Changes in Ghrelin and Glucagon following a Low Glycemic Load Diet in Women with PCOS

J Clin Endocrinol Metab. 2021 Apr 23;106(5):e2151-e2161. doi: 10.1210/clinem/dgab028.


Context: Altered satiety hormones in women with polycystic ovarian syndrome (PCOS) may contribute to obesity. Diets with a low glycemic load (GL) may influence appetite-regulating hormones including glucagon and ghrelin.

Objective: To test the hypothesis that following a 4-week, eucaloric low vs high GL diet habituation, a low vs high GL meal will increase glucagon and decrease ghrelin to reflect greater satiety and improve self-reported fullness.

Methods: Secondary analysis of a randomized crossover trial.

Participants: Thirty women diagnosed with PCOS.

Intervention: Participants were provided low (41:19:40% energy from carbohydrate:protein:fat) and high (55:18:27) GL diets for 8 weeks each. At each diet midpoint, a solid meal test was administered to examine postprandial ghrelin, glucagon, glucose, insulin, and self-reported appetite scores.

Results: After 4 weeks, fasting glucagon was greater with the low vs high GL diet (P = .035), and higher fasting glucagon was associated with lesser feelings of hunger (P = .009). Significant diet effects indicate 4-hour glucagon was higher (P < .001) and ghrelin was lower (P = .009) after the low vs high GL meal. A trending time × diet interaction (P = .077) indicates feelings of fullness were greater in the early postprandial phase after the high GL meal, but no differences were observed the late postprandial phase.

Conclusion: These findings suggest after low GL diet habituation, a low GL meal reduces ghrelin and increases glucagon in women with PCOS. Further research is needed to determine the influence of diet composition on ad libitum intake in women with PCOS.

Trial registration: NCT01028989.

Keywords: appetite; ghrelin; glucagon; glycemic load; hunger; satiety.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cross-Over Studies
  • Diet*
  • Energy Intake*
  • Female
  • Follow-Up Studies
  • Ghrelin / blood*
  • Glucagon / blood*
  • Glycemic Load*
  • Humans
  • Hunger
  • Male
  • Middle Aged
  • Polycystic Ovary Syndrome / blood
  • Polycystic Ovary Syndrome / physiopathology*
  • Prognosis
  • Satiety Response / physiology*
  • Young Adult


  • Ghrelin
  • Glucagon

Associated data