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DOI: 10.1055/s-0030-1249020
© Georg Thieme Verlag KG Stuttgart · New York
Very High Frequency of the Polymorphism for the Insulin Receptor Substrate 1 (IRS-1) at Codon 972 (Glycine972Arginine) in Southern Italian Women with Polycystic Ovary Syndrome
Publikationsverlauf
received 17.09.2009
accepted 03.02.2010
Publikationsdatum:
12. März 2010 (online)

Abstract
A major component of the polycystic ovary syndrome (PCOS) is the insulin resistance. Only a few studies have evaluated the IRS-1 polymorphism at codon 972, sometimes in the absence of a control group, and with great variability in frequency (0–23% in PCOS vs. 0–17% in controls), and with no unequivocal relationships between the polymorphism and clinical or biochemical indexes. The aim of the work was to evaluate the frequency of the IRS-1 polymorphism at codon 972 in PCOS, and correlate it to clinical and biochemical indexes. We assessed the rs 1801278 polymorphic variant in the IRS-1 gene (Gly972Gly=wild-type; Gly972Arg=heterozygosity; Arg972Arg=homozygosity) in genomic DNA by restriction fragment length polymorphism. The study was conducted at an academic medical center with the participation of 65 women with PCOS and 27 age-matched healthy women (controls). Compared to controls, Gly972Arg was very frequent in PCOS (77% vs. 18%, p<0.0001); one PCOS woman was homozygous. Compared to wild-type PCOS, heterozygous PCOS women had only three significantly different indexes: higher fasting insulin, insulin resistance index, and lower 120 min OGTT glucose. Moreover, in the correlation analysis between any two clinical or biochemical variables, the Pearson's correlation coefficients were frequently of different magnitude in heterozygous PCOS versus wild-type PCOS. Overall, heterozygous PCOS had a greater number of statistically significant relationships between different clinical, metabolic and hormonal indexes: 44 direct and 9 inverse versus 6 and 3, respectively. The IRS-1 Gly972Arg has the highest frequency reported world-wide for PCOS women. This variant is associated with insulin resistance and higher fasting insulin in PCOS women.
Key words
insulin resistance - hyperandrogenism - single nucleotide polymorphisms
References
- 1
Nestler JE.
Polycystic ovary syndrome: a disorder for the generalist.
Fertil Steril.
1998;
70
811-812
MissingFormLabel
- 2
Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R.
Prevalence of the polycystic ovary syndrome in unselected black and white women of
the southeastern United Stated: a prospective study.
J Clin Endocrinol Metab.
1998;
83
3078-3082
MissingFormLabel
- 3
Diamanti-Kandarakis E, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG, Zapanti ED, Bartzis MI.
A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal
and metabolic profile.
J Clin Endocrinol Metab.
1999;
84
4006-4011
MissingFormLabel
- 4
Asunción M, Calvo RM, San Millàn JL, Sancho J, Avila S, Escobar-Morreale HF.
A prospective study of the prevalence of the polycystic ovary syndrome in unselected
Caucasian women from Spain.
J Clin Endocrinol Metab.
2000;
85
2434-2438
MissingFormLabel
- 5
Balen AH, Laven JS, Tan SL, Dewailly D.
Ultrasound assessment of the polycystic ovary: international consensus definitions.
Human Reprod Update.
2003;
6
505-514
MissingFormLabel
- 6 Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach.. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR eds. Polycycistic ovary syndrome. Boston: Blackwell Scientific Publication; 1992: 377-384
MissingFormLabel
- 7
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus
on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.
Fertil Steril.
2004;
81
19-25
MissingFormLabel
- 8
Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF.
Androgen Excess Society. Positions statement: criteria for defining polycystic ovary
syndrome as a predominantly hyperandrogenic syndrome: an androgen Excess Society guideline.
J Clin Endocrinol Metab.
2006;
91
4237-4245
MissingFormLabel
- 9
Cussons AJ, Stuckey BG, Watts GF.
Cardiovascular disease in the polycystic ovary syndrome: new insights and perspectives.
Atherosclerosis.
