Normal Metabolic Flexibility despite Insulin Resistance Women with Polycystic Ovary Syndrome
Open accessAbstract
Polycystic ovary syndrome (PCOS) is a common heterogeneous disorder, where insulin resistance might be involved in the development of endocrine and metabolic abnormalities. Insulin resistance (IR) is connected with disturbances in switching between lipid and carbohydrate oxidation in response to insulin, called "metabolic inflexibility". The aim of the present study was to estimate the whole-body insulin sensitivity, lipid and carbohydrate oxidation, metabolic flexibility in lean and obese PCOS women. The study group consisted of 92 women with PCOS, 40 lean (BMI<25 kg/m²) and 52 overweight or obesity (BMI>25 kg/m²), and 30 healthy normally menstruating women (14 lean and 16 overweight/obese) with normal glucose tolerance. Hyperinsulinemic euglycemic clamp and indirect calorimetry were performed. An increase in respiratory exchange ratio in response to insulin was used as a measure of metabolic flexibility. Both the presence of PCOS (P<0.001) and obesity (P=0.005) were independently characterized by lower insulin sensitivity. PCOS (P=0.002) and obesity (P=0.001) independently predisposed to the lower non-oxidative glucose metabolism. Obese women had lower glucose oxidation (P=0.005) and higher lipid oxidation (P<0.001) in insulin-stimulated conditions in comparison to lean subject whereas PCOS had no effect on these parameters (P=0.29 and P=0.43; respectively). Metabolic flexibility was impaired in the obese (P=0.001) but it was not influenced by the presence of PCOS (P=0.78). Our data indicate that PCOS women have normal metabolic flexibility, which could suggest a distinct pathophysiological mechanism for insulin resistance in this group.
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Some data show that PCOS women have normal metabolic flexibility, which could suggest a distinct pathophysiological mechanism for insulin resistance in this group.
“However, some data show that PCOS women have normal metabolic flexibility, which could suggest a distinct pathophysiological mechanism for IR in this group [51].”
From The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome (2022) · cites this paper as [51]
Metabolic inflexibility is the impaired ability to switch from lipid to carbohydrate oxidation under insulin-stimulated conditions, and this state is associated with insulin resistance.
“Metabolic inflexibility is the impaired ability to switch from lipid to carbohydrate oxidation under insulin-stimulated conditions. This state is associated with IR.”
From The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome (2022) · cites this paper as [51]
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Cites
(2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.004 · Cited by 9,050 · see citing works
Glucose clamp technique: a method for quantifying insulin secretion and resistance.
DeFronzo, R. A., Tobin, J. D., & Andres, R. (1979) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1979.237.3.e214 · Cited by 7,425 · see citing works
A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.10.6079 · Cited by 3,824 · see citing works
Insulin Resistance and the Polycystic Ovary Syndrome: Mechanism and Implications for Pathogenesis
Dunaif, A. E. (1997) · Endocrine Reviews · doi:10.1210/edrv.18.6.0318 · Cited by 2,761 · see citing works
Diamanti-Kandarakis, E., & Dunaif, A. (2012) · Endocrine Reviews · doi:10.1210/er.2011-1034 · Cited by 1,947 · see citing works
Kelley, D. E., Goodpaster, B., Wing, R. R., & Simoneau, J.-A. (1999) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1999.277.6.e1130 · Cited by 1,096 · see citing works
Fuel selection in human skeletal muscle in insulin resistance: a reexamination.
