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Glucagon in hyperandrogenic women: relationships to abnormalities of insulin

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GollandIM_1992redux.pdf (22.68Mb)
Date
1992
Author
Golland, Ian Morris
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Abstract
 
 
In order to investigate whether glucagon is implicated in the reduced insulin sensitivity in hyperandrogenic women, concentrations of glucagon and insulin in serum were measured during a 75g oral glucose tolerance test (oGTT) in 24 obese (body mass index, BMI, >25kgm~2) and 20 non-obese women with polycystic ovary syndrome (PCO) , and 10 obese and 13 non-obese control subjects. The oGTT was repeated during alteration of concentrations of endogenous androgens by administration of buserelin, spironolactone or a combination of cyproterone acetate and ethinyl oestradiol to women with PCO, and by administration of goserelin or danazol to control subjects. The relationships between glucose, insulin, C-peptide and glucagon values and those of testosterone, androstenedione, dehydroepiandrosterone sulphate and sex hormone binding globulin were examined before and during treatment. Additionally, the relationship between basal and glucose-stimulated glucose concentrations and that of haemoglobin A^ (HbA^) was examined to assess the value of HbA-^ estimation for monitoring glycaemic control in women with PCO.
 
Obese women with PCO had higher serum concentrations of insulin and glucose than did non-obese women with PCO and control subjects, but plasma concentrations of glucagon were greater in obese control women. There were no significant relationships between fasting concentrations of insulin or insulin responses to oral glucose and those of testosterone or androstenedione in either group of PCO subjects, but the glucagon response to oral glucose was significantly related to both testosterone and androstenedione in obese women with PCO. No significant relationship was demonstrated between change in serum concentrations of androgens as a result of treatment and those of insulin or glucagon in any of the groups. In no case was the HbA^ concentration above normal laboratory values although a significant correlation between HbA^ and summed glucose levels was apparent.
 
Glucagon does not appear to be implicated in the insulin resistance exhibited by women with PCO nor do androgens appear to directly effect concentrations of insulin or glucagon in normal women or in those with PCO. Measurement of HbA-t is not sufficiently discriminatory for identification of impaired glucose tolerance in PCO.
 
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http://hdl.handle.net/1842/26544
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  • Edinburgh Medical School thesis and dissertation collection

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