Skip to main content
SpringerLink
Log in

Insulin resistance in nonobese Japanese women with polycystic ovary syndrome is associated with poorer glucose tolerance, delayed insulin secretion, and enhanced insulin response

  • Original Article
  • Published:
Reproductive Medicine and Biology

Abstract

Purpose

To determine the prevalence of insulin resistance (IR) and impaired glucose tolerance (IGT) in PCOS patients, the optimal screening method, and to compare our findings between nonobese and obese Japanese women with PCOS.

Methods

Ninety-eight PCOS patients were included in this research from 2006 to 2013. Glucose tolerance test (OGTT) was performed. Serum glucose and insulin concentration were assayed before and 30, 60, and 120 min after taking 75 g of glucose.

Results

All examined metabolic parameters were significantly favorable in the nonobese subjects, below 25 kg/m2. HOMA-IR, fasting insulin, glucose120, and insulin120 showed strong correlations with BMI. A total of 1.4 % of nonobese women had IR based on fasting insulin or HOMA-IR. However, 15.5 % (11/71) of nonobese women had IR as determined by a continuous increase of serum insulin level in OGTT. In comparison, the prevalence of IR among the obese women ranged from 41 to 59 %. AUCglucose, glucose60, glucose120, and insulin120 in nonobese women with a continuous insulin increase were higher than those without such a continuous increase.

Conclusions

All examined metabolic parameters were significantly correlated with BMI. As the presence of a continuous increase of insulin level reflects to some degree poorer glucose tolerance, delayed insulin secretion, and enhanced insulin response compared with non-continuous insulin increase, OGTT might not been excluded to determine IR and IGT for nonobese women with PCOS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Randeva HS, Tan BK, Weickert MO, Lois K, Nestler JE, Sattar N, Lehnert H. Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev. 2012;33:812–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Kubota T. Update in polycystic ovary syndrome: new criteria of diagnosis and treatment in Japan. Reprod Med Biol. 2013;12:71–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Kauffman RP, Baker VM, Dimarino P, Gimpel T, Castracane VD. Polycystic ovarian syndrome and insulin resistance in white and Mexican American women: a comparison of two distinct populations. Am J Obstet Gynecol. 2002;187:1362–9.

    Article  PubMed  Google Scholar 

  4. Radziuk J. Insulin sensitivity and its measurement: structural commonalities among the methods. J Clin Endocrinol Metab. 2000;85:4426–33.

    CAS  PubMed  Google Scholar 

  5. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997;20:1183–97.

  6. Carmina E, Koyama T, Chang L, Stanczyk FZ, Lobo RA. Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome? Am J Obstet Gynecol. 1992;167:1807–12.

    Article  CAS  PubMed  Google Scholar 

  7. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38:1165–74.

    Article  CAS  PubMed  Google Scholar 

  8. Dunaif A. Insulin action in the polycystic ovary syndrome. Endocrinol Metab Clin North Am. 1999;28:341–59.

    Article  CAS  PubMed  Google Scholar 

  9. Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertil Steril. 2002;77:1095–105.

    Article  PubMed  Google Scholar 

  10. Stovall DW, Amelia Purser Bailey AP, Lisa M, Pastore LM. Assessment of insulin resistance and impaired glucose tolerance in lean women with polycystic ovary syndrome. J Womens Health. 2011;20:37–43.

    Article  Google Scholar 

  11. Takeuchi T, Tsutsumi O, Taketani Y. Abnormal response of insulin to glucose loading and assessment of insulin resistance in non-obese patients with polycystic ovary syndrome. Gynecol Endocrinol. 2008;24:385–91.

    Article  CAS  PubMed  Google Scholar 

  12. Salley KE, Wickham EP, Cheang KI, Essah PA, Karjane NW, Nestler JE. Glucose intolerance in polycystic ovary syndrome—a position statement of the Androgen Excess Society. J Clin Endocrinol Metab. 2007;92:4546–56.

    Article  CAS  PubMed  Google Scholar 

  13. Dunaif A, Finegood DT. Beta-cell dysfunction independent of obesity and glucose intolerance in the polycystic ovary syndrome. J Clin Endocrinol Metab. 1996;81:942–7.

    CAS  PubMed  Google Scholar 

  14. Arslanian SA, Lewy VD, Danadian K. Glucose intolerance in obese adolescents with polycystic ovary syndrome: roles of insulin resistance and beta-cell dysfunction and risk of cardiovascular disease. J Clin Endocrinol Metab. 2001;86:66–71.