Kelley, D. E., & Mandarino, L. J. (2000) · Diabetes · doi:10.2337/diabetes.49.5.677 · Cited by 1,017 · see citing works
Stepto, N. K., Cassar, S., Joham, A. E., Hutchison, S. K., Harrison, C. L., Goldstein, R. F., & Teede, H. J. (2013) · Human Reproduction · doi:10.1093/humrep/des463 · Cited by 747 · see citing works
DeUgarte, C. M., Bartolucci, A. A., & Azziz, R. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.11.070 · Cited by 589 · see citing works
Dunaif, A., Xia, J., Book, C. B., Schenker, E., & Tang, Z. (1995) · Journal of Clinical Investigation · doi:10.1172/jci118126 · Cited by 561 · see citing works
Morin-Papunen, L. C., Vauhkonen, I., Koivunen, R. M., Ruokonen, A., & Tapanainen, J. S. (2000) · Human Reproduction · doi:10.1093/humrep/15.6.1266 · Cited by 226 · see citing works
Damsbo, P., Vaag, A., Hother-Nielsen, O., & Beck-Nielsen, H. (1991) · Diabetologia · doi:10.1007/bf00405082 · Cited by 203 · see citing works
Skov, V., Glintborg, D., Knudsen, S., Jensen, T. E., Kruse, T. A., Tan, Q., Brusgaard, K., Beck‐Nielsen, H., & Højlund, K. (2007) · Diabetes · doi:10.2337/db07-0275 · Cited by 202 · see citing works
Selective Insulin Resistance in the Polycystic Ovary Syndrome
Book, C. B., & Dunaif, A. E. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.9.6010 · Cited by 199 · see citing works
Ukropcova, B., Sereda, O., de Jonge, L., Bogacka, I., Nguyen, T., Xie, H., Bray, G. A., & Smith, S. R. (2007) · Diabetes · doi:10.2337/db06-0521 · Cited by 165 · see citing works
Polycystic ovaries and associated metabolic abnormalities in Indian subcontinent Asian women
Rodin, D. A., Bano, G., Bland, J. M., Taylor, K., & Nussey, S. (1998) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1998.00492.x · Cited by 161 · see citing works
Prevalence of Polycystic Ovary Syndrome and Related Disorders in Mexican Women
Morán, C., Tena, G., Morán, S., Ruiz, P., Reyna, R., & Duque, X. (2010) · Gynecologic and Obstetric Investigation · doi:10.1159/000277640 · Cited by 152 · see citing works
Højlund, K., Glintborg, D., Andersen, N. R., Birk, J. B., Treebak, J. T., Frøsig, C., Beck‐Nielsen, H., & Wojtaszewski, J. F. P. (2007) · Diabetes · doi:10.2337/db07-0706 · Cited by 144 · see citing works
Kowalska, I., Strączkowski, M., Nikołajuk, A., Adamska, A., Karczewska‐Kupczewska, M., Otziomek, E., Wołczyński, S., & Górska, M. (2007) · Human Reproduction · doi:10.1093/humrep/dem118 · Cited by 110 · see citing works
Self-citationObesity, body composition and metabolic disturbances in polycystic ovary syndrome
Svendsen, P. F., Nilas, L., Nørgaard, K., Jensen, J. B., & Madsbad, S. (2008) · Human Reproduction · doi:10.1093/humrep/den211 · Cited by 103 · see citing works
Karczewska‐Kupczewska, M., Strączkowski, M., Adamska, A., Nikołajuk, A., Otziomek, E., Górska, M., & Kowalska, I. (2009) · Metabolism · doi:10.1016/j.metabol.2009.07.036 · Cited by 36 · see citing works
Self-citationGlintborg, D., Højlund, K., Andersen, N. R., Hansen, B. F., Beck‐Nielsen, H., & Wojtaszewski, J. F. P. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0760 · Cited by 36 · see citing works
Nikołajuk, A., Kowalska, I., Karczewska‐Kupczewska, M., Adamska, A., Otziomek, E., Wołczyński, S., Kinalska, I., Górska, M., & Strączkowski, M. (2010) · Diabetes · doi:10.2337/db09-1316 · Cited by 31 · see citing works
Self-citationAdamska, A., Nikołajuk, A., Karczewska‐Kupczewska, M., Kowalska, I., Otziomek, E., Górska, M., & Strączkowski, M. (2011) · Acta Diabetologica · doi:10.1007/s00592-010-0252-y · Cited by 29 · see citing works
Self-citationInsulin Resistance Is Not Conserved in Myotubes Established from Women with PCOS
Eriksen, M. B., Pørneki, A. D., Skov, V., Burns, J. S., Beck‐Nielsen, H., Glintborg, D., & Gaster, M. (2010) · PLoS ONE · doi:10.1371/journal.pone.0014469 · Cited by 28 · see citing works
Kowalska, I., Adamska, A., Malecki, M. T., Karczewska‐Kupczewska, M., Nikołajuk, A., Szopa, M., Górska, M., & Strączkowski, M. (2012) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2012.04379.x · Cited by 28 · see citing works
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Sorted by citations
Cassar, S., Misso, M. L., Hopkins, W. G., Shaw, C. S., Teede, H. J., & Stepto, N. K. (2016) · Human Reproduction · doi:10.1093/humrep/dew243 · Cited by 415 · see citing works
Bednarz, K., Kowalczyk, K., Cwynar, M., Czapla, D., Czarkowski, W., Kmita, D., Nowak, A., & Madej, P. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23084334 · Cited by 148 · see citing works
