Controversial data were reported concerning fasting
ghrelin (decreased, normal or elevated) in
polycystic ovary syndrome (PCOS). The aim of our study was to clarify
ghrelin levels in non-obese,
overweight, and obese PCOS patients; to investigate the effect of acute
insulin infusion on
ghrelin in PCOS as a chronic
insulin-resistant state, with and without the impact of
obesity, and to examine
ghrelin-
androgen interaction. In that order, we evaluated 1)
ghrelin levels among 8 nonobese patients with PCOS [body mass index (BMI): 20.52+/-1.31 kg/m2], 8
overweight and obese patients with PCOS (BMI: 34.36+/-6.53 kg/m2) and their respective controls, 2)
ghrelin suppression during euglycemic hyperinsulinemic clamp, and 3)
ghrelin-
androgen interrelationship. After overnight fast, 2-h euglycemic hyperinsulinemic clamp, was performed in all investigated women. Fasting
ghrelin was significantly lower in non-obese PCOS than in controls (64.74+/-25.69 vs 108.36+/-52.60; p<0.05) as well as in
overweight and obese PCOS in comparison with controls (38.71+/-14.18 vs 98.77+/-40.49; p<0.05).
Insulin infusion significantly suppressed
ghrelin in all subgroups of investigated women. Analysis of variance for repeatable measures confirmed that there was no significant difference in pattern of response between PCOS and controls. In conclusion, women with PCOS had lower fasting
ghrelin and decreased
insulin sensitivity independently of their BMI, compared to the controls. In addition, there were no differences between fasting
ghrelin levels among non-obese,
overweight, and obese women with PCOS. During euglycemic hyperinsulinemic clamp,
ghrelin decreased in all studied groups to a similar extent, implying that, compared to chronic
hyperinsulinemia, acute
hyperinsulinemia reduces
ghrelin levels independently of the degree of
insulin resistance.