Abstract
Introduction: Insulin resistance is associated with both type 2 diabetes (T2 D) and polycystic ovary syndrome (PCOS). There is an association of T2 D with several polymorphisms in candidate genes related to insulin resistance. However, there is limited information about the association of these polymorphisms with PCOS. Methods: 57 non-diabetic women with PCOS and a control group of 567 healthy non-diabetic women underwent an oral glucose tolerance test (OGTT). They were genotyped for the polymorphisms Gly972Arg in IRS-1, Gly1057Asp in IRS-2, SNP 43, 44, and 45 in CAPN10, Pro12Ala in PPARγ2, C-512 T in FOXC2, and T45 G in adiponectin. Results: Women with PCOS had higher 2-h blood glucose levels (6.5 ± 0.2 vs. 6.0 ± 0.06 mmol/l, p = 0.03) compared to control women, higher fasting insulin (79 ± 7 vs. 53 ± 2 pmol/l, p = 0.02), and a lower insulin sensitivity estimated from the OGTT (12.4 ± 1.1 vs. 19.1 ± 0.5 U, p = 0.0001). More homozygous G allele carriers of the T45 G polymorphism in the adiponectin gene were found in women with PCOS compared to controls (13.2 % vs. 2.6 %, p = 0.008). In women with PCOS, G-allele carriers had lower fasting insulin levels than TT carriers (61 ± 9 vs. 88 ± 10, p = 0.02) in contrast to controls (p = 0.03 for interaction genotype × PCOS). The other polymorphisms were distributed equally among women with PCOS and controls (all p > 0.5). Summary: We found a higher prevalence of the T45 G polymorphism in the adiponectin gene in women with PCOS compared to controls. This was not associated with a more insulin resistant phenotype in PCOS, however. Other frequent polymorphisms in genes related to insulin resistance and type 2 diabetes showed no association with PCOS.
Key words
Polycystic ovary syndrome - polymorphism - insulin resistance - linkage - genetics
References
-
1
The Rotterdam consensus workshop .
Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.
Fertil Steril.
2004;
81
19-25
-
2
Chandran M, Phillips S A, Ciaraldi T, Henry R R.
Adiponectin: more than just another fat cell hormone?.
Diabetes Care.
2003;
26
2442-2450
-
3
Dunaif A.
Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis.
Endocr Rev.
1997;
18
774-800
-
4
Ehrmann D A, Tang X, Yoshiuchi I, Cox N J, Bell G I.
Relationship of insulin receptor substrate-1 and -2 genotypes to phenotypic features of polycystic ovary syndrome.
J Clin Endocrinol Metab.
2002 a;
87
4297-4300
-
5
Ehrmann D A, Tang X, Yoshiuchi I, Cox N J, Bell G I.
Relationship of insulin receptor substrate-1 and -2 genotypes to phenotypic features of polycystic ovary syndrome.
J Clin Endocrinol Metab.
2002 b;
87
4297-4300
-
6
El Mkadem S A, Lautier C, Macari F, Molinari N, Lefebvre P, Renard E, Gris J C, Cros G, Daures J P, Bringer J. et al .
Role of allelic variants Gly972Arg of IRS-1 and Gly1057Asp of IRS-2 in moderate-to-severe insulin resistance of women with polycystic ovary syndrome.
Diabetes.
2001;
50
2164-2168
-
7
Fritsche A, Machicao F, Staiger H, Haring H U, Stumvoll M.
Lack of association between metabolic traits and the - 512 polymorphism in FOXC2 in German people with normal glucose tolerance.
Diabetologia.
2004;
47
756-757
-
8
Fritsche A, Madaus A, Renn W, Tschritter O, Teigeler A, Weisser M, Maerker E, Machicao F, Haring H, Stumvoll M.
The prevalent Gly1057Asp polymorphism in the insulin receptor substrate-2 gene is not associated with impaired insulin secretion.
J Clin Endocrinol Metab.
2001;
86
4822-4825
-
9
Fumeron F, Aubert R, Siddiq A, Betoulle D, Pean F, Hadjadj S, Tichet J, Wilpart E, Chesnier M C, Balkau B. et al .
Adiponectin gene polymorphisms and adiponectin levels are independently associated with the development of hyperglycemia during a 3-year period: The Epidemiologic Data on the Insulin Resistance Syndrome Prospective Study.
Diabetes.
