Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome

Poyrazoglu, Sukran; DARENDELİLER, FATMA FEYZA; BAŞ, Firdevs; BUNDAK, Rüveyde; YETİM ŞAHİN, Aylin; Uçar, Ahmet; YETİM, Çağcıl

doi:10.3906/sag-1808-52

Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome

Aylin YETİM ŞAHİN, (İstanbul Üniversitesi)

Firdevs BAŞ, (İstanbul Üniversitesi)

Çağcıl YETİM, (Biruni Üniversitesi)

Ahmet UÇAR, (Sağlık Bakanlığı)

Şükran POYRAZOĞLU, (İstanbul Üniversitesi)

Rüveyde BUNDAK, (İstanbul Üniversitesi)

FATMA FEYZA DARENDELİLER (İstanbul Üniversitesi)

Turkish Journal of Medical Sciences

4 2

Yıl: 2019 Cilt: 49 Sayı: 4 Sayfa Aralığı: 1117 - 1125 Metin Dili: İngilizce DOI: 10.3906/sag-1808-52 İndeks Tarihi: 13-05-2020

Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome

Öz:

Background/aim: This study aims to investigate the association between polycystic ovary syndrome (PCOS) and obesity and insulinresistance (IR) with respect to anti-Müllerian hormone (AMH), inhibin A (INH-A), inhibin B (INH-B), and insulin-like peptide 3(INSL3) levels, all factors which may have an impact on IR.Materials and methods: In this cross sectional study, 52 adolescent girls diagnosed with PCOS [groups: nonobese (NO), n = 23;overweight/obese (OW/O), n = 29] were included. Blood samples were obtained to measure AMH, INH-B, INH-A, and INSL3 levels,together with hormonal and biochemical assessments. Oral glucose tolerance test (OGTT) was performed and the indexes of IR[homeostasis model assessment: insulin resistance (HOMA-IR) and Matsuda index] were calculated.Results: Insulin resistance was 56.5% with OGTT and 30.4% with HOMA-IR in nonobese-PCOS girls. There was a correlation betweenINH-A and HOMA-IR even when controlled for body mass index (BMI). INH-B and FAI also had correlations with HOMA-IR whichdisappeared when controlled for BMI. In regression analyses, AMH (odds ratio = [0.903, P = 0.015) and FAI (odds ratio = 1.353, P= 0.023) are found to be contributors to IR. Their effect was BMI-independent. In ROC analysis, the cutoff value for FAI was 5.93(sensitivity 71%) to define IR in PCOS girls.Conclusion: AMH and FAI may contribute to IR (defined by OGTT) in PCOS. FAI might be used as a supporting IR marker (definedby OGTT) in adolescent girls with PCOS.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Wiegand S, Maikowski U, Blankenstein O, Biebermann H, Tarnow P et al. Type 2 diabetes and impaired glucose tolerance in European children and adolescents with obesity–a problem that is no longer restricted to minority groups. European Journal of Endocrinology 2004; 151(2): 199-206.
2. Pasquali R, Pelusi C, Genghini S, Cacciari M, Gambineri A. Obesity and reproductive disorders in women. Human Reproduction Update 2003; 9: 359-372. doi: 10.1093/humupd/ dmg024
3. Bronstein J, Tawdekar S, Liu Y, Pawelczak M, David R et al. Age of onset of polycystic ovarian syndrome in girls may be earlier than previously thought. Journal of Pediatric and Adolescent Gynecology 2011; 24: 15-20. doi: 10.1016/j.jpag.2010.06.003
4. Chung PW, Chan SSC, Yiu KW, Lao TTH, Chung TKH. Menstrual disorders in a Paediatric and Adolescent Gynaecology Clinic: patient presentations and longitudinal outcomes. Hong Kong Medical Journal 2011; 17: 391-397.
5. Li HW, Anderson RA, Yeung WS, Ho PC, Ng EH. Evaluation of serum antimullerian hormone and inhibin B concentrations in the differential diagnosis of secondary oligoamenorrhea. Fertility and Sterility 2011; 96: 774-779. doi: 10.1016/j. fertnstert.2011.06.016
6. İliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can antiMullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. Journal of Clinical Endocrinology and Metabolism 2013; 98: 3332-3340. doi: 10.1210/jc.2013-1393
7. Gambineri A, Patton L, De Iasio R, Paladoro F, Pagotto U et al. Insulin-like factor 3: a new circulating hormone related to luteinizing hormone-dependent ovarian hyperandrogenism in the polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism 2007; 92: 2066-2073. doi: 10.1210/jc.2006-1678
8. Pigny P, Cortet-Rudelli C, Decanter C, Deroubaix D, Soudan B et al. Serum levels of inhibins are differentially altered in patients with polycystic ovary syndrome: effects of being overweight and relevance to hyperandrogenism. Fertility and Sterility 2000; 73: 972-977. doi: 10.1016/S0015-0282(00)00421-0
9. Segal S, Elmadjian M, Takeshiqe T, Karp S, Mercado R et al. Serum inhibin A concentration in women with polycystic ovarian syndrome and the correlation to ethnicity, androgens and insulin resistance. Reproductive BioMedicine Online 2010; 20: 675-680. doi: 10.1016/j.rbmo.2010.02.006
10. Yetim A, Yetim Ç, Baş F, Erol OB, Çığ G et al. Anti-Müllerian hormone and inhibin A, but not inhibin B or insulin-like peptide-3, may be used as surrogates in the diagnosis of polycystic ovary syndrome in adolescents: preliminary results. Journal of Clinical Research in Pediatric Endocrinology 2016; 8: 288-297. doi: 10.4274/jcrpe.3253
11. Cassar S, Teede HJ, Moran LJ, Joham AE, Harrison CL et al. Polycystic ovary syndrome and anti-Müllerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins. Clinical Endocrinology 2014; 81: 899-906. doi: 10.1111/ cen.12557
12. La Marca A, Stabile G, Artenisio AC, Volpe A. Serum antiMullerian hormone throughout the human menstrual cycle. Human Reproduction 2006; 21: 3103-3107. doi: 10.1093/ humrep/del291
13. Carmina E, Orio F, Palomba S, Longo RA, Lombardi G et al. Ovarian size and blood flow in women with polycystic ovary syndrome and their correlations with endocrine parameters. Fertility and Sterility 2005; 84: 413-419. doi: 10.1016/j. fertnstert.2004.12.061
14. Tokmak A, Kokanali D, Timur H, Kuntay Kokanali M, Yılmaz N. Association between anti-Mullerian hormone and insulin resistance in non-obese adolescent females with polycystic ovary syndrome. Gynecological Endocrinology 2016; 32: 926- 930. doi: 10.1080/09513590.2016.1193140
15. Chun S. 1-h Postprandial glucose level is related to the serum anti-Müllerian hormone level in women with polycystic ovary syndrome. Gynecological Endocrinology 2015; 31: 815-818. doi: 10.3109/09513590.2015.1056143
16. Fonseca HP, Brondi RS, Piovesan FX, Miklos TG, Aldrighi JM. Anti-Mullerian hormone and insulin resistance in polycystic ovary syndrome. Gynecological Endocrinology 2014; 30: 667- 670. doi: 10.3109/09513590.2014.920004
17. Kim JY, Tfayli H, Michaliszyn SF, Lee S, Nasr A et al. AntiMüllerian hormone in obese adolescent girls with polycystic ovary syndrome. Journal of Adolescent Health 2017; 60: 333- 339. doi: 10.1016/j.jadohealth.2016.10.015
18. Cengiz H, Ekin M, Dagdeviren H, Yıldız Ş, Kaya C et al. Comparison of serum anti-Müllerian hormone levels in normal weight and overweight-obese adolescent patients with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology 2014; 180: 46-50. doi: 10.1016/j.ejogrb.2014.06.018
19. Cassar S, Misso ML, Hopkins WG, Shaw CS, Teede HJ et al. Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemichyperinsulinaemic clamp studies. Human Reproduction 2016; 31: 2619-2631. doi: 10.1093/humrep/dew243
20. Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Human Reproduction Update 2011; 17: 17–33. doi: 10.1093/humupd/dmq032
21. De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G et al. Genetic, hormonal and metabolic aspects of PCOS: an update. Reproductive Biology and Endocrinology 2016; 14: 38. doi: 10.1186/s12958-016-0173-x
22. Cortet-Rudelli C, Pigny P, Decanter C, Leroy M, MaunouryLefebvre C et al. Obesity and serum luteinizing hormone level have an independent and opposite effect on the serum inhibin B level in patients with polycystic ovary syndrome. Fertility and Sterility 2002; 77: 281-287. doi: 10.1016/S0015-0282(01)02968-5
23. Welt CK, Taylor AE, Martin KA, Hall JE. Serum inhibin B in polycystic ovary syndrome. Regulation by insulin and luteinizing hormone. Journal of Clinical Endocrinology and Metabolism 2002; 87: 5559–5565. doi: 10.1210/jc.2002-020546
24. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. Journal of Clinical Endocrinology and Metabolism 1961; 21: 1440-1447. doi: 10.1210/jcem-21-11-1440
25. Neyzi O, Bundak R, Gökçay G, Furman A, Darendeliler F et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. Journal of Clinical Research in Pediatric Endocrinology 2015; 7: 280-293. doi: 10.4274/jcrpe.2183
26. Kurtoğlu S, Hatipoğlu N, Mazıcıoğlu MM, Akın MA, Çoban D et al. Body weight, length and head circumference at birth in a cohort of Turkish newborns. Journal of Clinical Research in Pediatric Endocrinology 2012; 4: 132-139. doi: 10.4274/ jcrpe.693
27. Unalan D, Senol V, Bayat M, Mazicioğlu MM, Ozturk A et al. Change in waist circumference over 3 years in Turkish children and adolescents. Annals of Human Biology 2013; 40: 419- 425. doi: 10.3109/03014460.2013.791720
28. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114 (2 Suppl 4th Report): 555-576.
29. Matthews D, Hosker J, Rudenski A, Naylor BA, Treacher DF et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419.
30. Matsuda M, De Fronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999; 22: 1462-1470. doi: 10.2337/diacare.22.9.1462
31. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2011; 34:S11-S61. doi: 10.2337/ dc11-S011
32. Reaven GM, Brand JR, Chen YD, Mathur AK, Goldfine I. Insulin resistance and insulin secretion are determinants of oral glucose tolerance in normal individuals. Diabetes 1993; 42:1324-1332. doi: 10.2337/diab.42.9.1324
33. Zannolli R, Rebeggiani A, Chiarelli F, Morgese G. Hyperinsulinism a marker in obese children. American Journal of Diseases of Children 1993; 147: 837-841.
34. Flannery CA, Rackow B, Cong X, Duran E, Selen DJ et al. Polycystic ovary syndrome in adolescence: impaired glucose tolerance occurs across the spectrum of BMI. Pediatr Diabetes 2013; 14: 42-49. doi: 10.1111/j.1399- 5448.2012.00902.x
35. Coles N, Bremer K, Kives S, Zhao X, Hamilton J. Utility of the oral glucose tolerance test to assess glucose abnormalities in adolescents with polycystic ovary syndrome. Journal of Pediatric and Adolescent Gynecology 2016; 29: 48-52. doi: 10.1016/j. jpag.2015.06.004
36. Hart R, Doherty DA, Mori T, Huang RC, Norman RJ et al. Extent of metabolic risk in adolescent girls with features of polycystic ovary syndrome. Fertility and Sterility 2011; 95: 2347-2353. doi: 10.1016/j.fertnstert.2011.03.001
37. Reyes-Muñoz E, Ortega-González C, Matínez-Cruz N, ArceSánchez L, Estrada-Gutierrez G et al. Association of obesity and overweight with the prevalence of insulin resistance, pre-diabetes and clinical-biochemical characteristics among infertile Mexican women with polycystic ovary syndrome: a cross-sectional study. BMJ Open 2016; 6:e012107. doi: 10.1136/bmjopen-2016-012107
38. Cui Y, Shi Y, Cui L, Han T, Gao X et al. Agespecific serum antimüllerian hormone levels in women with and without polycystic ovary syndrome. Fertility and Sterility 2014; 102: 230-236. doi: 10.1016/j.fertnstert.2014.03.032
39. Cui L, Qin Y, Gao X, Lu J, Geng L et al. Anti-Müllerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause. Fertility and Sterility 2016; 105: 481-485. doi: 10.1016/j. fertnstert.2015.10.017
40. Skalba P, Cygal A, Madej P, Dąbkowska-Huć A, Sikora J, Martirosian G et al. Is the plasma antiMüllerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome? European Journal of Obstetrics & Gynecology and Reproductive Biology 2011; 158: 254-259. doi: 10.1016/j. ejogrb.2011.06.006
41. Feldman RA, O’Neill K, Butts SF, Dokras A. Antimüllerian hormone levels and cardiometabolic risk in young women with polycystic ovary syndrome. Fertility and Sterility 2016; 107: 276-281. doi: 10.1016/j.fertnstert.2016.10.009
42. Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reproductive BioMedicine Online 2016; 33: 15-28. doi: 10.1016/j.rbmo.2016.04.007

APA	YETİM ŞAHİN A, BAŞ F, YETİM Ç, Uçar A, Poyrazoglu S, BUNDAK R, DARENDELİLER F (2019). Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. , 1117 - 1125. 10.3906/sag-1808-52
Chicago	YETİM ŞAHİN Aylin,BAŞ Firdevs,YETİM Çağcıl,Uçar Ahmet,Poyrazoglu Sukran,BUNDAK Rüveyde,DARENDELİLER FATMA FEYZA Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. (2019): 1117 - 1125. 10.3906/sag-1808-52
MLA	YETİM ŞAHİN Aylin,BAŞ Firdevs,YETİM Çağcıl,Uçar Ahmet,Poyrazoglu Sukran,BUNDAK Rüveyde,DARENDELİLER FATMA FEYZA Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. , 2019, ss.1117 - 1125. 10.3906/sag-1808-52
AMA	YETİM ŞAHİN A,BAŞ F,YETİM Ç,Uçar A,Poyrazoglu S,BUNDAK R,DARENDELİLER F Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. . 2019; 1117 - 1125. 10.3906/sag-1808-52
Vancouver	YETİM ŞAHİN A,BAŞ F,YETİM Ç,Uçar A,Poyrazoglu S,BUNDAK R,DARENDELİLER F Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. . 2019; 1117 - 1125. 10.3906/sag-1808-52
IEEE	YETİM ŞAHİN A,BAŞ F,YETİM Ç,Uçar A,Poyrazoglu S,BUNDAK R,DARENDELİLER F "Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome." , ss.1117 - 1125, 2019. 10.3906/sag-1808-52
ISNAD	YETİM ŞAHİN, Aylin vd. "Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome". (2019), 1117-1125. https://doi.org/10.3906/sag-1808-52

