Top

Published in:

Open Access 01-12-2010 | Research

Changes in androgens and insulin sensitivity indexes throughout pregnancy in women with polycystic ovary syndrome (PCOS): relationships with adverse outcomes

Authors: Angela Falbo, Morena Rocca, Tiziana Russo, Antonietta D'Ettore, Achille Tolino, Fulvio Zullo, Francesco Orio, Stefano Palomba

Published in: Journal of Ovarian Research | Issue 1/2010

Abstract

Background

Given the high rate of pregnancy and perinatal complications recently observed in patients with polycystic ovary syndrome (PCOS) and the lack of data on the serum variations in androgens and insulin sensitivity indexes in pregnant women with PCOS, the current study was aimed to assess these changes and their potential effect on pregnancy outcomes in a population of women with PCOS.

Methods

Forty-five pregnant patients with ovulatory PCOS (PCOS group) and other 42 healthy pregnant women (control group) were studied assaying serum androgen levels and insulin sensitivity indexes throughout pregnancy serially, and recording obstetrical outcomes.

Results

Serum androgen levels and insulin resistance indexes were significantly (p < 0.05) higher in PCOS than in control group at study entry, these differences were sustained throughout pregnancy, and their changes resulted significantly (p < 0.05) different between PCOS and control group. In PCOS patients, women who had a complicated pregnancy showed serum androgen levels and insulin sensitivity indexes significantly (p < 0.05) worse in comparison to subjects without any pregnancy and/or neonatal complications.

Conclusions

PCOS patients have impaired changes in serum androgen levels and insulin sensitivity indexes during pregnancy. These alterations could be implicated in the pregnancy and neonatal complications frequently observed in women affected by PCOS.

Available only for authorised users

Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS: A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update 2006, 12: 673–683. 10.1093/humupd/dml036CrossRefPubMed

Palomba S, Falbo A, Russo T, Battista L, Tolino A, Orio F, Zullo F: Uterine blood flow in pregnant patients with polycystic ovary syndrome: relationships with clinical outcomes. BJOG 2010, 117: 711–721. 10.1111/j.1471-0528.2010.02525.xCrossRefPubMed

Palomba S, Falbo A, Russo T, Tolino A, Orio F, Zullo F: Pregnancy in women with polycystic ovary syndrome: the effect of different phenotypes and features on obstetric and neonatal outcomes. Fertil Steril, in press.

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004, 81: 19–25.

Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961, 21: 1440–1447. 10.1210/jcem-21-11-1440CrossRefPubMed

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and b-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28: 412–419. 10.1007/BF00280883CrossRefPubMed

Ducluzeau PH, Cousin P, Malvoisin E, Bornet H, Vidal H, Laville M, Pugeat M: Glucose-to-insulin ratio rather than sex hormone-binding globulin and adiponectin levels is the best predictor of insulin resistance in nonobese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003, 88: 3626–3631. 10.1210/jc.2003-030219CrossRefPubMed

Morley JE, Patrick P, Perry HM III: Evaluation of assays available to measure free testosterone. Metabolism 2002, 51: 554–559. 10.1053/meta.2002.31975CrossRefPubMed

Orio F Jr, Lucidi P, Palomba S, Tauchmanovà L, Cascella T, Russo T, Zullo F, Colao A, Lombardi G, De Feo P: Circulating ghrelin concentrations in the polycystic ovary syndrome. J Clin Endocrinol Metab 2003, 88: 942–945. 10.1210/jc.2002-021451CrossRefPubMed

10.

Mizuno M, Lobotsky J, Lloyd CW, Kobayashi T, Murasawa Y: Plasma androstenedione and testosterone during pregnancy and in the newborn. J Clin Endocrinol Metab 1968, 28: 1133–1142. 10.1210/jcem-28-8-1133CrossRefPubMed

11.

Rivarola MA, Forest MG, Migeon CJ: Testosterone, androstenedione and dehydroepiandrosterone in plasma during pregnancy and at delivery: concentration and protein binding. J Clin Endocrinol Metab 1968, 28: 34–40. 10.1210/jcem-28-1-34CrossRefPubMed

12.

Berger NG, Repke JT, Woodruff JD: Markedly elevated serum testosterone in pregnancy without foetal virilization. Obstet Gynecol 1984, 63: 260–262.PubMed

13.

McClamrock AD, Adashi EY: Gestational hyperandrogenism. Fertil Steril 1992, 57: 257–274.PubMed

14.

Sir-Petermann T, Maliqueo M, Angel B, Lara HE, Pérez-Bravo F, Recabarren SE: Maternal serum androgens in pregnant women with polycystic ovarian syndrome: possible implications in prenatal androgenization. Hum Reprod 2002, 17: 2573–2579. 10.1093/humrep/17.10.2573CrossRefPubMed

15.

Acromite MT, Mantzoros CS, Leach RE, Hurwitz J, Dorey LG: Androgens in preeclampsia. Am J Obstet Gynecol 1999, 180: 60–63. 10.1016/S0002-9378(99)70150-XCrossRefPubMed

16.

Serin IS, Kula M, Başbuğ M, Unlühizarci K, Güçer S, Tayyar M: Androgen levels of preeclamptic patients in the third trimester of pregnancy and six weeks after delivery. Acta Obstet Gynecol Scand 2001, 80: 1009–1013.CrossRefPubMed

17.

