Tropeano G, Lucisano A, Liberale I, Barini A, Vuolo I P, Martino G, Menini E, Dell'Acqua S
Department of Obstetrics and Gynecology, Universitá Cattolica, del S. Guore, Rome, Italy.
J Clin Endocrinol Metab. 1994 Feb;78(2):305-9. doi: 10.1210/jcem.78.2.8106616.
We examined the effects of an oral glucose load on plasma insulin, androgens, and beta-endorphin (beta EP) concentrations in patients carefully selected as having polycystic ovary syndrome (PCOS) and normal glucose tolerance. Our aim was to verify whether insulin resistance is a common feature of PCOS and to differentiate the metabolic abnormalities related to PCOS from those associated with obesity. Plasma immunoreactive insulin (IRI), C-peptide (C-PR), testosterone, androstenedione, dehydroepiandrosterone sulfate, ACTH, and beta EP responses to a 3-h oral glucose tolerance test (OGTT) were evaluated in 10 obese (OB-PCOS) and 10 nonobese (NO-PCOS) patients with PCOS and in 7 obese and 7 nonobese ovulatory controls. OB-PCOS and NO-PCOS did not differ significantly from weight-matched controls in the IRI response, but had a significantly higher C-PR response in terms of mean postglucose load levels and mean incremental areas. During OGTT, mean plasma levels of testosterone, androstenedione, and dehydroepiandrosterone sulfate declined in both PCOS groups as well as in controls, and no significant correlation between the plasma androgen and IRI or C-PR responses was found. The ACTH response in OB-PCOS and NO-PCOS was similar to that in controls, with a progressive decrease until 180 min. A similar decline in plasma beta EP was found in controls, whereas no change in plasma beta EP was observed in OB-PCOS and NO-PCOS. These findings indicate that independently of the presence of obesity, PCOS patients have enhanced insulin secretion in response to OGTT and show a peculiar pattern of changes in plasma beta EP.
我们研究了口服葡萄糖负荷对精心挑选的患有多囊卵巢综合征（PCOS）且糖耐量正常的患者血浆胰岛素、雄激素和β-内啡肽（β-EP）浓度的影响。我们的目的是验证胰岛素抵抗是否是PCOS的一个共同特征，并将与PCOS相关的代谢异常与肥胖相关的代谢异常区分开来。对10名肥胖（OB-PCOS）和10名非肥胖（NO-PCOS）的PCOS患者以及7名肥胖和7名非肥胖的排卵对照者进行了评估，检测其血浆免疫反应性胰岛素（IRI）、C肽（C-PR）、睾酮、雄烯二酮、硫酸脱氢表雄酮、促肾上腺皮质激素（ACTH）和β-EP对3小时口服葡萄糖耐量试验（OGTT）的反应。OB-PCOS和NO-PCOS在IRI反应方面与体重匹配的对照组无显著差异，但在葡萄糖负荷后平均水平和平均增量面积方面，C-PR反应显著更高。在OGTT期间，PCOS组和对照组的血浆睾酮、雄烯二酮和硫酸脱氢表雄酮平均水平均下降，且未发现血浆雄激素与IRI或C-PR反应之间存在显著相关性。OB-PCOS和NO-PCOS的ACTH反应与对照组相似，直到180分钟逐渐下降。对照组血浆β-EP也有类似下降，而OB-PCOS和NO-PCOS的血浆β-EP未观察到变化。这些发现表明，无论是否存在肥胖，PCOS患者对OGTT的胰岛素分泌增强，且血浆β-EP呈现出特殊的变化模式。
