THE EFECTS OF ACUTE HYPERINSULINEMIA AND INSULIN SENISTIVITY ON PLASMA HOMOCYSTEINE IN NON-OBESE WOMEN WITH POLYCYSTIC OVARY SYNDROME
M Sumarac-Dumanovic1, D Micic1, D Mirkovic2, Dj Macut1, A Kendereski1, S Zoric1, G Cvijovic1 & D Pejkovic1
Insulin resistance and/or hyperinsulinemia are risk factors for CVD. Plasma homocysteine is also important risk factor for the development of premature cardiovascular disease (CVD) in type 2 diabetes. The relationship between level of insulin and homocysteine in insulin resistant state is not clear. The aim of our study was to investigate whether plasma homocystein levels are changed by acute hyperinsulinemia and to associate the change of plasma homocysteine with the level of insulin sensitivity in non-obese women with polycystic ovary syndrome (PCOS). We determined plasma homocystein (Hcy) during fasting and during hyperinsulinemic euglycemic clamp (insulin infusion rate 01IU/kg/h). Plasma homocysteine ( HPLC, mcmol/l) was measured in fasting state, at 90 and 120min of clamp and after next 120 min after the end of clamp (at 240 min) in 7 non-obese PCOS women with normal glucose tolerance ( mean age 24.27 +/- 1.52 yrs; BMI 22.67 ± 0.94 kg/m2 , testosterone 4.78 +/- 0.45nmol/l, SHBG 30.41+/-9.26). Acute hyperinsulinemia reduces Hcy (0 min vs. 90 min 7.94+/-0.74 vs. 6.95+/-0.90, p>0.05) and significantly reduces Hcy at 120 min (0 min vs. 120 min 7.94+/-0.74 vs. 6.60+/-0.37, p <0.05). There was no difference between Hcy at 0 min and 240min (7.94+/-0.74 vs. 8.18+/-0.50, p >0.05). Insulin sensitivity parameter (M) obtained from clamp (5.78+/- 0.86mg/kg/min) doesn't correlate with delta Hcy (0min -120min, %) (r=-0.172) neither delta Hcy with fasting insulin (19.61+/-2.34 mU/l) (r=-0.095). There was no correlation between fasting insulinemia and fasting Hcy levels (r=-0.147) nether between fasting Hcy and insulin sensitivity (r=-0.001). Our data confirmed that acute hyperinsulinemia cannot induce the elevation of plasma homocysteine levels in non-obese PCOS women. Further investigation of the effect of chronic hyperinsulinemia on plasma levels are needed to elucidate the relationship between plasma insulin and/or insulin sensitivity and homocystein levels.