Carlsen SM, Jacobsen G, Romundstad P: Maternal testosterone levels during pregnancy are associated with offspring size at birth. Eur J Endocrinol 2006, 155: 365–370. 10.1530/eje.1.02200CrossRefPubMed

18.

Vanky E, Salvesen KA, Asberg A, Carlsen SM: Haemoglobin, C-reactive protein and androgen levels in uncomplicated and complicated pregnancies of women with polycystic ovary syndrome. Scand J Clin Lab Invest 2008, 68: 421–426. 10.1080/00365510701810613CrossRefPubMed

19.

Sir-Petermann T, Hitchsfeld C, Maliqueo M, Codner E, Echiburú B, Gazitúa R, Recabarren S, Cassorla F: Birth weight in offspring of mothers with polycystic ovarian syndrome. Hum Reprod 2005, 20: 2122–2126. 10.1093/humrep/dei009CrossRefPubMed

20.

Shobel HP, Fischer T, Heuszer K, Geiger H, Schmieder RE: Preeclampsia: a state of sympathetic overactivity. N Engl J Med 1996, 335: 1480–1485. 10.1056/NEJM199611143352002CrossRef

21.

Lampinen KH, Rönnback M, Groop PH, Kaaja RJ: A relationship between insulin sensitivity and vasodilation in women with a history of preeclamptic pregnancy. Hypertension 2008, 52: 394–401. 10.1161/HYPERTENSIONAHA.108.113423CrossRefPubMed

22.

Seely EW, Solomon CG: Insulin resistance and its potential role in pregnancy-induced hypertension. J Clin Endocrinol Metab 2003, 88: 2393–2398. 10.1210/jc.2003-030241CrossRefPubMed

23.

Sowers JR, Saleh AA, Sokol RJ: Hyperinsulinemia and insulin resistance are associated with preeclampsia in African-Americans. Am J Hypertens 1995, 8: 1–4. 10.1016/0895-7061(94)00166-9CrossRefPubMed

24.

Joffe GM, Esterlitz JR, Levine RJ, Clemens JD, Ewell MG, Sibai BM, Catalano PM: The relationship between abnormal glucose tolerance and hypertensive disorders of pregnancy in healthy nulliparous women. Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol 1998, 179: 1032–1037. 10.1016/S0002-9378(98)70210-8CrossRefPubMed

25.

Wolf M, Sandler L, Muñoz K, Hsu K, Ecker JL, Thadhani R: First trimester insulin resistance and subsequent preeclampsia: a prospective study. J Clin Endocrinol Metab 2002, 87: 1563–1568. 10.1210/jc.87.4.1563CrossRefPubMed

26.

Thadhani R, Ecker JL, Mutter WP, Wolf M, Smirnakis KV, Sukhatme VP, Levine RJ, Karumanchi SA: Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia. Hypertension 2004, 43: 988–992. 10.1161/01.HYP.0000124460.67539.1dCrossRefPubMed

27.

Thadhani R, Ecker J, Kettyle E, Sandler L, Frigoletto F: Pulse pressure and risk of preeclampsia: a prospective study. Obstet Gynecol 2001, 97: 515–520. 10.1016/S0029-7844(00)01192-3CrossRefPubMed

28.

Wolf M, Kettyle E, Sandler L, Ecker JL, Roberts J, Thadhani R: Obesity and preeclampsia: the potential role of inflammation. Obstet Gynecol 2001, 98: 757–762. 10.1016/S0029-7844(01)01551-4CrossRefPubMed

29.

Sibai BM, Ewell M, Levine RJ, Klebanoff MA, Esterlitz J, Catalano PM, Goldenberg RL, Joffe G: Risk factors associated with preeclampsia in healthy nulliparous women. The Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol 1997, 177: 1003–1010. 10.1016/S0002-9378(97)70004-8CrossRefPubMed

Title: Changes in androgens and insulin sensitivity indexes throughout pregnancy in women with polycystic ovary syndrome (PCOS): relationships with adverse outcomes
Authors: Angela Falbo
Morena Rocca
Tiziana Russo
Antonietta D'Ettore
Achille Tolino
Fulvio Zullo
Francesco Orio
Stefano Palomba
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Journal of Ovarian Research / Issue 1/2010
Electronic ISSN: 1757-2215
DOI: https://doi.org/10.1186/1757-2215-3-23

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in androgens and insulin sensitivity indexes throughout pregnancy in women with polycystic ovary syndrome (PCOS): relationships with adverse outcomes

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

Struma ovarii associated with pseudo-Meigs' syndrome and elevated serum CA 125: a case report and review of the literature

CCR9 interactions support ovarian cancer cell survival and resistance to cisplatin-induced apoptosis in a PI3K-dependent and FAK-independent fashion

Analysis of ovarian tumor pathology by Fourier Transform Infrared Spectroscopy

Constitutive activation of BMP signalling abrogates experimental metastasis of OVCA429 cells via reduced cell adhesion

Augmented inhibition of angiogenesis by combination of HER2 antibody chA21 and trastuzumab in human ovarian carcinoma xenograft

Curcumin induces chemo/radio-sensitization in ovarian cancer cells and curcumin nanoparticles inhibit ovarian cancer cell growth