Obesity worsens hyperproinsulinemia in women with PCOS but metformin improves it

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 498-523-Female Reproductive Endocrinology & Case Reports
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-516
Aleksandra Kruszynska*, Jadwiga Slowinska-Srzednicka and Wojciech Zgliczynski
The Medical Centre of Postgraduate Education, Warsaw, Poland
 

Context:PCOS women suffer from obesity, insulin resistance and chronic inflammation, which exposes them to an increased cardiovascular risk. Proinsulin is the prohormone precursor to insulin and seems to be a marker of insulin resistance. The role of proinsulin in pathogenesis of PCOS has not been well elucidated.

The objectivewas: 1. to determine proinsulin and hsCRP concentrations in lean and obese PCOS women in comparison to lean and obese healthy women. 2.to compare insulin resistance indexes and androgens levels between obese and lean PCOS women 3. to access  the influence of metformin treatment on proinsulin and hsCRP in lean and obese PCOS patients.

Design and Setting:Two PCOS groups of patients (lean and obese)  with two control groups were compared at baseline. Metformin was administered for six months. The study was performed at a teaching hospital.

Patients and Interventions: 90 lean and 88 obese or overweight women diagnosed according to Rotterdam PCOS criteria were included.  Control groups consisted of 42 healthy women. PCOS women (n=32) were studied at baseline, after three months, and after six months of metformin (1000mg/day) treatment.  Proinsulin and hsCRP concentrations within the four groups were compared at baseline and after the metformin treatment in PCOS women.

Results:

1. Proinsulin and hsCRP levels in obese PCOS women were higher than in both lean PCOS women (proinsulin: 11,4 vs 6,9 pmol/l; hsCRP 2,46 vs 0,47 mg/l, p<0,01) and in obese controls.

2. Fasting insulin, the AUC-insulin, HOMA, Quicki, sigmaIRI and Matsuda index were significantly higher in obese PCOS compared with lean PCOS and compared with obese controls.

3. FAI and freeT levels in obese PCOS were higher than in lean PCOS women.

4. In obese PCOS there was a positive correlation between plasma levels of proinsulin and: fasting insulin, AUC-insulin, HOMA, hsCRP and FAI and negative correlation between proinsulin and Quicki.

5. Plasma proinsulin levels decreased after metformin treatment only in obese PCOS women.

6. No influence of the metformin treatment on hsCRP levels was observed.

Conclusions: PCOS, when accompanied by obesity, is associated with increased hsCRP and proinsulin level, which decrease after metformin treatment. Proinsulin seems to be a very sensitive marker of insulin resistance in PCOS. Obese PCOS women are characterized by hyperproinsulinemia and therefore intensive therapy of obesity and metformin treatment may prevent metabolic complications.

Nothing to Disclose: AK, JS, WZ

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm