Urinary Metabolites Reveal Hyperinsulinemia and Insulin Resistance in Polycystic Ovarian Syndrome (PCOS)
Anna Maria Fulghesu,
Cristina Piras,
Angelica Dessì,
Claudia Succu,
Luigi Atzori,
Roberta Pintus,
Cecilia Gentile,
Stefano Angioni,
Vassilios Fanos
Affiliations
Anna Maria Fulghesu
Clinica Ostetrica Ginecologica, Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Cristina Piras
Department of Biomedical Sciences, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Angelica Dessì
Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Claudia Succu
Clinica Ostetrica Ginecologica, Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Luigi Atzori
Department of Biomedical Sciences, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Roberta Pintus
Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Cecilia Gentile
Clinica Ostetrica Ginecologica, Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Stefano Angioni
Clinica Ostetrica Ginecologica, Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
Vassilios Fanos
Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, University of Cagliari, SS 554, km 4.5, 09042 Monserrato, Italy
The identification of insulin resistance and hyperinsulinemia in polycystic ovary syndrome (PCOS) is not a minor issue. The homeostasis model assessment of insulin resistance index (HOMA) is the most used index of IR (Insulin Resistance), validated in overweight and obese patients but not in normal-weight PCOS subjects, who can still present with increased insulin secretion by an oral glucose tolerance test (OGTT). The evaluation of insulin secretion and resistance represents a still unresolved problem. The aim of this study is to identify a possible yet noninvasive method to properly evaluate the insulin metabolism in young non-diabetic subjects. Girls aged 14–22 years, afferent to the center of Gynecological Diseases in Childhood and Adolescence of Cagliari (Italy), were screened for PCOS. A total of 42 subjects comprised the study group. Hormonal assays, OGTT, transabdominal (TA) or transvaginal (TV) US, and urine collection for 1H-NMR analysis were assayed in the early follicular phase. A 1H-NMR coupled multivariate statistical analysis was performed. The OPLS model indicated that the NMR profile of urine had a good fit and prediction ability for the AUC OGTT with R2 = 0.813. Metabolomics can be a promising tool to the potential identification of biomarkers of an exaggerated insulin response to OGTT and can encourage substantial progress for a more accurate and early diagnosis in PCOS.