APA	YETİM ŞAHİN A, BAŞ F, YETİM Ç, Uçar A, Poyrazoglu S, BUNDAK R, DARENDELİLER F (2019). Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. Turkish Journal of Medical Sciences, 49(4), 1117 - 1125. 10.3906/sag-1808-52
Chicago	YETİM ŞAHİN Aylin,BAŞ Firdevs,YETİM Çağcıl,Uçar Ahmet,Poyrazoglu Sukran,BUNDAK Rüveyde,DARENDELİLER FATMA FEYZA Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. Turkish Journal of Medical Sciences 49, no.4 (2019): 1117 - 1125. 10.3906/sag-1808-52
MLA	YETİM ŞAHİN Aylin,BAŞ Firdevs,YETİM Çağcıl,Uçar Ahmet,Poyrazoglu Sukran,BUNDAK Rüveyde,DARENDELİLER FATMA FEYZA Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. Turkish Journal of Medical Sciences, vol.49, no.4, 2019, ss.1117 - 1125. 10.3906/sag-1808-52
AMA	YETİM ŞAHİN A,BAŞ F,YETİM Ç,Uçar A,Poyrazoglu S,BUNDAK R,DARENDELİLER F Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. Turkish Journal of Medical Sciences. 2019; 49(4): 1117 - 1125. 10.3906/sag-1808-52
Vancouver	YETİM ŞAHİN A,BAŞ F,YETİM Ç,Uçar A,Poyrazoglu S,BUNDAK R,DARENDELİLER F Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome. Turkish Journal of Medical Sciences. 2019; 49(4): 1117 - 1125. 10.3906/sag-1808-52
IEEE	YETİM ŞAHİN A,BAŞ F,YETİM Ç,Uçar A,Poyrazoglu S,BUNDAK R,DARENDELİLER F "Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome." Turkish Journal of Medical Sciences, 49, ss.1117 - 1125, 2019. 10.3906/sag-1808-52
ISNAD	YETİM ŞAHİN, Aylin vd. "Determination of insulin resistance and its relationship with hyperandrogenemia, anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome". Turkish Journal of Medical Sciences 49/4 (2019), 1117-1125. https://doi.org/10.3906/sag-1808-52