Increased insulin-like growth factor-1 in relation to cardiovascular function in polycystic ovary syndrome: friend or foe?

Abstract

The incidence of cardiovascular disease (CVD) in patients with polycystic ovary syndrome (PCOS) is very high and conventional risk factors only partially explain excessive risk of developing CVD in patients of PCOS. The pathophysiology of PCOS is very unique, and several hormonal and metabolic changes occur. Several observations suggest that serum IGF-1 levels decrease in insulin resistance, which results in IGF-1 deficiency. In patient of PCOS, close relationships have been demonstrated between insulin resistance and serum IGF-1 levels. Hyperinsulinemic insulin resistance results in a general augmentation of steroidogenesis and LH release in PCOS. The action of IGF-1 varies in different tissues possibly via autocrine or paracrine mechanisms. The increase or decrease in IGF-1 in different tissues results in differential outcomes. Several studies suggest that lowered circulating IGF-1 levels play important role in the initiation of the cardiac hypertrophic response which results in the risk of cardiovascular disease. While recent results suggests that individual with elevated IGF-1 is protected against cardiovascular disease. Thus IGF-1 shows versatile pleiotropic actions. This review provides a current perspective on increased level of IGF-1 in PCOS and also adds to the current controversy regarding the roles of IGF-1 in cardiovascular disease.

Chinese abstract

多囊卵巢综合征（PCOS）患者中心血管疾病（CVD）的发病率非常高，传统的危风险因素只能部分解释心血管疾病在多囊卵巢综合征患者中发展的过度风险。多囊卵巢综合征的病理生理机制是非常独特的，会发生一些激素和代谢的变化。一些观察表明，血清胰岛素样因子-1水平降低胰岛素抵抗，导致胰岛素样因子-1缺乏。在多囊卵巢综合征患者中, 胰岛素抵抗和血清胰岛素样因子-1水平的密切关系被证明。多囊卵巢综合征中,高胰岛素-胰岛素抵抗导致类固醇激素总体增强和黄体生成素释放。胰岛素样因子-1可能通过自分泌或旁分泌机制而在不同的组织中作用不同。在不同的组织中胰岛素样因子-1增加或减少导致不同的结果。一些研究表明，降低血液中胰岛素样因子-1的水平在导致心血管疾病风险的心肌肥大反应发生中起重要作用。而最近的研究结果表明，胰岛素样因子-1升高防止个体心血管疾病的发生。因此，胰岛素样因子-1具有多功能性、多效性。这篇综述为多囊卵巢综合征中胰岛素样因子-1水平升高提供了新的观点，并且增加了胰岛素样因子-1在心血管疾病中作用的争议。

• Cardiovascular disease
• hyperinsulinemia
• insulin like growth factor-1
• polycystic ovary syndrome

Acknowledgement

The authors would like to acknowledge refunding provided by Institute of Pharmacy, Nirma University, in the form of post-graduate contingency.

Declaration of interest

The authors declare that there is no conflict of interest concerning the publication of this paper.