DiMenna, F. J., & Arad, A. D. (2018) · BMC Sports Science, Medicine and Rehabilitation · doi:10.1186/s13102-018-0110-8 · Cited by 68 · see citing works
Metabolic Evidence of Diminished Lipid Oxidation in Women With Polycystic Ovary Syndrome
Whigham, L. D., Bütz, D. E., Dashti, H., Tonelli, M., Johnson, L. K., Cook, M. E., Porter, W. P., Eghbalnia, H. R., Markley, J. L., Lindheim, S. R., et al. (2014) · Current Metabolomics · doi:10.2174/2213235x01666131203230512 · Cited by 65 · see citing works
Kim, J. Y., Tfayli, H., Michaliszyn, S. F., & Arslanian, S. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-01958 · Cited by 55 · see citing works
Pohlmeier, A. M., Phy, J. L., Watkins, P., Boylan, M., Spallholz, J., Harris, K. S., & Cooper, J. A. (2014) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2014-0073 · Cited by 34 · see citing works
Insulin-Mediated Substrate Use in Women With Different Phenotypes of PCOS: the Role of Androgens
Tosi, F., Villani, M., Migazzi, M., Faccin, G., Garofalo, S., Fiers, T., Kaufman, J., Bonora, E., & Moghetti, P. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab380 · Cited by 31 · see citing works
Metabolic inflexibility in women with polycystic ovary syndrome: a systematic review
Rimmer, M., Tan, B. K., Teede, H., Thangaratinam, S., & H. Al Wattar, B. (2020) · Gynecological Endocrinology · doi:10.1080/09513590.2019.1698025 · Cited by 29 · see citing works
Nesfatin-1 levels and metabolic markers in polycystic ovary syndrome
Alp, E., Görmüş, U., Güdücü, N., & Bozkurt, S. (2015) · Gynecological Endocrinology · doi:10.3109/09513590.2015.1024219 · Cited by 29 · see citing works
Metabolic inflexibility in women with PCOS is similar to women with type 2 diabetes
Broskey, N. T., Tam, C. S., Sutton, E. F., Altazan, A. D., Burton, J. H., Ravussin, É., & Redman, L. M. (2018) · Nutrition & Metabolism · doi:10.1186/s12986-018-0312-9 · Cited by 24 · see citing works
Glaves, A., Díaz‐Castro, F., Farías, J., Ramírez-Romero, R., Galgani, J. E., & Fernández‐Verdejo, R. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.744187 · Cited by 15 · see citing works
Characterizing skeletal muscle dysfunction in women with polycystic ovary syndrome
McDonnell, T., Cussen, L., McIlroy, M., & O’Reilly, M. (2022) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188221113140 · Cited by 13 · see citing works
Nguo, K., McGowan, M., Cowan, S., Davidson, Z. E., Pirotta, S., Dordevic, A. L., Teede, H. J., Hajishafiee, M., Carmichael, M. A., & Moran, L. (2023) · Nutrition Reviews · doi:10.1093/nutrit/nuad169 · Cited by 9 · see citing works
Ryan, A. S., & Ortmeyer, H. K. (2018) · International Journal of Obesity · doi:10.1038/s41366-018-0068-3 · Cited by 9 · see citing works
Adam, L. N., & Adam, L. N. (2025) · Obesity Medicine · doi:10.1016/j.obmed.2025.100606 · Cited by 7 · see citing works
Are Individuals With Type 2 Diabetes Metabolically Inflexible? A Systematic Review and Meta‐Analysis
Hansen, M., Lange, K. K., Stausholm, M. B., & Dela, F. (2025) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70044 · Cited by 4 · see citing works
Room Calorimetry as a Method of Measuring Metabolic Flexibility
Leger, J. (2015) · University Libraries (University of Maryland) · doi:10.13016/m24065
- Authors
- Adamska, A., Karczewska-Kupczewska, M., Nikolajuk, A., Otziomek, E., Górska, M., Kowalska, I., & Straczkowski, M.
- Affiliations
- Medical University of Białystok (PL)
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
- Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2013
- Volume
- 60
- Issue
- 9
- Pages
- 1107-1113
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W2046691349
- Cited by
- 17
- References
- 26
- Citations by year
- 2025: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 2
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- polycystic ovary syndrome, insulin resistance, metabolic flexibility, whole-body insulin sensitivity, lipid oxidation, carbohydrate oxidation, respiratory exchange ratio, obesity, hyperinsulinemic-euglycemic clamp, indirect calorimetry
- MeSH terms
- Adult, Calorimetry, Indirect, Carbon Dioxide, Female, Humans, Hypoglycemic Agents, Insulin, Insulin Resistance, Obesity, Oxygen Consumption, Polycystic Ovary Syndrome, Glucose Clamp Technique, Body Mass Index, Adiposity, Overweight, Carbohydrate Metabolism, Lipid Metabolism, Young Adult
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