Insulin-like growth factor 1, liver enzymes, and insulin resistance in patients with PCOS and hirsutism

Hyperinsulinemia and insulin resistance are commonly seen in patients with hirsutism and polycystic ovary syndrome (PCOS), and are associated with cardiovascular disease risk. However, it is not yet known whether insulin-like growth factor I (IGF-I) and alanine transaminase (ALT) produced by the liver play roles in hyperinsulinemia and subclinical atherosclerotic process in patients with PCOS and idiopathic hirsutism (IH). Materials and methods: This was a prospective case-controlled study. The study population consisted of 25 reproductive-age PCOS women, 33 women with IH, and 25 control subjects. Results: Mean IGF-I levels and median ALT levels were higher in patients with IH and PCOS than controls, but these differences were not statistically significant. The participants who had a homeostasis model assessment insulin resistance index (HOMA-IR) greater than 2.7 had significantly higher IGF-1 and ALT levels. ALT levels were positively correlated with body mass index, FG, insulin and HOMA-IR. Conclusion: The study illustrated that IGF-1 and ALT levels were significantly higher in patients with increased insulin resistance. Due to short disease duration in younger participants, we did not observe any correlation between IGF-1 and hyperinsulinemia. These findings suggest that increased hepatic production of IGF-I and ALT might be an early indicator of insulin resistance in hirsutism.

Insulin-like growth factor 1, liver enzymes, and insulin resistance in patients with PCOS and hirsutism

Hyperinsulinemia and insulin resistance are commonly seen in patients with hirsutism and polycystic ovary syndrome (PCOS), and are associated with cardiovascular disease risk. However, it is not yet known whether insulin-like growth factor I (IGF-I) and alanine transaminase (ALT) produced by the liver play roles in hyperinsulinemia and subclinical atherosclerotic process in patients with PCOS and idiopathic hirsutism (IH). Materials and methods: This was a prospective case-controlled study. The study population consisted of 25 reproductive-age PCOS women, 33 women with IH, and 25 control subjects. Results: Mean IGF-I levels and median ALT levels were higher in patients with IH and PCOS than controls, but these differences were not statistically significant. The participants who had a homeostasis model assessment insulin resistance index (HOMA-IR) greater than 2.7 had significantly higher IGF-1 and ALT levels. ALT levels were positively correlated with body mass index, FG, insulin and HOMA-IR. Conclusion: The study illustrated that IGF-1 and ALT levels were significantly higher in patients with increased insulin resistance. Due to short disease duration in younger participants, we did not observe any correlation between IGF-1 and hyperinsulinemia. These findings suggest that increased hepatic production of IGF-I and ALT might be an early indicator of insulin resistance in hirsutism.

