Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositols metabolism

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Abstract

BACKGROUND

We have shown that American women with polycystic ovary syndrome (PCOS) have decreased glucose-stimulated release of a putative mediator of insulin action, D-chiro-inositol (DCI)-containing inositolphosphoglycan (DCI-IPG), and increased urinary clearance of DCI (uClDCI), which was associated with hyperinsulinemia.

METHODS

DCI levels and the release of insulin and DCI-IPG during an oral glucose tolerance test (AUCs) were assessed in 27 Greek PCOS and 10 normal Greek women.

RESULTS

PCOS women were heavier than controls (BMI=28.4 versus 23.7 kg/m2, P=0.05) with higher waist-to-hip ratios (WHR=0.78 versus 0.71, P=0.009) and increased free testosterone (P=0.048) and AUCinsulin (P=0.04). In PCOS women, incremental AUCDCI-IPG was significantly decreased by 59% (2158 versus 5276%·min, P=0.01), even after correction for BMI and WHR. Finally, increased uClDCI (r=0.35, P=0.04) and decreased AUCDCI-IPG (r=0.46, P=0.004) were significantly associated with hyperinsulinemia in all women together, even after correction for BMI and WHR (Ps=0.02 and 0.007), and regardless of PCOS status.

CONCLUSIONS

Greek women, with or without PCOS, display increased uClDCI and decreased AUCDCI-IPG in association with higher insulin levels but independent of adiposity. Increased clearance of inositols might reduce tissue availability of DCI and decrease the release of DCI-IPG mediator, which could contribute to insulin resistance and compensatory hyperinsulinemia in Greek women, as previously described in American women.

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