Session: SUN 498-523-Female Reproductive Endocrinology & Case Reports
Poster Board SUN-503
Ten PCOS and 9 reproductively-normal premenopausal control women (C) of comparable age and BMI underwent 180 min hypoglycemic clamp studies at a 60 mU/m2/min insulin dose. Plasma glucose was clamped at ~52 mg/dL. Endogenous glucose production (EGP) was determined in the postabsorptive state and during the last 30 min of the clamp (steady-state) using steady-state tracer kinetics. Insulin-mediated glucose disposal (IMGD) was the sum of the glucose infusion rate and residual EGP. Groups were compared by two-tailed t- or non-parametric tests, as appropriate (mean ± SD).
PCOS and C women reached glucose nadir at 45 and 35 min, respectively, P< 0.001. In the postabsorptive state, glucose levels were similar but insulin levels were higher in PCOS (PCOS 26±8 vs C 16±6 µU/mL, P=0.008). Steady-state insulin levels were higher in PCOS (PCOS 158±35 vs C 126±16 µU/ml, P=0.02). Neither basal nor steady-state EGP differed. IMGD was significantly decreased in PCOS (PCOS 101±37 vs C 144±46 mg/m2/min, P=0.02), despite higher insulin levels in affected women. The change (Δ) from postabsorptive to steady-state glucagon levels was increased in PCOS (PCOS 55±35 vs C 22±25 pg/mL, P=0.04). There was a trend towards decreased Δ steady-state cortisol levels in PCOS (P=0.07). Postabsorptive lactate levels were higher in PCOS (PCOS 9.3±1.7 vs C 7.1±3.1 mg/dL, P=0.03) and showed an inverse correlation with IMGD (R2= 0.27, P= 0.03). Postabsorptive and Δ steady-state growth hormone, cortisol, catecholamines, free fatty acid, glycerol and pancreatic polypeptide levels did not differ.
CRR modulated by estrogen did not differ in PCOS and C women. In contrast, glucagon responses were increased in PCOS, a male pattern not entirely accounted for by differences in circulating estrogen levels. Our findings suggest that CRR are masculinized in PCOS. Higher basal lactate levels in PCOS may reflect decreased insulin sensitivity as reported in other insulin-resistant states.
Disclosure: AD: Speaker, Bayer Schering Pharma, Advisory Group Member, Amylin Pharmaceuticals, Advisory Group Member, Bristol-Myers Squibb. Nothing to Disclose: PV, SKY, RNB
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