Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition

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.