Abstract

Rationale: Insulin (INS) resistance associated with hyperestrogenemias occurs in gestational diabetes mellitus, polycystic ovary syndrome, ovarian hyperstimulation syndrome, estrogen therapies, metabolic syndrome, and obesity. The mechanism by which INS and estrogen interact is unknown. We hypothesize that estrogen binds directly to INS and the insulin receptor (IR) producing INS resistance.Objectives: To determine the binding constants of steroid hormones to INS, the IR, and INS-like peptides derived from the IR; and to investigate the effect of estrogens on the binding of INS to its receptor.Methods: Ultraviolet spectroscopy, capillary electrophoresis, and NMR demonstrated estrogen binding to INS and its receptor. Horse-radish peroxidase-linked INS was used in an ELISA-like procedure to measure the effect of estradiol on binding of INS to its receptor.Measurements: Binding constants for estrogens to INS and the IR were determined by concentration-dependent spectral shifts. The effect of estradiol on INS binding to its receptor was determined by shifts in the INS binding curve.Main Results: Estradiol bound to INS with a Kd of 12 × 10−9 M and to the IR with a Kd of 24 × 10−9 M, while other hormones had significantly less affinity. Twenty-two nanomolars of estradiol shifted the binding curve of INS to its receptor 0.8 log units to the right.Conclusion: Estradiol concentrations in hyperestrogenemic syndromes may interfere with INS binding to its receptor producing significant INS resistance.

Highlights

  • Estradiol concentrations in hyperestrogenemic syndromes may interfere with INS binding to its receptor producing significant INS resistance

  • Insulin (INS) resistance associated with hyperestrogenemias occurs in gestational diabetes mellitus (GDM), polycystic ovary syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS), estrogen therapies, metabolic syndrome, and obesity

  • Some degree of Abbreviations: E2, estradiol; ERα, ERβ, alpha and beta chains of estrogen receptor; ER, estrogen receptor; GDM, gestational diabetes mellitus; INS, insulin; INS–HRP, insulin conjugated to horse-radish peroxidase; IR, insulin receptor; IVF, in vitro fertilization; OHSS, ovarian hyperstimulation syndrome; PCOS, polycystic ovarian syndrome; SHBG, sex hormone binding globulin

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Summary

Introduction

Insulin (INS) resistance associated with hyperestrogenemias occurs in gestational diabetes mellitus (GDM), polycystic ovary syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS), estrogen therapies, metabolic syndrome, and obesity. Some degree of Abbreviations: E2, estradiol; ERα, ERβ, alpha and beta chains of estrogen receptor; ER, estrogen receptor; GDM, gestational diabetes mellitus; INS, insulin; INS–HRP, insulin conjugated to horse-radish peroxidase; IR, insulin receptor; IVF, in vitro fertilization; OHSS, ovarian hyperstimulation syndrome; PCOS, polycystic ovarian syndrome; SHBG, sex hormone binding globulin. Similar rates of INS resistance and diabetes occur as a result of OHSS in which E2 concentrations often exceed 10 nM [16, 17]. In PCOS, concentrations of E2 can exceed 1 ng/ml or 4 nM [36, 37]

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