Reduced Serum Glycodelin and Insulin-Like Growth Factor-Binding Protein-1 in Women with Polycystic Ovary Syndrome during First Trimester of Pregnancy

• Published in: The journal of clinical endocrinology and metabolism Vol. 89; no. 2; pp. 833 - 839
• Main Authors: Jakubowicz, Daniela J., Essah, Paulina A., Seppälä, Markku, Jakubowicz, Salomon, Baillargeon, Jean-Patrice, Koistinen, Riitta, Nestler, John E.
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01-02-2004; Copyright by The Endocrine Society
• Subjects: Abortion, Spontaneous - etiology; Adult; Biological and medical sciences; Blood Glucose - analysis; Case-Control Studies; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Glycodelin; Glycoproteins - blood; Gonadal Steroid Hormones - blood; Humans; Insulin - blood; Insulin Resistance; Insulin-Like Growth Factor Binding Protein 1 - blood; Medical sciences; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - physiopathology; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - physiopathology; Pregnancy Proteins - blood; Pregnancy Trimester, First; Vertebrates: endocrinology; Human; Female sterility; First trimester; Polycystic ovary; Female genital diseases; Pregnancy; Ovarian diseases; Insulin like growth factor binding protein 1; Cyst; Female; Serum; Benign neoplasm; Endocrinology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2003-030975

The polycystic ovary syndrome (PCOS) is associated with an increased rate of early pregnancy loss (EPL). Hyperinsulinemia is an independent risk factor for EPL and has been found to decrease levels of glycodelin and IGF binding protein-1 (IGFBP-1), two major endometrial proteins. We hypothesized that serum glycodelin IGFBP-1 concentrations would be reduced in women with PCOS during the first trimester of pregnancy.
Fasting serum insulin, glycodelin, and IGFBP-1 were measured, and oral glucose tolerance tests were performed in 72 women with PCOS and 62 normal women. Each woman was seen once and assigned to one of three gestational groups: wk 3–5, 6–8, and 9–11.
The insulin sensitivity index during oral glucose tolerance test was lower in women with PCOS compared with normal women throughout the first trimester (P < 0.0001). Both serum glycodelin and IGFBP-1 were markedly lower in women with PCOS (for glycodelin: wk 3–5, P < 0.0001; wk 6–8, P = 0.03; wk 9–11, P = 0.19; and for IGFBP-1: wk 3–5 and 6–8, P < 0.0001; wk 9–11, P = 0.0003). Comparing women with PCOS who experienced EPL with those who did not, serum glycodelin was significantly lower during wk 3–8 (P < 0.02) and serum IGFBP-1 during wk 9–11 (P = 0.003).
During the first trimester, serum glycodelin and IGFBP-1 concentrations are markedly decreased in PCOS, implicating endometrial epithelial and stromal dysfunction during periimplantation and early pregnancy as a possible mechanism for EPL in PCOS. These decreases are likely to be secondary to hyperinsulinemia and reduced insulin sensitivity.