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Women with polycystic ovary syndrome are sensitive to the TNF‐α‐lowering effect of glucose‐induced hyperinsulinaemia
Author(s) -
Puder J. J.,
Varga S.,
Nusbaumer C. P. G.,
Zulewski H.,
Bilz S.,
Müller B.,
Keller U.
Publication year - 2006
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.2006.01734.x
Subject(s) - medicine , endocrinology , polycystic ovary , insulin , hyperinsulinemia , impaired glucose tolerance , glucose tolerance test , progestin , insulin resistance , hormone
Background Restoration of near‐euglycaemia by intensive insulin therapy results in decreased serum levels of inflammatory mediators. The authors investigated whether the anti‐inflammatory effect of insulin was independent of its glucose‐lowering action and if this effect was intact in insulin‐resistant women with the polycystic ovary syndrome (PCOS) characterized by low‐grade chronic inflammation. Materials and methods Blood was drawn on the third and sixth days after progestin‐induced withdrawal bleeding in 20 young non‐diabetic women with PCOS and once between the third and sixth days of the menstrual cycle in 21 age‐matched lean healthy control women during a 75‐g oral glucose tolerance test (oGTT). Serum insulin, glucose and tumour necrosis factor alpha (TNF‐α) concentrations were measured after 0, 30, 60, 90 and 120 min. Results The increase in insulin and glucose concentrations during the oGTT was significantly more pronounced in patients with PCOS (one patient with impaired fasting glucose, one patient with impaired glucose tolerance, three patients with both) compared with healthy controls. The TNF‐α serum concentrations decreased in patients with PCOS (mean of both days, P = 0·004). In patients and in controls, there was an inverse correlation between the serum concentrations of insulin and of TNF‐α during oGTT (for patients, a mean of both days, P = 0·009; for controls, P = 0·047), but not between the serum concentrations of glucose and TNF‐α. Conclusions The decrease in TNF‐α concentrations during oGTT and the inverse correlation between endogenous hyperinsulinaemia and serum TNF‐α concentrations suggested an anti‐inflammatory effect of moderately‐high insulin concentrations. This occurred despite the presence of moderate hyperglycaemia. These findings also demonstrated a preserved responsiveness of inflammatory mediators to insulin in PCOS.