2004;
53
1150-1157
-
10
Gonzalez A, Abril E, Roca A, Aragon M J, Figueroa M J, Velarde P, Royo J L, Real L M, Ruiz A.
Comment: CAPN10 alleles are associated with polycystic ovary syndrome.
J Clin Endocrinol Metab.
2002;
87
3971-3976
-
11
Haddad L, Evans J C, Gharani N, Robertson C, Rush K, Wiltshire S, Frayling T M, Wilkin T J, Demaine A, Millward A. et al .
Variation within the type 2 diabetes susceptibility gene calpain-10 and polycystic ovary syndrome.
J Clin Endocrinol Metab.
2002;
87
2606-2610
-
12
Hara K, Boutin P, Mori Y, Tobe K, Dina C, Yasuda K, Yamauchi T, Otabe S, Okada T, Eto K. et al .
Genetic variation in the gene encoding adiponectin is associated with an increased risk of type 2 diabetes in the Japanese population.
Diabetes.
2002 a;
51
536-540
-
13
Hara M, Alcoser S Y, Qaadir A, Beiswenger K K, Cox N J, Ehrmann D A.
Insulin resistance is attenuated in women with polycystic ovary syndrome with the Pro(12)Ala polymorphism in the PPARgamma gene.
J Clin Endocrinol Metab.
2002 b;
87
772-775
-
14
Horikawa Y, Oda N, Cox N J, Li X, Orho-Melander M, Hara M, Hinokio Y, Lindner T H, Mashima H, Schwarz P E. et al .
Genetic variation in the gene encoding calpain-10 is associated with type 2 diabetes mellitus.
Nat Genet.
2000;
26
163-175
-
15
Hu F B, Doria A, Li T, Meigs J B, Liu S, Memisoglu A, Hunter D, Manson J E.
Genetic variation at the adiponectin locus and risk of type 2 diabetes in women.
Diabetes.
2004;
53
209-213
-
16
Jellema A, Zeegers M P, Feskens E J, Dagnelie P C, Mensink R P.
Gly972Arg variant in the insulin receptor substrate-1 gene and association with Type 2 diabetes: a meta-analysis of 27 studies.
Diabetologia.
2003;
46
990-995
-
17
Legro R S.
Diabetes prevalence and risk factors in polycystic ovary syndrome.
Obstet Gynecol Clin North Am.
2001;
28
99-109
-
18
Legro R S, Spielman R, Urbanek M, Driscoll D, Strauss III J F, Dunaif A.
Phenotype and genotype in polycystic ovary syndrome.
Recent Prog Horm Res.
1998;
53
217-256
-
19
Legro R S, Strauss J F.
Molecular progress in infertility: polycystic ovary syndrome.
Fertil Steril.
2002;
78
569-576
-
20
Matsuda M, DeFronzo R A.
Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp.
Diabetes Care.
1999;
22
1462-1470
-
21
Menzaghi C, Ercolino T, Di Paola R, Berg A H, Warram J H, Scherer P E, Trischitta V, Doria A.
A haplotype at the adiponectin locus is associated with obesity and other features of the insulin resistance syndrome.
Diabetes.
2002;
51
2306-2312
-
22
Olefsky J M, Saltiel A R.
PPAR gamma and the treatment of insulin resistance.
Trends Endocrinol Metab.
2000;
11
362-368
-
23
Orio Jr F, Palomba S, Cascella T, Milan G, Mioni R, Pagano C, Zullo F, Colao A, Lombardi G, Vettor R.
Adiponectin levels in women with polycystic ovary syndrome.
J Clin Endocrinol Metab.
2003;
88
2619-2623
-
24
Panidis D, Kourtis A, Farmakiotis D, Mouslech T, Rousso D, Koliakos G.
Serum adiponectin levels in women with polycystic ovary syndrome.
Hum Reprod.
2003;
18
1790-1796
-
25
Panidis D, Kourtis A, Kukuvitis A, Farmakiotis D, Xita N, Georgiou I, Tsatsoulis A.
Association of the T45 G polymorphism in exon 2 of the adiponectin gene with polycystic ovary syndrome: role of {Delta}4-androstenedione.
Hum Reprod.
2004;
19
1728-1733
-
26
Ridderstrale M, Carlsson E, Klannemark M, Cederberg A, Kosters C, Tornqvist H, Storgaard H, Vaag A, Enerback S, Groop L.
