Acute Hypertriglyceridemia, Insulin Resistance, and Platelet Hyperactivity in PCOS

JUNE 19, 2013
Mandy Armitage, MD
Recent study data suggests that acute, induced hypertriglyceridemia (HTG) increases platelet activation; however, this effect is not attenuated by insulin in women with PCOS as it is in healthy subjects.
Myint M. Aye, MRCP, at the Hull York Medical School in the United Kingdom, and colleagues reported their findings at ENDO 2013: The Endocrine Society’s 95th Annual Meeting & Expo in San Francisco on June 18, 2013.
According to the researchers, PCOS is commonly associated with metabolic syndrome, postprandial hypertriglyceridemia, insulin resistance (IR), and subsequent cardiovascular risks. IR is associated with platelet dysfunction, which plays a role in atherothrombosis. The authors aimed to evaluate the effects of induced, acute HTG and IR on platelet function in women with PCOS.
The study included 13 women with PCOS and 12 healthy women. As expected, the PCOS women were hyperandrogenic and insulin resistant when compared with controls. After an overnight fast, they received a 5 hour saline infusion. At 180 minutes, insulin sensitivity was measured using a hyperinsulinemic euglycemic clamp. Blood samples for platelet studies were collected at hours 2 and 5; platelet activation was measured by fibrinogen binding and P selectin expression in response to the agonist adenosine diphosphate (ADP) and antagonist prostacyclin (PGI2). This process was repeated one week later with a 5 hour infusion of 20% intralipid instead of saline.  

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