Alterations in carbohydrate metabolism as they apply to reproductive endocrinology

M. P. Diamond, A. C. Wentz, A. D. Cherrington

Research output: Contribution to journalReview article

29 Citations (Scopus)

Abstract

This review has characterized the current state of knowledge of four clinical situations in which an interrelationship of gynecology, endocrinology and carbohydrate metabolism is recognized. The literature contains conflicting descriptions of changes in glucose homeostasis during the menstrual cycle and while using birth control pills. Physiologic changes in receptor number have been demonstrated in each of these situations, so failure to observe differences using glucose tolerance testing may reflect an in vivo homeostatic response to changes in these hormone levels. Thus, in vivo identification of alterations in carbohydrate metabolism induced by endogenous or exogenous steroids may require utilization of models that prevent these homeostatic mechanisms. The association between hyperandrogenism and hyperinsulinism has been better characterized, but the relationship is complicated by the frequent coexistence of obesity. The association may be due to insulin-stimulated ovarian androgen production, and insulin insensitivity may reflect a postreceptor defect. Insulin and its metabolic effects have also been implicated in ovulatory dysfunction in women with diabetes mellitus and identified as a factor affecting all levels of the hypothalamic-pituitary-ovarian axis. A clearer understanding of these relationships and their application to clinical management await further study.

Original languageEnglish (US)
Pages (from-to)387-397
Number of pages11
JournalFertility and sterility
Volume50
Issue number3
StatePublished - Jan 1 1988

Fingerprint

Endocrinology
Carbohydrate Metabolism
Insulin
Hyperandrogenism
Glucose
Hyperinsulinism
Menstrual Cycle
Gynecology
Contraception
Androgens
Diabetes Mellitus
Homeostasis
Obesity
Steroids
Hormones

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Alterations in carbohydrate metabolism as they apply to reproductive endocrinology. / Diamond, M. P.; Wentz, A. C.; Cherrington, A. D.

In: Fertility and sterility, Vol. 50, No. 3, 01.01.1988, p. 387-397.

Research output: Contribution to journalReview article

Diamond, M. P. ; Wentz, A. C. ; Cherrington, A. D. / Alterations in carbohydrate metabolism as they apply to reproductive endocrinology. In: Fertility and sterility. 1988 ; Vol. 50, No. 3. pp. 387-397.
@article{a835ee753ecc4371bce8f32786e5bb80,
title = "Alterations in carbohydrate metabolism as they apply to reproductive endocrinology",
abstract = "This review has characterized the current state of knowledge of four clinical situations in which an interrelationship of gynecology, endocrinology and carbohydrate metabolism is recognized. The literature contains conflicting descriptions of changes in glucose homeostasis during the menstrual cycle and while using birth control pills. Physiologic changes in receptor number have been demonstrated in each of these situations, so failure to observe differences using glucose tolerance testing may reflect an in vivo homeostatic response to changes in these hormone levels. Thus, in vivo identification of alterations in carbohydrate metabolism induced by endogenous or exogenous steroids may require utilization of models that prevent these homeostatic mechanisms. The association between hyperandrogenism and hyperinsulinism has been better characterized, but the relationship is complicated by the frequent coexistence of obesity. The association may be due to insulin-stimulated ovarian androgen production, and insulin insensitivity may reflect a postreceptor defect. Insulin and its metabolic effects have also been implicated in ovulatory dysfunction in women with diabetes mellitus and identified as a factor affecting all levels of the hypothalamic-pituitary-ovarian axis. A clearer understanding of these relationships and their application to clinical management await further study.",
author = "Diamond, {M. P.} and Wentz, {A. C.} and Cherrington, {A. D.}",
year = "1988",
month = "1",
day = "1",
language = "English (US)",
volume = "50",
pages = "387--397",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Alterations in carbohydrate metabolism as they apply to reproductive endocrinology

AU - Diamond, M. P.

AU - Wentz, A. C.

AU - Cherrington, A. D.

PY - 1988/1/1

Y1 - 1988/1/1

N2 - This review has characterized the current state of knowledge of four clinical situations in which an interrelationship of gynecology, endocrinology and carbohydrate metabolism is recognized. The literature contains conflicting descriptions of changes in glucose homeostasis during the menstrual cycle and while using birth control pills. Physiologic changes in receptor number have been demonstrated in each of these situations, so failure to observe differences using glucose tolerance testing may reflect an in vivo homeostatic response to changes in these hormone levels. Thus, in vivo identification of alterations in carbohydrate metabolism induced by endogenous or exogenous steroids may require utilization of models that prevent these homeostatic mechanisms. The association between hyperandrogenism and hyperinsulinism has been better characterized, but the relationship is complicated by the frequent coexistence of obesity. The association may be due to insulin-stimulated ovarian androgen production, and insulin insensitivity may reflect a postreceptor defect. Insulin and its metabolic effects have also been implicated in ovulatory dysfunction in women with diabetes mellitus and identified as a factor affecting all levels of the hypothalamic-pituitary-ovarian axis. A clearer understanding of these relationships and their application to clinical management await further study.

AB - This review has characterized the current state of knowledge of four clinical situations in which an interrelationship of gynecology, endocrinology and carbohydrate metabolism is recognized. The literature contains conflicting descriptions of changes in glucose homeostasis during the menstrual cycle and while using birth control pills. Physiologic changes in receptor number have been demonstrated in each of these situations, so failure to observe differences using glucose tolerance testing may reflect an in vivo homeostatic response to changes in these hormone levels. Thus, in vivo identification of alterations in carbohydrate metabolism induced by endogenous or exogenous steroids may require utilization of models that prevent these homeostatic mechanisms. The association between hyperandrogenism and hyperinsulinism has been better characterized, but the relationship is complicated by the frequent coexistence of obesity. The association may be due to insulin-stimulated ovarian androgen production, and insulin insensitivity may reflect a postreceptor defect. Insulin and its metabolic effects have also been implicated in ovulatory dysfunction in women with diabetes mellitus and identified as a factor affecting all levels of the hypothalamic-pituitary-ovarian axis. A clearer understanding of these relationships and their application to clinical management await further study.

UR - http://www.scopus.com/inward/record.url?scp=0023693081&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023693081&partnerID=8YFLogxK

M3 - Review article

C2 - 3044841

AN - SCOPUS:0023693081

VL - 50

SP - 387

EP - 397

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 3

ER -