Insulin-induced capillary recruitment is impaired in both lean and obese women with PCOS

I. J. G. Ketel, Erik H. Serne, R.G. Ijzerman, T. J. M. Korsen, J.W. Twisk, P. G. A. Hompes, Yvo M. Smulders, R. Homburg, L. Vorstermans, C. D. A. Stehouwer, Cornelis B. Lambalk*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Insulin resistance, i.e. impaired insulin-mediated glucose uptake (IMGU), is a major risk factor for type 2 diabetes in women with polycystic ovary syndrome (PCOS). Insulin-induced capillary recruitment (IICR) is considered a significant determinant of IMGU. We investigated whether IICR is a determinant IMGU in obese and lean women with and without PCOS. METHODS: The study included 36 women with PCOS (20 lean, BMI 21.9 +/- 2.3 kg/m(2) and 16 obese, BMI 35.9 +/- 6.0 kg/m(2)) and 27 age-matched healthy controls (14 lean, BMI 22.2 +/- 1.8 kg/m(2) and 13 obese, BMI 40.5 +/- 7.0 kg/m(2)). IICR was evaluated by capillary microscopy during an isoglycemic-hyperinsulinemic clamp. IMGU was expressed as M/I value. RESULTS: The M/I value was significantly lower in obese PCOS women compared with obese controls [0.5 (0.2-1.1) versus 0.8 (0.3-1.4) (mg kg(-1) min(-1) pmol l(-1)) x 100, P <0.01], whereas the small difference between lean PCOS and lean control women was non-significant [1.5 (0.5-2.6) versus 1.7 (1.0-3.7) (mg kg(-1) min(-1) pmol l(-1)) x 100, P = 0.17]. Hyperinsulinemia increased capillary recruitment in lean controls (53.5 +/- 20.3 versus 64.9 +/- 27.4 n/mm(2), P <0.05), but not in either PCOS group nor in obese controls. IICR and androgens were a determinant of M/I value only in lean women with or without PCOS. CONCLUSIONS: PCOS per se is associated with impaired IICR. Obese women with PCOS, in part independent of obesity, demonstrated a profound insulin resistance, whereas the difference between lean PCOS women and healthy controls was small and statistically non-significant. IICR was a determinant of IMGU in lean, but not in obese, women regardless of the presence of PCOS.
Original languageEnglish
Pages (from-to)3130-3137
JournalHuman Reproduction
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 2011

Keywords

  • insulin resistance
  • capillary recruitment
  • obesity
  • PCOS

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