FOXC2 mRNA Expression and a 5′untranslated region polymorphism of the gene are associated with insulin resistance.
Diabetes.
2002;
51
3554-3560
-
27
Sesti G, Federici M, Hribal M L, Lauro D, Sbraccia P, Lauro R.
Defects of the insulin receptor substrate (IRS) system in human metabolic disorders.
FASEB J.
2001;
15
2099-2111
-
28
Stumvoll M, Fritsche A, Madaus A, Stefan N, Weisser M, Machicao F, Haring H.
Functional significance of the UCSNP-43 polymorphism in the CAPN10 gene for proinsulin processing and insulin secretion in nondiabetic Germans.
Diabetes.
2001 a;
50
2161-2163
-
29
Stumvoll M, Fritsche A, Volk A, Stefan N, Madaus A, Maerker E, Teigeler A, Koch M, Machicao F, Haring H.
The Gly972Arg polymorphism in the insulin receptor substrate-1 gene contributes to the variation in insulin secretion in normal glucose-tolerant humans.
Diabetes.
2001 b;
50
882-885
-
30
Stumvoll M, Haring H.
The peroxisome proliferator-activated receptor-gamma2 Pro12Ala polymorphism.
Diabetes.
2002;
51
2341-2347
-
31
Stumvoll M, Tschritter O, Fritsche A, Staiger H, Renn W, Weisser M, Machicao F, Haring H.
Association of the T-G polymorphism in adiponectin (exon 2) with obesity and insulin sensitivity: interaction with family history of type 2 diabetes.
Diabetes.
2002 a;
51
37-41
-
32
Stumvoll M, Wahl H G, Machicao F, Haring H.
Insulin sensitivity of glucose disposal and lipolysis: no influence of common genetic variants in IRS-1 and CAPN10.
Diabetologia.
2002 b;
45
651-656
-
33
Thamer C, Stumvoll M, Niess A, Tschritter O, Haap M, Becker R, Shirkavand F, Bachmann O, Rett K, Volk A. et al .
Reduced skeletal muscle oxygen uptake and reduced β-cell funtion. Two early abnormalities in normal glucose tolerant offspring of patients with type 2 diabetes.
Diabetes Care.
2003;
26
2126-2132
-
35
Urbanek M, Legro R S, Driscoll D A, Azziz R, Ehrmann D A, Norman R J, Strauss III J F, Spielman R S, Dunaif A.
Thirty-seven candidate genes for polycystic ovary syndrome: strongest evidence for linkage is with follistatin.
Proc Natl Acad Sci USA.
1999;
96
8573-8578
-
36
Vankova M, Vrbikova J, Hill M, Cinek O, Bendlova B.
Association of insulin gene VNTR polymorphism with polycystic ovary syndrome.
Ann N Y Acad Sci.
2002;
967
558-565
-
37
Vasseur F, Helbecque N, Dina C, Lobbens S, Delannoy V, Gaget S, Boutin P, Vaxillaire M, Lepretre F, Dupont S. et al .
Single-nucleotide polymorphism haplotypes in the both proximal promoter and exon 3 of the APM1 gene modulate adipocyte-secreted adiponectin hormone levels and contribute to the genetic risk for type 2 diabetes in French Caucasians.
Hum Mol Genet.
2002;
11
2607-2614
-
38
Waterworth D M, Bennett S T, Gharani N, McCarthy M I, Hague S, Batty S, Conway G S, White D, Todd J A, Franks S. et al .
Linkage and association of insulin gene VNTR regulatory polymorphism with polycystic ovary syndrome.
Lancet.
1997;
349
986-990
-
39
Xita N, Georgiou I, Tsatsoulis A.
The genetic basis of polycystic ovary syndrome.
Eur J Endocrinol.
2002;
147
717-725
-
40
Yang W S, Tsou P L, Lee W J, Tseng D L, Chen C L, Peng C C, Lee K C, Chen M J, Huang C J, Tai T Y. et al .
Allele-specific differential expression of a common adiponectin gene polymorphism related to obesity.
J Mol Med.
2003;
81
428-434
MD Andreas Fritsche
Medizinische Universitätsklinik
Ottfried-Müller-Straße 10
72076 Tübingen
Germany
Telefon: + 4970712980590
Fax: + 49 70 71 29 59 74
eMail: andreas.fritsche@med.uni-tuebingen.de