2006;
185
227-239
MissingFormLabel
- 10
Cussons AJ, Stuckey BG, Watts GF.
Metabolic syndrome and cardiometabolic risk in PCOS.
Curr Diabetes Rep.
2007;
7
66-73
MissingFormLabel
- 11
Glueck CJ, Papanna R, Wang P, Goldenberg N, Sieve-Smith L.
Incidence and treatment of metabolic syndrome in newly referred women with confirmed
polycystic ovarian syndrome.
Metabolism.
2003;
52
908-915
MissingFormLabel
- 12
Norman RJ, Dewailly D, Legro RS, Hickey TE.
Polycystic ovary syndrome.
Lancet.
2007;
370
685-697
MissingFormLabel
- 13
Willis D, Mason H, Gilling-Smith C, Franks S.
Modulation by insulin of follicle-stimulation hormone and leuteinizing hormone actions
in human granulosa cells of normal and polycystic ovaries.
J Clin Endocrinol Metab.
1996;
81
302-309
MissingFormLabel
- 14
Legro RS, Bentley-Lewis R, Driscoll D, Wang SC, Dunaif A.
Insulin resistance in the sisters of women with polycystic ovary syndrome: association
with hyperandrogenemia rather than menstrual irregularity.
J Clin Endocrinol Metab.
2002;
87
2128-2133
MissingFormLabel
- 15
Suikkari AM, Koivisto VA, Rutanen EM, Yki-Järvinen H, Karonen SL, Seppälä M.
Insulin regulates the serum levels of low molecular weight insulin-like growth factor-binding
protein.
J Clin Endocrinol Metab.
1988;
66
266-272
MissingFormLabel
- 16
Diamanti-Kandarakis E, Kouli C, Tsianateli T, Bergiele A.
Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic
ovary syndrome.
Eur J Endocrinol.
1998;
138
269-274
MissingFormLabel
- 17
Bayram F, Unluhizarci K, Kelestimur F.
Potential utility of insulin sensitizers in the treatment of patients with Polycystic
ovary syndrome.
Treat Endocrinol.
2002;
1
45-53
MissingFormLabel
- 18
Lander ES, Schork NJ.
Genetic dissection of complex traits.
Science.
1994;
265
2037-2048
MissingFormLabel
- 19
Jellema A, Zeegers MP, Feskens EJ, Dagnelie PC, Mensink RP.
Gly972Arg variant in the insulin receptor substrate-1 gene and association with type
2 diabetes: a meta-analysis of 27 studies.
Diabetologia.
2003;
46
990-995
MissingFormLabel
- 20
Sesti G.
Insulin receptor substrate polymorphism and type 2 diabetes mellitus.
Pharmacogenomics.
2001;
1
343-357
MissingFormLabel
- 21
Happ M, Machicao F, Stefan N, Thamer C, Tschritter O, Schnuck F, Wallwiener D, Stumvoll M, Häring H-U, Fritsche A.
Genetic determinants of insulin action in polycystic ovary syndrome.
Exp Clin Endocrinol Diabetes.
2005;
113
275-281
MissingFormLabel
- 22
El Mkadem SA, Lautier C, Macari F, Molinari N, Lefèbvre P, Renard E, Gris JC, Cros G, Daurès JP, Bringer J, White MF, Grigorescu F.
Role of allelic variant Gly972Arg of IRS-1 and Gly1057Asp of IRS-2 in moderate-to-severe
insulin resistance of women with polycystic ovary syndrome.
Diabetes.
2001;
50
2164-2168
MissingFormLabel
- 23
Villuendas G, Botella-Carretero JI, Roldán B, Sancho J, Escobar-Morreale HF, San Millán JL.
Polymorphisms in the insulin receptor substrate-1 (IRS-1) gene and the insulin receptor
substrate-2 (IRS-2) gene influence glucose homeostasis and body mass index in women
with polycystic ovary syndrome and non-hyperandrogenic controls.
Hum Reprod.
2005;
20
3184-3191
MissingFormLabel
- 24
Dilek S, Ertunc D, Tok EC, Erdal EM, Aktas A.