___

  • Pasquali R, Gambineri A, Pagotto U. The impact of obesity on reproduction in women with polycystic ovary syndrome. BJOG 2006; 113: 1148–1159.
  • Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007; 370: 685–697. 3. Orio F, Jr., Palomba S, Spinelli L, Cascella T, Tauchmanova L, Zullo F, Lombardi G, Colao A. The cardiovascular risk of young women with polycystic ovary syndrome: an observational, analytical, prospective case-control study. J Clin Endocrinol Metab 2004; 89: 3696–3701.
  • Kelly CJ, Speirs A, Gould GW, Petrie JR, Lyall H, Connell JM. Altered vascular function in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002; 87: 742–746.
  • Dikmen E, Tarkun İ, Öztürk F, Arslan B, Cantürk Z. Plasma adiponectin and resistin levels in women with polycystic ovary syndrome: relation to body mass index and insulin resistance. Turk J Med Sci 2011; 41: 45–52.
  • Escobar-Morreale HF, Luque-Ramirez M, San Millan JL. The molecular-genetic basis of functional hyperandrogenism and the polycystic ovary syndrome. Endocr Rev 2005; 26: 251–282. 7. Legro RS. Polycystic ovary syndrome and cardiovascular disease: a premature association? Endocr Rev 2003; 24: 302–312.
  • Ecemiş GC, Kahraman H, Nural MS, Aslan HS, Atmaca A. The relationship between insulin resistance and carotid artery intima- media thickness in obese and morbidly obese women. Turk J Med Sci 2012; 42: 1121–1128. 9. LeRoith D, Roberts CT, Jr. The insulin-like growth factor system and cancer. Cancer Lett 2003; 195: 127–137.
  • Frasca F, Pandini G, Sciacca L, Pezzino V, Squatrito S, Belfiore A, Vigneri R. The role of insulin receptors and IGF-I receptors in cancer and other diseases. Arch Physiol Biochem 2008; 114: 23–37.
  • 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.
  • Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.
  • Gokcel A, Ozsahin AK, Sezgin N, Karakose H, Ertorer ME, Akbaba M, Baklaci N, Sengul A, Guvener N. High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes Care 2003; 26: 3031–3034.
  • Bonnet F, Ducluzeau PH, Gastaldelli A, Laville M, Anderwald CH, Konrad T, Mari A, Balkau B. Liver enzymes are associated with hepatic insulin resistance, insulin secretion, and glucagon concentration in healthy men and women. Diabetes 2011; 60: 1660–1667.
  • Oh J, Kim JY, Park S, Youn JC, Son NH, Shin DJ, Lee SH, Kang SM, Jee SH, Jang Y. The relationship between insulin- like growth factor-1 and metabolic syndrome, independent of adiponectin. Clin Chim Acta 2012; 413: 506–510.
  • Akanji AO, Smith RJ. The insulin-like growth factor system, metabolic syndrome, and cardiovascular disease risk. Metab Syndr Relat Disord 2012; 10: 3–13.
  • Eden JA, Jones J, Carter GD, Alaghband-Zadeh J. Follicular fluid concentrations of insulin-like growth factor 1, epidermal growth factor, transforming growth factor-alpha and sex- steroids in volume matched normal and polycystic human follicles. Clin Endocrinol (Oxf) 1990; 32: 395–405.
  • Kaaks R, Lukanova A. Energy balance and cancer: the role of insulin and insulin-like growth factor-I. Proc Nutr Soc 2001; 60: 91–106.
  • Pollak M. Insulin, insulin-like growth factors and neoplasia. Best Pract Res Clin Endocrinol Metab 2008; 22: 625–638.
  • Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer 2008; 8: 915–928.
  • Tekin O, Avci Z, Isik B, Ozkara A, Uraldi C, Catal F, Eraslan E, Delibasi T. Hirsutism: common clinical problem or index of serious disease? Med Gen Med 2004; 6: 56.
  • Abbas A, Imrie H, Viswambharan H, Sukumar P, Rajwani A, Cubbon RM, Gage M, Smith J, Galloway S, Yuldeshava N et al. The insulin-like growth factor-1 receptor is a negative regulator of nitric oxide bioavailability and insulin sensitivity in the endothelium. Diabetes 2011; 60: 2169–2178.
  • Hogg K, Wood C, McNeilly AS, Duncan WC. The in utero programming effect of increased maternal androgens and a direct fetal intervention on liver and metabolic function in adult sheep. PLoS One 2011; 6: e24877.
  • Juul A, Scheike T, Davidsen M, Gyllenborg J, Jorgensen T. Low serum insulin-like growth factor I is associated with increased risk of ischemic heart disease: a population-based case-control study. Circulation 2002; 106: 939–944.
  • Janssen JA, Stolk RP, Pols HA, Grobbee DE, Lamberts SW. Serum total IGF-I, free IGF-I, and IGFB-1 levels in an elderly population: relation to cardiovascular risk factors and disease. Arterioscler Thromb Vasc Biol 1998; 18: 277–282.
  • Botker HE, Skjaerbaek C, Eriksen UH, Schmitz O, Orskov H. Insulin-like growth factor-I, insulin, and angina pectoris secondary to coronary atherosclerosis, vasospasm, and syndrome X. Am J Cardiol 1997; 79: 961–963.
  • Spallarossa P, Brunelli C, Minuto F, Caruso D, Battistini M, Caponnetto S, Cordera R. Insulin-like growth factor-I and angiographically documented coronary artery disease. Am J Cardiol 1996; 77: 200–202.
  • Higashi Y, Sukhanov S, Anwar A, Shai SY, Delafontaine P. Aging, atherosclerosis, and IGF-1. J Gerontol A Biol Sci Med Sci 2012; 67: 626–639.
  • Chen W, Wang S, Tian T, Bai J, Hu Z, Xu Y, Dong J, Chen F, Wang X, Shen H. Phenotypes and genotypes of insulin- like growth factor 1, IGF-binding protein-3 and cancer risk: evidence from 96 studies. Eur J Hum Genet 2009; 17: 1668– 1675.
  • Rinaldi S, Cleveland R, Norat T, Biessy C, Rohrmann S, Linseisen J, Boeing H, Pischon T, Panico S, Agnoli C et al. Serum levels of IGF-I, IGFBP-3 and colorectal cancer risk: results from the EPIC cohort, plus a meta-analysis of prospective studies. Int J Cancer 2010; 126: 1702–1715.
  • Arteaga CL, Osborne CK. Growth inhibition of human breast cancer cells in vitro with an antibody against the type I somatomedin receptor. Cancer Res 1989; 49: 6237–6241.
  • Chappell J, Leitner JW, Solomon S, Golovchenko I, Goalstone ML, Draznin B. Effect of insulin on cell cycle progression in MCF-7 breast cancer cells. Direct and potentiating influence. J Biol Chem 2001; 276: 38023–38028.
  • Pollak MN, Polychronakos C, Yousefi S, Richard M. Characterization of insulin-like growth factor I (IGF-I) receptors of human breast cancer cells. Biochem Biophys Res Commun 1988; 154: 326–331.
  • Khandwala HM, McCutcheon IE, Flyvbjerg A, Friend KE. The effects of insulin-like growth factors on tumorigenesis and neoplastic growth. Endocr Rev 2000; 21: 215–244.
  • Arcidiacono B, Iiritano S, Nocera A, Possidente K, Nevolo MT, Ventura V, Foti D, Chiefari E, Brunetti A. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res 2012; 2012: 789174.
  • Cohen DH, Leroith D. Obesity, type 2 diabetes and cancer: the insulin and insulin-like growth factor connection. Endocr Relat Cancer 2012; 19: 27–45.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Leptin and leptin receptor polymorphisms are related to body mass index in a Turkish population

