THE RELATIONSHIP BETWEEN CIRCULATING ANDROGENS, OBESITY, AND HYPERINSULINEMIA ON SERUM INSULIN-LIKE GROWTH-FACTOR BINDING PROTEIN-1 IN THE POLYCYSTIC OVARIAN SYNDROME
Rp. Buyalos et al., THE RELATIONSHIP BETWEEN CIRCULATING ANDROGENS, OBESITY, AND HYPERINSULINEMIA ON SERUM INSULIN-LIKE GROWTH-FACTOR BINDING PROTEIN-1 IN THE POLYCYSTIC OVARIAN SYNDROME, American journal of obstetrics and gynecology, 172(3), 1995, pp. 932-939
OBJECTIVE: Our purpose was to evaluate the relationship of obesity, hy
perinsulinemia, and hyperandrogenemia on serum insulin-like growth fac
tor binding protein-1 levels in women with the polycystic ovarian synd
rome. STUDY DESIGN: Insulin-like growth factor binding protein-1, insu
lin, and androgen levels were studied during a 3-hour intravenous gluc
ose tolerance test in 16 women with polycystic ovarian syndrome (nine
obese and seven nonobese) and 20 healthy control women (10 obese and 1
0 nonobese). RESULTS: Positive Correlations were observed between basa
l (r = 0.77, p = 0.04) and area under curve (r = 0.86, p < 0.001) insu
lin-like growth factor binding protein-1 with basal androstenedione in
the nonobese women with polycystic ovarian syndrome but not in other
groups of women examined or between other androgens and insulin-like g
rowth factor binding protein-1. An inverse relationship was observed b
etween log area under curve insulin-like growth factor binding protein
-1 levels and log body mass index in polycystic ovarian syndrome (r =
-0.54, p = 0.03) and in normal women (r = -0.43, p = 0.06). The log ar
ea under curve insulin-like growth factor binding protein-1 level was
approximately an inverse linear function of log area under curve insul
in response for both women with polycystic ovarian syndrome (r = -0.70
, p < 0.001) and control women (r = -0.72, p < 0.001). Additionally, a
fter the area under curve insulin response during intravenous glucose
tolerance testing was controlled for, the decline in area under curve
insulin-like growth factor binding protein-1 responses was on average
66% less in both obese and nonobese women with polycystic ovarian synd
rome compared with same-weight controls (95% confidence interval 110%
to 270%, p = 0.04). CONCLUSION: These data indicate that insulin and b
ody mass index are the major determinants of circulating insulin-like-
growth factor binding protein-1 and that chronic hyperandrogenemia doe
s not appear to further reduce serum insulin-like growth factor bindin
g protein-1 levels in obese or normal-weight women with polycystic ova
rian syndrome.