Association of Gly972Arg variant of insulin receptor substrate-1 with metabolic features
in women with polycystic ovary syndrome.
Fertil Steril.
2005;
84
407-412
MissingFormLabel
- 25
Sir-Petermann T, Angel B, Maliqueo M, Santos JL, Riesco MV, Toloza H, Pérez-Bravo F.
Insulin secretion in women who have polycystic ovary syndrome and carry Gly972Arg
variant of insulin receptor substrate-1 in response to a high-glycemic or low-glycemic
carbohydrate load.
Nutrition.
2004;
20
905-910
MissingFormLabel
- 26
Valdés P, Cerda A, Barrenechea C, Kehr M, Soto C, Salazar LA.
No association between common Gly972Arg variant of the insulin receptor substrate-1
and polycystic ovary syndrome in Southern Chilean women.
Clin Chim Acta.
2008;
390
63-66
MissingFormLabel
- 27
Baba T, Endo T, Sata F, Homma H, Kitajima Y, Manase K, Kanaya M, Yamada H, Minatami H, Kishi R, Saito T.
Polycystic ovary syndrome is associated with genetic polymorphism in the insulin signaling
gene IRS-1 but not ENPP1 in Japanese population.
Life Sci.
2007;
81
850-854
MissingFormLabel
- 28
Ehrmann DA, Tang X, Yoshiuchi I, Cox NJ, Bell GI.
Relationship of insulin receptor substrate-1 and 2 genotypes to phenotypic features
of polycystic ovary syndrome.
J Clin Endocrinol Metab.
2002;
87
4297-4300
MissingFormLabel
- 29
Lin TC, Yen JM, Gong KB, Kuo TC, Ku DC, Liang SF, Wu MJ.
Abnormal glucose tolerance and insulin resistance in polycystic ovary syndrome amongst
with insulin receptor substrate-1 Gly972Arg/Ala513Pro polymorphism.
BMC Med Genet.
2006;
7
2350-2370
MissingFormLabel
- 30
Ehrmann DA, Sturis J, Byrne MM, Karrison T, Rosenfield RL, Polonsky KS.
Insulin secretory defects in polycystic ovary syndrome. Relationship to insulin sensitivity
and family history of non-insulin-dependent diabetes mellitus.
J Clin Invest.
1995;
96
520-527
MissingFormLabel
- 31
Legro RS, Driscoll D, Strauss 3rd JF, Fox J, Dunaif A.
Evidence for a genetic basis for hyperandrogenemia in polycystic ovary syndrome.
Proc Natl Acad Sci USA.
1998;
95
14956-14960
MissingFormLabel
- 32
Azziz R, Kashar-Miller MD.
Family history as a risk factor for the polycystic ovary syndrome.
J Pediatr Endocrinol Metab.
2000;
13
1303-1306
MissingFormLabel
- 33
Dunaif A, Segal KR, Futterweit W, Dobrjansky A.
Profound peripheral insulin resistance, independent of obesity, in polycystic ovary
syndrome.
Diabetes.
1989;
38
1165-1174
MissingFormLabel
- 34
Corboulda A, Zhao H, Mirzoeva S, Aird F, Dunaif A.
Enhanced mitogenic signalling in skeletal muscle of women with polycystic ovary syndrome.
Diabetes.
2006;
55
751-759
MissingFormLabel
- 35
Diamanti-Kandarakis E, Kouli C, Alexandraki K, Spina G.
Failure of mathematical indices of accurately assess insulin resistance in lean, overweight,
or obese women with polycystic ovary syndrome.
J Clin Endocrinol Metab.
2004;
89
1273-1276
MissingFormLabel
- 36
Berga SL.
Polycystic ovary syndrome: a model of combinatorial endocrinology?.
J Clin Endocrinol Metab.
2009;
94
2250-2251
MissingFormLabel
Correspondence
M. A. PappalardoMD
Unit of Endocrinology
Policlinico Universitario
“G. Martino”
Via Consolare Valeria
98125 Messina
Italy
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Fax: +39/090/221 35 18
eMail: mapp20@libero.it