Uzay GÖRMÜŞ, Özlem TİMİRCİ KAHRAMAN, Bahar TOPTAŞ, Turgay İSBİR

The effect of Malaysian honey and its major components on the proliferation of cultured fibroblasts

Al-mahdi AL-JADI, Francis Kanyan ENCHANG, Kamaruddin Mohd YUSOFF

The correlation of ECHO findings of right cardiac pathologies with BNP, uric acid, and CRP in OSAS

Ömer ARAZ, Elif YILMAZEL UÇAR, Hüsnü DEĞİRMENCİ, Didem PULUR

Early extracorporeal life support experiences in 2 tertiary pediatric intensive care units in Turkey

Makbule Nilüfer ÖZTÜRK, Koray AK, Nilgün ERKEK, Edanur YEŞİL, Muhterem DUYU, Pınar YAZICI, Ayşen Yaprak ENGİN, Bülent KARAPINAR

Evaluation and comparison of alpha- and beta-amanitin toxicity on MCF-7 cell line

Ertuğrul KAYA, Recep BAYRAM, Kürşat Oğuz YAYKAŞLI, İsmail YILMAZ, Sait BAYRAM

Comparative study of photodynamic therapy monotherapy versus triple management in age-related macular degeneration*

Hüseyin ASLANKARA, Ahmet SELİM, Süleyman KAYNAK, Nilüfer KOÇAK

Early surgical results of a 23-gauge trocar combined with a one-directional valve system in primary and secondary pars plana vitrectomy

Ayşe Gül ALTINTAŞ, Hasan Basri ARİFOĞLU, Şükrü Gültekin KÖKLÜ, Kenan SÖNMEZ

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Işın ÜREYEN, Ülkü AKSOY, Betül DÜNDAR, Ömer Lütfi TAPISIZ, Mustafa Alper KARALÖK, Ahmet Taner TURAN, Nurettin BORAN, Hakkı Gökhan TULUNAY

Endothelial dysfunction and insulin resistance in young women with polycystic ovarian syndrome

Mine YAVUZ TAŞLIPINAR, Nedret KILIÇ, Nilüfer BAYRAKTAR, İsmail GÜLER, Yasemin GÜLCAN KURT

Polymorphisms in MMP-2 and TIMP-2 in Turkish patients with prostate cancer

Kürşat Oğuz YAYKAŞLI, Muhammet Ali KAYIKÇI, Nesibe YAMAK, Hatice SOĞUKTAŞ, Selma DÜZENLİ