Japur Camila Cremonezi, Diez-Garcia Rosa Wanda, de Oliveira Penaforte Fernanda Rodrigues, de Sá Marcos Felipe Silva
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil Laboratory of Eating Practices and Behavior (PratiCA), Course of Nutrition and Metabolism, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
Laboratory of Eating Practices and Behavior (PratiCA), Course of Nutrition and Metabolism, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Reprod Sci. 2014 Aug;21(8):1020-1026. doi: 10.1177/1933719114522521. Epub 2014 Feb 11.
Obese women with polycystic ovary syndrome (PCOS) may have impairment in the regulation of food intake associated with ghrelin and insulin. In order to compare postprandial ghrelin and insulin responses to an ad libitum meal, we assessed 30 obese women with PCOS and 23 obese women without PCOS (control group). Blood samples were taken under fasting conditions, preprandially, and 15, 45, 75, and 135 minutes after the beginning of an ad libitum meal and ghrelin and insulin concentrations were analyzed. Insulin resistance (IR) was classified using basal insulin, quantitative insulin sensitivity check index, and homeostasis model assessment index. Mean ad libitum food intake was similar between the groups (468 ± 150 vs 444 ± 165 g, P = .60). The IR was found in 56.6% in PCOS group compared with 30.4% in the control group (P < .01). The postprandial ghrelin response was similar in both the groups but the insulin area under the curve (AUC) tend to be greater in the PCOS group (12807 ± 8149.4 vs 8654.4 ± 7232.3 μIU/mL/min; P = .057). The ghrelin AUC was negatively correlated with the insulin AUC (r = -.5138; P = .01) only in the control group. The imbalance in the feedback mechanisms between insulin and ghrelin, present in obese women, especially those with IR, may affect food intake throughout the day and that could be a mechanism for the development of obesity in PCOS.
患有多囊卵巢综合征（PCOS）的肥胖女性在与胃饥饿素和胰岛素相关的食物摄入调节方面可能存在障碍。为了比较随意进食餐后的餐后胃饥饿素和胰岛素反应，我们评估了30名患有PCOS的肥胖女性和23名无PCOS的肥胖女性（对照组）。在空腹条件下、餐前以及随意进食餐开始后的15、45、75和135分钟采集血样，并分析胃饥饿素和胰岛素浓度。使用基础胰岛素、定量胰岛素敏感性检查指数和稳态模型评估指数对胰岛素抵抗（IR）进行分类。两组之间的平均随意食物摄入量相似（468±150 vs 444±165克，P = 0.60）。PCOS组中56.6%存在IR，而对照组为30.4%（P < 0.01）。两组的餐后胃饥饿素反应相似，但PCOS组的胰岛素曲线下面积（AUC）往往更大（12807±8149.4 vs 8654.4±7232.3 μIU/mL/分钟；P = 0.057）。仅在对照组中，胃饥饿素AUC与胰岛素AUC呈负相关（r = -0.5138；P = 0.01）。肥胖女性，尤其是那些有IR的女性，胰岛素和胃饥饿素之间反馈机制的失衡可能会影响全天的食物摄入，这可能是PCOS肥胖发生的一种机制。
