Increased Body Iron Stores of Obese Women With Polycystic Ovary Syndrome Are a Consequence of Insulin Resistance and Hyperinsulinism and Are Not a Result of Reduced Menstrual Losses
OBJECTIVE:--Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insu...
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| Published in | Diabetes care Vol. 30; no. 9; pp. 2309 - 2313 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Alexandria, VA
American Diabetes Association
01.09.2007
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0149-5992 1935-5548 1935-5548 |
| DOI | 10.2337/dc07-0642 |
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| Abstract | OBJECTIVE:--Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer. RESEARCH DESIGN AND METHODS--Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 μg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane³⁵ Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment. RESULTS:--Despite the fact that treatment with Diane³⁵ Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane³⁵ Diario. CONCLUSIONS:--Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. |
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| AbstractList | Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer.
Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 microg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane(35) Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment.
Despite the fact that treatment with Diane(35) Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane(35) Diario.
Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. OBJECTIVE:--Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer. RESEARCH DESIGN AND METHODS--Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 μg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane³⁵ Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment. RESULTS:--Despite the fact that treatment with Diane³⁵ Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane³⁵ Diario. CONCLUSIONS:--Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer.OBJECTIVEIncreased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer.Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 microg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane(35) Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment.RESEARCH DESIGN AND METHODSThirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 microg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane(35) Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment.Despite the fact that treatment with Diane(35) Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane(35) Diario.RESULTSDespite the fact that treatment with Diane(35) Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane(35) Diario.Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS.CONCLUSIONSOur present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. Increased Body Iron Stores of Obese Women With Polycystic Ovary Syndrome Are a Consequence of Insulin Resistance and Hyperinsulinism and Are Not a Result of Reduced Menstrual Losses Manuel Luque-Ramírez , MD , Francisco Álvarez-Blasco , MD , José I. Botella-Carretero , MD, PHD , Raul Sanchón , MD , José L. San Millán , PHD and Héctor F. Escobar-Morreale , MD, PHD From the Department of Endocrinology and Molecular Genetics, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Madrid, Spain Address correspondence and reprint requests to Héctor F. Escobar-Morreale, MD, PhD, Department of Endocrinology, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Carretera de Colmenar Viejo Km 9,1, 28034 Madrid, Spain. E-mail: hescobarm.hrc{at}salud.madrid.org Abstract OBJECTIVE —Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer. RESEARCH DESIGN AND METHODS —Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 μg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane 35 Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment. RESULTS —Despite the fact that treatment with Diane 35 Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane 35 Diario. CONCLUSIONS —Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. CRP, C-reactive protein PCOS, polycystic ovary syndrome Footnotes Published ahead of print at http://care.diabetesjournals.org on 29 May 2007. DOI: 10.2337/dc07-0642. Clinical trial reg. no. NCT00428311, clinicaltrials.gov. M.L.-R. is currently affiliated with the Department of Endocrinology, Hospital Universitario de La Princesa, Madrid, Spain. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. Accepted May 21, 2007. Received April 3, 2007. DIABETES CARE Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer. Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 µg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane^sup 35^ Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment. Despite the fact that treatment with Diane^sup 35^ Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane^sup 35^ Diario. Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. OBJECTIVE—Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS). This finding might result from reduced menstrual losses secondary to oligo- or amenorrhea or from hyperinsulinism secondary to insulin resistance, because insulin favors the intestinal absorption and the tissue deposition of iron. To explore which of these mechanisms is responsible for the increase in body iron stores in women with PCOS, we have monitored the changes in serum ferritin levels during treatment with an antiandrogenic oral contraceptive or an insulin sensitizer. RESEARCH DESIGN AND METHODS—Thirty-four consecutive PCOS patients were randomized to an oral contraceptive containing 35 μg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane35 Diario) or metformin (850 mg twice daily), and their serum ferritin levels were evaluated at baseline and after 12 and 24 weeks of treatment. RESULTS—Despite the fact that treatment with Diane35 Diario restored regular menstrual cycles in all the patients, whereas metformin only did so in 50% of them, serum ferritin levels decreased at 12 and 24 weeks of treatment only with metformin, in association with a marked increase in insulin sensitivity. On the contrary, no changes in ferritin and insulin sensitivity were observed with Diane35 Diario. CONCLUSIONS—Our present results suggest that insulin resistance and hyperinsulinism, and not the reduced menstrual losses secondary to from oligo- or amenorrhea, are responsible of the increased ferritin levels and body iron stores found in overweight and obese women with PCOS. |
| Audience | Professional |
| Author | Botella-Carretero, José I San Millán, José L Álvarez-Blasco, Francisco Luque-Ramírez, Manuel Sanchón, Raul Escobar-Morreale, Héctor F |
| Author_xml | – sequence: 1 givenname: Manuel surname: LUQUE-RAMIREZ fullname: LUQUE-RAMIREZ, Manuel organization: Department of Endocrinology and Molecular Genetics, Hospital Universitario Ram6n y Cajal and Universidad de Alcalá, Madrid, Spain – sequence: 2 givenname: Raul surname: SANCHON fullname: SANCHON, Raul organization: Department of Endocrinology and Molecular Genetics, Hospital Universitario Ram6n y Cajal and Universidad de Alcalá, Madrid, Spain – sequence: 3 givenname: Francisco surname: ALVAREZ-BLASCO fullname: ALVAREZ-BLASCO, Francisco organization: Department of Endocrinology and Molecular Genetics, Hospital Universitario Ram6n y Cajal and Universidad de Alcalá, Madrid, Spain – sequence: 4 givenname: Jose L surname: SAN MILLAN fullname: SAN MILLAN, Jose L organization: Department of Endocrinology and Molecular Genetics, Hospital Universitario Ram6n y Cajal and Universidad de Alcalá, Madrid, Spain – sequence: 5 givenname: Jose I surname: BOTELLA-CARRETERO fullname: BOTELLA-CARRETERO, Jose I organization: Department of Endocrinology and Molecular Genetics, Hospital Universitario Ram6n y Cajal and Universidad de Alcalá, Madrid, Spain – sequence: 6 givenname: Hector F surname: ESCOBAR-MORREALE fullname: ESCOBAR-MORREALE, Hector F organization: Department of Endocrinology and Molecular Genetics, Hospital Universitario Ram6n y Cajal and Universidad de Alcalá, Madrid, Spain |
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| Keywords | Endocrinopathy Hyperinsulinemia Pancreatic hormone Polycystic ovary Result Iron storage Cyst Adult Female Benign neoplasm Woman Body Nutritional status Human Obesity Nutrition Nutrition disorder Female sterility Metabolic diseases Insulin Female genital diseases Ovarian diseases Target tissue resistance Insulin resistance Endocrinology |
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| PublicationTitle | Diabetes care |
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| Snippet | OBJECTIVE:--Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary... Increased Body Iron Stores of Obese Women With Polycystic Ovary Syndrome Are a Consequence of Insulin Resistance and Hyperinsulinism and Are Not a Result of... OBJECTIVE—Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome... Increased serum ferritin levels, indicating increased body iron stores, have been found in overweight and obese women with polycystic ovary syndrome (PCOS).... |
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| SubjectTerms | acetates Adolescent Adult amenorrhea Androgen Antagonists Androgen Antagonists - therapeutic use Anemia animal ovaries Apoptosis Biological and medical sciences blood blood serum complications Cyproterone Acetate Cyproterone Acetate - therapeutic use Diabetes Diabetes. Impaired glucose tolerance Diet Drug Combinations Drug resistance drug therapy Endocrine pancreas. Apud cells (diseases) Endocrinopathies Ethinyl Estradiol Ethinyl Estradiol - therapeutic use Female ferritin Ferritins Ferritins - blood Health aspects Hospitals Humans hyperinsulinemia Hyperinsulinism Hyperinsulinism - physiopathology Hypoglycemic Agents Hypoglycemic Agents - therapeutic use Insulin Insulin resistance Insulin Resistance - physiology intestinal absorption Iron Iron - metabolism Medical sciences Metabolic diseases Metabolic syndrome metabolism metformin Metformin - therapeutic use Miscellaneous Nutrition Obesity Obesity - complications Obesity - metabolism Oligomenorrhea Oligomenorrhea - physiopathology oral contraceptives overweight patients physiology physiopathology polycystic ovary syndrome Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - drug therapy Polycystic Ovary Syndrome - metabolism Public health. Hygiene Public health. Hygiene-occupational medicine Risk factors Sample size therapeutic use Women |
| Title | Increased Body Iron Stores of Obese Women With Polycystic Ovary Syndrome Are a Consequence of Insulin Resistance and Hyperinsulinism and Are Not a Result of Reduced Menstrual Losses |
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