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Metabolic Evidence of Diminished Lipid Oxidation in Women With Polycystic Ovary Syndrome

Leah D. Whigham, Daniel E. Butz, Hesam Dashti, Marco Tonelli, LuAnn K. Johnson, Mark E. Cook, Warren P. Porter, Hamid R. Eghbalnia, John L. Markley, Steven R. Lindheim, Dale A. Schoeller, David H. Abbott, Fariba M. Assadi-Porter
Current metabolomics 2013 v.1 no.4 pp. 269-278
acetone, amino acids, blood glucose, blood serum, butyrates, carbon, fasting, formates, glucose, glucose tolerance tests, lipid peroxidation, lipids, metabolic syndrome, metabolism, metabolites, metabolomics, nitrogen, nitrogen content, nuclear magnetic resonance spectroscopy, polycystic ovary syndrome, pyruvic acid, stable isotopes, testosterone, urine, weight gain, women
Polycystic ovary syndrome (PCOS), a common female endocrinopathy, is a complex metabolic syndrome of enhanced weight gain. The goal of this pilot study was to evaluate metabolic differences between normal (n=10) and PCOS (n=10) women via breath carbon isotope ratio, urinary nitrogen and nuclear magnetic resonance (NMR)- determined serum metabolites. Breath carbon stable isotopes measured by cavity ring down spectroscopy (CRDS) indicated diminished (p<0.030) lipid use as a metabolic substrate during overnight fasting in PCOS compared to normal women. Accompanying urinary analyses showed a trending correlation (p<0.057) between overnight total nitrogen and circulating testosterone in PCOS women, alone. Serum analyzed by NMR spectroscopy following overnight, fast and at 2 h following an oral glucose tolerance test showed that a transient elevation in blood glucose levels decreased circulating levels of lipid, glucose and amino acid metabolic intermediates (acetone, 2-oxocaporate, 2-aminobutyrate, pyruvate, formate, and sarcosine) in PCOS women, whereas the 2 h glucose challenge led to increases in the same intermediates in normal women. These pilot data suggest that PCOS-related inflexibility in fasting-related switching between lipid and carbohydrate/protein utilization for carbon metabolism may contribute to enhanced weight gain.