Relationship of Androgenic Activity to Splanchnic Insulin Metabolism and Peripheral Glucose Utilization in Premenopausal Women*
- 1 January 1987
- journal article
- research article
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 64 (1), 162-169
- https://doi.org/10.1210/jcem-64-1-162
Abstract
The importance of androgenic activity in mediating the effects of obesity and body fat topography on splanchnic insulin metabolism and peripheral insulin sensitivity was studied in 19 nonhirsute premenopausal women with a wide range of ideal body weight [percent ideal body weight (% IBW), 78–202%] and body fat distribution pattern [waist to hip girth ratio (WHR), 0.67–0.91]. Turnover kinetics of peripheral plasma C-peptide and insulin were measured, and estimates of pancreatic insulin production (PIP) and the hepatic extraction fraction (HEF) were calculated. The peripheral insulin sensitivity index (M/I) was determined during an euglycemic insulin clamp study. Androgenic activity was assessed by estimating the plasma level of sex hormone-binding globulin (SHBG) and percentage of free testosterone (% FT). After iv glucose stimulation, PIP ranged from 40–254 mU/min·m2 and correlated highly with % IBW (r = 0.78; P < 0.01). Insulin HEF ranged from 5–69% of the pancreatic production and was inversely proportional to WHR (r = −0.60; P < 0.01). Increasing WHR also correlated with the diminution in M/I (r = −0.47; P < 0.05), which, in turn, correlated with the decline in the HEF of insulin (r = 0.60; P < 0.01). Since PIP, HEF, and M/I correlated with SHBG and % FT, and since the degree of androgenic activity correlated with % IBW and WHR, partial regression analysis was performed. After adjusting for the effects of SHBG and % FT, the relationship between % IBW and PIP remained unaltered, whereas the correlation between WHR and HEF or M/I and their relationship to each other were either markedly reduced or became insignificant. Thus, in premenopausal women, the increase in pancreatic insulin production with increasing weight is independent of the degree of androgenic activity. On the other hand, the decline in hepatic insulin extraction and diminution in peripheral insulin sensitivity with upper body fat localization are in part mediated by increased androgenic activity. This association may account for the pronounced hyperinsulinemia and insulin resistance characteristic of this form of obesity.Keywords
This publication has 18 references indexed in Scilit:
- Insulin Resistance in Nonobese Patients with Polycystic Ovarian Disease*Journal of Clinical Endocrinology & Metabolism, 1983
- Relationship of Androgenic Activity to Body Fat Topography, Fat Cell Morphology, and Metabolic Aberrations in Premenopausal Women*Journal of Clinical Endocrinology & Metabolism, 1983
- Hyperinsulinism and insulin resistance in polycystic ovarian syndrome: A verification using oral glucose, i.v. glucose and tolbutamideActa Diabetologica, 1983
- Splanchnic and renal metabolism of insulin in human subjects: a dose-response studyAmerican Journal of Physiology-Endocrinology and Metabolism, 1983
- Intravascular volume, extracellular fluid volume, and total body water in obese and nonobese hypertensive patientsThe American Journal of Cardiology, 1983
- Relation of Body Fat Distribution to Metabolic Complications of Obesity*Journal of Clinical Endocrinology & Metabolism, 1982
- Glucose clamp technique: a method for quantifying insulin secretion and resistance.American Journal of Physiology-Endocrinology and Metabolism, 1979
- Obesity, lipids, and glucose intolerance The Framingham StudyThe American Journal of Clinical Nutrition, 1979
- Kinetics of human connecting peptide in normal and diabetic subjects.JCI Insight, 1978
- EFFECT OF ANABOLIC STEROIDS ON BLOOD SUGAR AND PLASMA INSULIN LEVELS IN MAN1963