    CAS  PubMed  Google Scholar 

  15. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141–6.

    Article  CAS  PubMed  Google Scholar 

  16. Holte J, Bergh T, Berne C, Wide L, Lithell H. Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1995;80:2586–93.

    CAS  PubMed  Google Scholar 

  17. Morin-Papunen LC, Vauhkonen I, Koivunen RM, Ruokonen A, Tapanainen JS. Insulin sensitivity, insulin secretion, and metabolic and hormonal parameters in healthy women and women with polycystic ovarian syndrome. Hum Reprod. 2000;15:1266–74.

    Article  CAS  PubMed  Google Scholar 

  18. Vrbikova J, Grimmichova T, Dvorakova K, Hill M, Stanicka S, Vondra K. Family history of diabetes mellitus determines insulin sensitivity and beta cell function in polycystic ovary syndrome. Physiol Res. 2008;57:547–53.

    CAS  PubMed  Google Scholar 

  19. Manco M, Castagneto-Gissey L, Arrighi E, Carnicelli A, Brufani C, Luciano R, Mingrone G. Insulin dynamics in young women with polycystic ovary syndrome and normal glucose tolerance across categories of body mass index. PLoS One. 2014;4(9):e92995.

    Article  Google Scholar 

  20. The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;8:19–25.

    Google Scholar 

  21. Office for Life-Style Related Diseases Control. General Affairs Division, Ministry of Health, Labour and Welfare, Japan. The National Health and Nutrition Survey in Japan, 2009.

  22. Tan S, Hahn S, Benson S, Dietz T, Lahner H, Moeller LC, Schmidt M, Elsenbruch S, Kimmig R, Mann K, Janssen OE. Metformin improves polycystic ovary syndrome symptoms irrespective of pre-treatment insulin resistance. Eur J Endocrinol. 2007;157:669–76.

    Article  CAS  PubMed  Google Scholar 

  23. Marcondes JA, Yamashita SA, Maciel GA, Baracat EC, Halpern A. Metformin in normal-weight hirsute women with polycystic ovary syndrome with normal insulin sensitivity. Gynecol Endocrinol. 2007;23:273–8.

    Article  CAS  PubMed  Google Scholar 

  24. Yilmaz M, Biri A, Karakoç A, Törüner F, Bingöl B, Cakir N, Tiras B, Ayvaz G, Arslan M. The effects of rosiglitazone and metformin on insulin resistance and serum androgen levels in obese and lean patients with polycystic ovary syndrome. J Endocrinol Invest. 2005;28:1003–8.

    Article  CAS  PubMed  Google Scholar 

  25. Kumari AS, Haq A, Jayasundaram R, Abdel-Wareth LO, Al Haija SA, Alvares M. Metformin monotherapy in lean women with polycystic ovary syndrome. Reprod Biomed Online. 2005;10:100–4.

    Article  CAS  PubMed  Google Scholar 

  26. Palomba S, Falbo A, La Sala GB. Metformin and gonadotropins for ovulation induction in patients with polycystic ovary syndrome: a systematic review with meta-analysis of randomized controlled trials. Reprod Biol Endocrinol. 2014;12:3.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge the contributions of Rena Ishii, Rena Ikeda, Kumiko Kuroda, and Hisae Yokota for sample processing.

Conflict of interest

H. Negishi, K. Nakao, M. Kimura, H. Takenaka, and M. Horikawa declare that they have no conflicts of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later amendments. Informed consent was obtained from all patients for being included in the study.

Animal rights

This article does not contain any studies with animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Women’s Clinic Ooizumigakuen, Higashi-oizumi 1-27-19, Nerima-ku, Tokyo, 178-0063, Japan

    Hiroaki Negishi, Kazuki Nakao, Hiroshi Takenaka & Michiharu Horikawa

  2. Department of Obstetrics and Gynecology, Saitama Medical College, Morohongou 38, Moroyama Town, Iruma-gun, Saitama, 350-0495, Japan

    Michiko Kimura

Authors
  1. Hiroaki Negishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuki Nakao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michiko Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Takenaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michiharu Horikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroaki Negishi.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Negishi, H., Nakao, K., Kimura, M. et al. Insulin resistance in nonobese Japanese women with polycystic ovary syndrome is associated with poorer glucose tolerance, delayed insulin secretion, and enhanced insulin response. Reprod Med Biol 14, 123–129 (2015). https://doi.org/10.1007/s12522-015-0204-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12522-015-0204-x

Keywords

Search

Navigation