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Ghrelin and Measures of Satiety Are Altered in Polycystic Ovary Syndrome But Not Differentially Affected by Diet Composition

Reproductive Medicine Unit (L.J.M., L.T., R.J.N.), Department of Obstetrics and Gynaecology and Departments of Medicine (G.A.W., N.D.L.) and Psychiatry (C.G.), The University of Adelaide, Adelaide, South Australia, Australia 5000; and Commonwealth Scientific and Industrial Research Organization Health Sciences and Nutrition (L.J.M., M.N., P.M.C.), Adelaide, South Australia, Australia 5000

Address all correspondence and requests for reprints to: CSIRO Health Sciences and Nutrition, P.O. Box 10041 BC, Adelaide, South Australia, Australia 5000. E-mail: lisa.moran{at}csiro.au.

Polycystic ovary syndrome (PCOS) is a common endocrine condition in women of reproductive age associated with obesity. It may involve dysregulation of ghrelin, a hormone implicated in appetite regulation. The effect of diet composition on ghrelin is unclear. Overweight women with and without PCOS were randomized to a high-protein (40% carbohydrate, 30% protein; 10 PCOS, six non-PCOS) or standard protein diet (55% carbohydrate, 15% protein; 10 PCOS, six non-PCOS) for 12 wk of energy restriction and 4 wk of weight maintenance. Diet composition had no effect on fasting or postprandial ghrelin or measures of satiety. Non-PCOS subjects had a 70% higher fasting baseline ghrelin (P = 0.011), greater increase in fasting ghrelin (57.5 vs. 34.0%, P = 0.033), and greater maximal decrease in postprandial ghrelin after weight loss (–144.1 ± 58.4 vs. –28.9 ± 14.2 pg/ml, P = 0.02) than subjects with PCOS. Subjects with PCOS were less satiated (P = 0.001) and more hungry (P = 0.007) after a test meal at wk 0 and 16 than subjects without PCOS. Appetite regulation, as measured by subjective short-term hunger and satiety and ghrelin homeostasis, may be impaired in PCOS.

Abbreviations: AUC, Area under the curve; BMI, body mass index; HOMA, homeostasis model assessment; HP, high protein; MTT, meal tolerance test; PCOS, polycystic ovary syndrome; SP, standard protein.

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