Alterations in nonesterified free fatty acid trafficking rather than hyperandrogenism contribute to metabolic health in obese women with polycystic ovary syndrome

NEFA公司 内科学 内分泌学 多囊卵巢 高雄激素血症 胰岛素抵抗 医学 肥胖 胰岛素 脂肪酸 卵巢 生物 生物化学
作者
Uche Ezeh,Y-D Ida Chen,Marita Pall,Richard P. Buyalos,Jessica L. Chan,Margareta D. Pisarska,Ricardo Azziz
出处
期刊:Fertility and Sterility [Elsevier BV]
卷期号:121 (6): 1040-1052
标识
DOI:10.1016/j.fertnstert.2024.01.030
摘要

Objective To determine whether alterations in nonesterified fatty acid (NEFA) dynamics or degree of hyperandrogenism (HA) contribute to the difference in insulin sensitivity between women with metabolically healthy obese polycystic ovary syndrome (PCOS) (MHO-PCOS) and women with metabolically unhealthy obese PCOS (MUO-PCOS). Design Prospective cross-sectional study. Setting Tertiary-care academic center. Patients One hundred twenty-five obese women with PCOS. Intervention Consecutive obese (body mass index [BMI] ≥ 30 kg/m2) oligo-ovulatory women (n = 125) with PCOS underwent an oral glucose tolerance test and a subgroup of 16 participants underwent a modified frequently sampled intravenous glucose tolerance test to determine insulin-glucose and -NEFA dynamics. Main Outcome Measures Degree of insulin resistance (IR) in adipose tissue (AT) basally (Adipo-IR) and dynamically (the nadir in NEFA levels observed [NEFAnadir], the time it took for NEFA levels to reach nadir [TIMEnadir], and the percent suppression in plasma NEFA levels from baseline to nadir [%NEFAsupp]); peak lipolysis rate (SNEFA) and peak rate of NEFA disposal from plasma pool (KNEFA); whole-body insulin-glucose interaction (acute response of insulin to glucose [AIRg], insulin sensitivity index [Si], glucose effectiveness [Sg], and disposition index [Di]); and HA (hirsutism score, total and free testosterone levels, and dehydroepiandrosterone sulfate levels). Results A total of 85 (68%) women were MUO-PCOS and 40 (32%) were MHO-PCOS using the homeostasis model of assessment of IR. Subjects with MUO-PCOS and MHO-PCOS did not differ in mean age, BMI, waist-to-hip ratio, HA, and lipoprotein levels. By a modified frequently sampled intravenous glucose tolerance test, eight women with MUO-PCOS had lesser Si, KNEFA, and the percent suppression in plasma NEFA levels from baseline to nadir (%NEFAsupp) and greater TIMEnadir, NEFAnadir, and baseline adipose tissue IR index (Adipo-IR) than eight subjects with MHO-PCOS, but similar fasting NEFA levels and SNEFA. Women with MUO-PCOS had a higher homeostasis model of assessment-β% and fasting insulin levels than women with MHO-PCOS. In bivalent analysis, Si correlated strongly and negatively with Adipo-IR and NEFAnadir, weakly and negatively with TIMEnadir, and positively with KNEFA and %NEFAsupp, in women with MUO-PCOS only. Conclusion Independent of age and BMI, women with MUO-PCOS have reduced NEFA uptake and altered insulin-mediated NEFA suppression, but no difference in HA, compared with women with MHO-PCOS. Altered insulin-mediated NEFA suppression, rather than HA or lipolysis rate, contributes to variations in insulin sensitivity among obese women with PCOS. To determine whether alterations in nonesterified fatty acid (NEFA) dynamics or degree of hyperandrogenism (HA) contribute to the difference in insulin sensitivity between women with metabolically healthy obese polycystic ovary syndrome (PCOS) (MHO-PCOS) and women with metabolically unhealthy obese PCOS (MUO-PCOS). Prospective cross-sectional study. Tertiary-care academic center. One hundred twenty-five obese women with PCOS. Consecutive obese (body mass index [BMI] ≥ 30 kg/m2) oligo-ovulatory women (n = 125) with PCOS underwent an oral glucose tolerance test and a subgroup of 16 participants underwent a modified frequently sampled intravenous glucose tolerance test to determine insulin-glucose and -NEFA dynamics. Degree of insulin resistance (IR) in adipose tissue (AT) basally (Adipo-IR) and dynamically (the nadir in NEFA levels observed [NEFAnadir], the time it took for NEFA levels to reach nadir [TIMEnadir], and the percent suppression in plasma NEFA levels from baseline to nadir [%NEFAsupp]); peak lipolysis rate (SNEFA) and peak rate of NEFA disposal from plasma pool (KNEFA); whole-body insulin-glucose interaction (acute response of insulin to glucose [AIRg], insulin sensitivity index [Si], glucose effectiveness [Sg], and disposition index [Di]); and HA (hirsutism score, total and free testosterone levels, and dehydroepiandrosterone sulfate levels). A total of 85 (68%) women were MUO-PCOS and 40 (32%) were MHO-PCOS using the homeostasis model of assessment of IR. Subjects with MUO-PCOS and MHO-PCOS did not differ in mean age, BMI, waist-to-hip ratio, HA, and lipoprotein levels. By a modified frequently sampled intravenous glucose tolerance test, eight women with MUO-PCOS had lesser Si, KNEFA, and the percent suppression in plasma NEFA levels from baseline to nadir (%NEFAsupp) and greater TIMEnadir, NEFAnadir, and baseline adipose tissue IR index (Adipo-IR) than eight subjects with MHO-PCOS, but similar fasting NEFA levels and SNEFA. Women with MUO-PCOS had a higher homeostasis model of assessment-β% and fasting insulin levels than women with MHO-PCOS. In bivalent analysis, Si correlated strongly and negatively with Adipo-IR and NEFAnadir, weakly and negatively with TIMEnadir, and positively with KNEFA and %NEFAsupp, in women with MUO-PCOS only. Independent of age and BMI, women with MUO-PCOS have reduced NEFA uptake and altered insulin-mediated NEFA suppression, but no difference in HA, compared with women with MHO-PCOS. Altered insulin-mediated NEFA suppression, rather than HA or lipolysis rate, contributes to variations in insulin sensitivity among obese women with PCOS.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
月军完成签到,获得积分10
3秒前
小静完成签到 ,获得积分10
7秒前
SYLH应助月军采纳,获得10
9秒前
悄悄是心上的肖肖完成签到 ,获得积分10
13秒前
13秒前
wangermazi完成签到,获得积分0
17秒前
执着的忆雪完成签到 ,获得积分10
18秒前
骄傲慕尼黑完成签到,获得积分10
19秒前
飞龙在天完成签到,获得积分0
23秒前
银海里的玫瑰_完成签到 ,获得积分10
23秒前
marc107完成签到,获得积分10
24秒前
朱佳宁完成签到 ,获得积分10
25秒前
量子星尘发布了新的文献求助50
25秒前
小土豆完成签到 ,获得积分10
26秒前
搜集达人应助法桐落梦采纳,获得100
30秒前
alho完成签到 ,获得积分10
40秒前
执着乐双完成签到,获得积分10
40秒前
peng完成签到,获得积分10
46秒前
波里舞完成签到 ,获得积分10
46秒前
世间安得双全法完成签到,获得积分0
48秒前
Xenia完成签到 ,获得积分10
49秒前
小胖完成签到 ,获得积分10
50秒前
豆花浮元子完成签到 ,获得积分10
51秒前
修语完成签到,获得积分10
51秒前
aDou完成签到 ,获得积分10
52秒前
菓小柒完成签到 ,获得积分10
54秒前
xc完成签到 ,获得积分10
56秒前
i2stay完成签到,获得积分10
56秒前
随心所欲完成签到 ,获得积分10
1分钟前
panda完成签到,获得积分10
1分钟前
吃饱再睡完成签到 ,获得积分10
1分钟前
星辰大海应助Wang采纳,获得10
1分钟前
沙漠西瓜皮完成签到 ,获得积分10
1分钟前
1分钟前
法桐落梦发布了新的文献求助100
1分钟前
为你钟情完成签到 ,获得积分10
1分钟前
sougardenist完成签到 ,获得积分10
1分钟前
1分钟前
量子星尘发布了新的文献求助10
1分钟前
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
A new approach to the extrapolation of accelerated life test data 1000
Coking simulation aids on-stream time 450
北师大毕业论文 基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 390
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Robot-supported joining of reinforcement textiles with one-sided sewing heads 360
Novel Preparation of Chitin Nanocrystals by H2SO4 and H3PO4 Hydrolysis Followed by High-Pressure Water Jet Treatments 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4015603
求助须知:如何正确求助?哪些是违规求助? 3555597
关于积分的说明 11318138
捐赠科研通 3288782
什么是DOI,文献DOI怎么找? 1812284
邀请新用户注册赠送积分活动 887882
科研通“疑难数据库(出版商)”最低求助积分说明 812015