Virginia Commonwealth University researchers are on the forefront of studying the connection between insulin resistance and Polycystic Ovary Syndrome, or PCOS.
Insulin resistance is a condition in which the body produces insulin, a hormone made by the pancreas, but the muscle, fat and liver cells do not respond to insulin properly. Insulin helps to lower blood sugars (glucose) in the body after a meal. When the cells fail to respond adequately to circulating insulin, glucose levels rise, and the body needs to produce an increased amount of insulin to maintain the blood glucose in the normal range. Therefore, people with insulin resistance have elevated circulating levels of insulin. If the pancreas cannot keep up with the increased demand for insulin, type 2 diabetes can develop with high levels of both glucose and insulin circulating in the blood at the same time. Insulin resistance is also associated with an increased risk for developing heart disease.
Polycystic Ovary Syndrome causes hormonal imbalances leading to irregular menstrual cycles, excess facial and body hair, weight gain and adult acne. Women with PCOS also have insulin resistance and are at high risk for developing type 2 “We’re one of the top institutions worldwide looking at the connection between PCOS and insulin resistance,” said John Nestler, M.D., the William Branch Porter Professor and chair of the Department of Internal Medicine at the VCU School of Medicine. “Our ongoing research is investigating the influence of insulin on fertility.”
In the 1980s, Nestler was among the first scientists in the world to suggest that insulin was an important reproductive hormone. His pioneering work to induce ovulation through the use of such insulin-sensitizing drugs as metformin has led to the common use of metformin to treat infertility in women with PCOS.
“We know metformin can be an effective fertility treatment for most women with PCOS. However, we have found that some women don’t respond to metformin, and we want to know why. We think it may be related to individual genetic differences and gene variation in enzymes affected by metformin. This variation in specific genes may explain why metformin is not an effective treatment for some women,” said Nestler.
Nestler and his research team are currently focusing on pharmacogenomics, which is the study of how the actions of and reactions to drugs vary with individuals. The implication of this research is that based on the genetic profile of a patient, a physician may be able to discern whether the patient should be on metformin or not and would be able to apply therapy for PCOS more effectively.
This research is funded through a U54 grant from the National Institutes of Health. The center grant includes three main projects studying PCOS, including the work by Nestler and his team. For more information about PCOS research at VCU, visit www.vcu.edu/pcos.
About VCU and the VCU Medical Center
Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.