Insulin, ghrelin and early return of hunger in women with obesity and polycystic ovary syndrome

Abstract

Background & aims: Women with polycystic ovary syndrome (PCOS) have greater predisposition to obesity, but the mechanisms are still unknown. Hyperinsulinemia, insulin resistance and low levels of ghrelin are common in this group. For the purposes of the present study, it was assumed that such changes could have an influence on hunger. This study aimed to assess the hunger pattern before and after an ad libitum meal and the association between insulin and plasma ghrelin with hunger perception in women with obesity, with and without PCOS.

Method: This cross-sectional study included 53 women with obesity, 30 with PCOS, and 23 controls (with obesity but without PCOS). Insulin, ghrelin, glucose and subjective ratings of hunger (by 100 mm visual analogue scales) were analyzed in a fasting state, preprandially at 12:00 before the ad libitum meal, and postprandially 15, 45, 75 and 135 min after the beginning of the ad libitum meal.

Results: There was a significant increase in hunger one hour after the beginning of the ad libitum meal (75 min) in the PCOS group (p = .01) compared to 15 min, whereas this only occurred after 135 min in the control group (2 h later). The usual energy intake adjusted by the intra-individual variability was higher in the PCOS group than in the control group (2309 ± 461 kcal·d^-1 × 2124 ± 480 kcal·d^-1; p = .04). The concentrations of insulin and ghrelin, in both preprandial and postprandial periods, were not associated with the perception of hunger.

Conclusions: Women with obesity and PCOS had an earlier return of hunger in the postprandial period after an ad libitum meal, but there was not associated with postprandial ghrelin and insulin levels.

Keywords: Appetite; Ghrelin; Hunger; Insulin; Obesity; Polycystic ovary syndrome.