2005) conducted a case-control in Polycystic ovary syndrome (PCOS) (n=10). Polycystic ovary syndrome (PCOS) vs. Healthy lean and non-PCOS, non-diabetic controls was evaluated on Maximal insulin effect on glucose uptake (p=0.02). Subcutaneous adipocytes from women with PCOS exhibited normal insulin sensitivity but significantly lower maximal insulin effect on glucose uptake compared to controls (2.2- vs 3.8-fold, P=0.02).
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